What Causes Cognitive Changes?

3 out of 4 people with cancer struggle with chemo brain. Also known as cognitive impairment, it is mostly commonly connected with chemotherapy, but other treatments, such as hormone therapy, radiation, and surgery may be associated with it also.

These treatments can cause short-term, long-term, or delayed mental changes or cognitive problems. This may lead to finding it hard to be able to remember certain things, trouble finishing tasks, concentrating, or learning new skills. 

Signs & Symptoms

  • Memory loss 
  • Difficulty thinking of the right word for a particular object
  • Difficulty following the flow of a conversation
  • Trouble concentrating or focusing on one thing
  • Difficulty doing more than one thing at a time 
  • More difficulty doing things you used to do easily
  • Fatigue
  • Confusion
  • Mental fogginess

Historically, cancer patients with these symptoms were often diagnosed with depression. Research over the past decade has revealed that many cancer patients may experience cognitive changes as a consequence of damage to the brain caused by either their tumour or their treatment. While radiation to the brain has long been linked to causing cognitive difficulties, the effects of chemotherapy on brain structure and function have only recently been discovered. 

For most people, these mental changes only last a short time. Others can have long-term or delayed mental changes. When it starts, how long it lasts, and how much trouble it causes may be different for every patient. Usually the changes you may notice are subtle, and others around them might not even notice any changes at all.

Symptoms of chemo brain can fade after treatment ends, but each patient is different. Some may take a year or more after treatment to feel normal again. Even though its exact cause isn’t known, it is believed certain things can increase the risk of developing chemo brain or worsening brain function problems. 

What Can Increase Chemo Brain

  • The diagnosis of cancer and all the stress and emotion that this brings
  • The cancer itself
  • Cancer treatment 
  • Very intensive treatment such as high dose chemotherapy followed by a stem cell transplant
  • Side effects of treatment such as fatigue, low levels of red blood cells in the blood (anaemia), sleep disturbances or hormonal changes
  • Low mood, stress and anxiety
  • Nutritional deficiencies
  • Infections
  • Surgery and the drugs used during surgery 
  • Other conditions or illnesses, such as diabetes 

You may be at more risk of developing chemo brain through these factors 

  • Older age
  • High - dose treatment 
  • Chemotherapy agent combinations
  • Additional treatments, such as hormone therapy or radiation
  • Other medical conditions 
  • Treatment to the brain, such as chemotherapy into the fluid around the spinal cord (intrathecal chemotherapy) or radiotherapy to the brain
  • A genetic variation that might make some people more likely to develop chemo brain.

So far, there is no known way to prevent the cognitive changes that cause chemo brain. This is because the causes are still being studied. But that doesn't mean you can't do anything! 

Reducing anxiety and stress may decrease cognitive changes and eating particular foods. For more help read - How to Reduce Cognitive Changes or Nutrition Tips for Cognitive Changes