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About Lymphoma

Chemo brain & Brain Fog

About 7 out of every 10 people with cancer experience Cancer Related Cognitive Impairment (CRCI). We more commonly call this  ‘Chemo Brain’ or ‘Brain fog’, and it can affect your memory and thought patterns. Despite calling it “chemo brain”, it can affect anyone with cancer, even if you don’t have chemotherapy.

On this page:
"OMG sometimes I thought I was going mad until I realised brain fog or chemo brain comes with the cancer. If I use lists or a diary this has helped with my memory for some things"
Ken

What is cognition?

To understand cognitive changes, you first need to understand what cognition is.

Cognition is the everyday functioning of our brains and involves our: 

  • perception – how we hear, see, become aware of, and understand things.
  • attention – being able to focus.
  • language – speaking and understanding spoken and written words.
  • memory – short and long-term memory.
  • reasoning – thinking about things logically. How we work things out.
  • judgement – our ability to make considered and sensible decisions.
  • problem solving – our ability to find and act on solutions to problems.

What causes Cancer Related Cognitive Impairment?

Cancer related cognitive impairment (CRCI) is often called chemo brain or brain fog. However, despite often being called, ‘Chemo Brain’, CRCI isn’t solely caused by chemotherapy! In fact, people with cancer who haven’t even had chemo can get CRCI.

The exact cause of cancer related cognitive impairment is unknown. It’s likely there are many contributing factors including:

  • the lymphoma itself (particularly if it is in or spreads to your brain)
  • chemicals released by the lymphoma and immune cells
  • treatment including surgery, radiotherapy, immunotherapy, and chemotherapy
  • supportive medications including steroids, pain medications and antivirals
  • side effects of treatment such as infections, fatigue, low blood counts, disrupted sleep patterns, hormonal changes and malnutrition
  • pain and inflammation
  • stress, anxiety and/or depression.

What are the symptoms of Cancer Related Cognitive Impairment (CRCI)?

CRCI will affect people differently. You may have subtle symptoms that are more of a nuisance, or symptoms can be severe enough to cause you worry and affect your ability to function normally. For most people, CRCI will improve over time, but some may have lasting effects.

Some symptoms you may notice include:

You may:

  • be more disorganised than usual
  • get confused easily
  • have difficulty concentrating
  • be more forgetful
  • have problems with making decisions
  • have difficulty finding the right words, or understanding what others are saying
  • forget names
  • having difficulty following directions
  • have difficulty learning new skills
  • struggle with multitasking more than usual
  • feel like your mind or thinking is foggy or slow
  • have a short attention span.

What are some management strategies?

There are many strategies that can help improve symptoms of CRCI depending on what difficulties you are having. 

Involving others 

This is important! You should not have to do this alone. You may have friends or families who can help, or it may be a health professional. Involving others may include:

  • Support person. You can bring a support person along to your appointments. This is usually a trusted family member, friend or carer. They can help remember key information or ask questions for you. You can also ask them to take notes for you.
  • Counsellor or psychologist. Counselling and psychology can help you understand the changes that are happening, and how to cope emotionally with these changes and develop new behaviours or strategies to manage the changes and decrease the impact they ha on your life,
  • Occupational Therapist (OT). An OT is a health professional who can assess your CRCI and help you plan a way to manage it.

Use checklists

Checklists, notes, alarms on your phone or keeping a diary can help remind you of: 

  • what you need to do
  • appointments, blood tests or scans
  • birthdays 
  • important information
  • instructions
  • other special information.

Healthy lifestyle

A healthy lifestyle is important for everyone! Exercise has many benefits including increasing blood flow and oxygen to your brain. This can help improve symptoms of CRCI. 

Your body also needs energy to fuel your body, so eating a healthy diet and getting decent sleep is important. You can find more information on these by clicking the links below.

Fatigue and sleep issues.

Diet, nutrition and lymphoma – YouTube video

 

Memory and Stimulation

Stimulating your brain can improve symptoms of CRCI.

Creative activities such as art, jigsaw puzzles or crosswords, learning a new skill or language can all help keep your brain active, and improve symptoms of CRCI.

You can also ask your doctor or nurses about more formal brain training through cognitive rehabilitation.

Involving others is important!

Ask a trusted friend or family member to go to important appointments or meetings with you. They can help with taking notes, and ask questions for you.

Health professionals and support people that can help.

If you are concerned about your CRCI and feel you need extra help, there are people who are trained to help you. Below we list some health professionals who can help with improving the symptoms of CRCI and what they do.

Occupational Therapist

Occupational therapists can help if you are having trouble with your every day tasks because of you cognitive impairment (brain fog). They can do an assessment, and help you come up with strategies that may help lessen the impact it has on your life.

Psychologist

A psychologist can help you learn how to accept and cope with the challenges that come with changes to your cognition. They may also be able to give exercise or strategies to improve your cognition.

Neuropsychologist

A neuropsychologist can help assess the impact of your cognitive changes and how these affect your behaviour. They can help you learn strategies to lessen the impact of the cognitive changes on your life.

Other things you can try

There are several things you and your friends/family/mob can do to help you manage your cancer related cognitive impairment. 

Firstly, go easy on yourself. Don’t expect too much. Your mind and body are going through a lot, and with your diagnosis and treatment, you are learning more than you probably realise!

Allow time for healing and know that CRCI can improve with time.

Aim to conserve your energy and improve your sleep or rest patterns. You can find more information by clicking here. 

Exercise your body and your brain. Going for a walk each day in the fresh air is a good start. Also try puzzles, word games or quizzes.

Learn a new skill that makes you think. This could be trying a new language, a craft, painting or writing. What else interests you? Give it a try (so long as it doesn’t put you at risk. If you’re not sure ask your doctor or nurse).

Have conversations in quiet places without distractions. Turn off the tv, put the phone down or stop doing what you are doing to have the conversation so you can focus only on the conversation.

Write things down in a diary or journal. Use post it notes or set reminders or alarms on your phone – Make sure you write what the reminder or alarm is for!

Get used to saying no. It is healthy to say no sometimes. 

Let family and friends know what CRCI is ang share this page with them so they can understand and support you.

Tell people what you need from them. People often want to help but don’t know how. Help them by letting them know what you need.

Take time each day to rest and clear your mind. Meditation or visualisation apps, or CDs can help with this.

If you have anxiety, depression, or stress, talk to your doctor. Managing these will help improve your CRCI.

Life coach

You may even like to try talking to a life coach. Life coaches cannot help with psycholgy or counselling. But they can help you to set realistic goals and making a plan to achieve them.

Below are some videos from a life coach. If you would like to refer yourself to see her, click the link below.

Summary

  • Cancer related cognitive impairment (CRCI) is common, affecting about 7 out of every 10 people with cancer.
  • Chemo brain or brain fog are other names for CRCI.
  • Cognitive function is how you think, plan, and act on information as well as how you communicate and understand information. It is these things that are affected by CRCI.
  • CRCI can affect people differently and usually improves with time.
  • Exercising your mind and body can help improve the symptoms of CRCI.
  • Occupational therapists, psychologists, neuropsychologists and life coaches can all help you manage your CRCI.
  • Family and friends can also help you manage CRCI – share this page with them.
  • Go easy on yourself – you have a lot going on and you are probably learning more than you realise.
  • Reach out to our Lymphoma Care Nurses if you need support. You can contact them by clicking on the Contact us button at the bottom of this screen. 

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