Cancer side effect isn't easy to understand

'Chemobrain' adds frustration for cancer patients.
KNIGHT RIDDER NEWSPAPERS
ORLANDO, Fla. -- Perhaps three times a week Dr. Nikita Shah hears one of her breast cancer patients who has undergone chemotherapy complain about a hazy fog that has rolled in.
Most chemo patients are prepared for nausea, fatigue, nerve damage, hair loss and infections. However, many are caught off-guard when they are unable to concentrate, when their brain seems enveloped in a cloud, when they struggle to find the right word in conversations.
"There are people who are able to do three-digit multiplication in their minds and aren't able to do that and others who have difficulty with day-to-day details," says Shah, an oncologist at M.D. Anderson Cancer Center Orlando.
Doctors call the condition cognitive impairment, but cancer patients know it by the informal name they've given it: "chemobrain." Recent dueling research casts doubt about where the blame lies for the symptoms: Chemobrain may be collateral damage of the treatment or a physiological response to the cancer, as some patients show signs of impairment before chemotherapy. Still, studies suggest that up to 30 percent of chemo patients suffer impaired thinking.
Despite those numbers, some say there's little regard for chemobrain both as a recognized long-term cancer side effect and as a syndrome that demands treatment.
"Most people had to figure out [chemobrain] on their own," says Ellen Coleman, associate executive director of CancerCare, a national nonprofit patient advocacy group. Eventually, survivors reckoned "that this was a real thing happening, that they weren't going crazy."
Embracing it
Indeed, as recently as 10 years ago, chemobrain "was looked at as more a pejorative term," says Dr. George Bobustuc, a neuro-oncologist with M.D. Anderson Cancer Center Orlando. "Things have changed, and we've kind of adopted the term. It's a term with a lot of meaning."
What it often means is frustration for those burdened with it. Loved ones' perspectives often are: You're "looking good, feeling good, but why did you forget your keys?" Coleman says, referring to a study her group did on chemobrain. "Because it's an invisible symptom, friends and family [have] a lot less patience."
Chemobrain sometimes fades within a year, but it can also linger for years after treatment. A doctor might refer a patient to a neuropsychologist for evaluation. If chemobrain is confirmed, doctors might address the symptoms with drugs such as Ritalin. For some patients, Bobustuc says, the drugs have done "wonders" but are no silver bullet.