Should Chemotherapy Patients With Chemo Brain Be Prescribed More Drugs?
It’s a scene fitting for a science fiction movie: across the world thousands of women, men, and children recline in specially designed chairs as they watch lab-attired attendants roll their heavily monitored and controlled, individualized chemical “cocktails” in infusion bags and connect them to an IV or catheter implanted in the patient’s body.In a few moments the toxins begin dripping down the bag, into tubes, and into the veins of the willing patients. Some are frightened, especially if it’s their first infusion. Others make conversation and might tell a few jokes. Most are passive, quiet recipients of noxious liquids they know little about. Paradoxically, the poisons are intended to sustain life. There’s a price to pay, and it’s not just the staggering medical bill: it’s an unknown price called side effects, many of which damage the central nervous system, including the brain.I experienced just the scenario depicted above, as a breast cancer patient. Only in sober retrospect, years later, does the sci-fi analogy occur to me. Six years ago I was fearful and through that fear had to find a way to blindly trust my oncologist and the infusion room nurses. I was worried about nausea and fatigue, completely unprepared for the side effect now called chemo brain. I am still living with the damage.Chemo brain, or chemotherapy induced cognitive impairment, results from the destruction of healthy brain cells in the same way that hair cells are often destroyed. If you have ever experienced memory loss, mental fog, mental fatigue, or confusion, then you may have had a taste of what chemo brain feels like. The episode was devastating for me, since my mind has always been central to my sense of self and to my livelihood. Fortunately, I have largely recovered, and in the course of doing so, became a pioneer in “neuro-nutrition” and brain recovery.The experience of mental problems related to cancer treatment is just now being discussed regularly in medical circles. Often, doctors are so concerned about saving or extending the patient’s life, they minimize major quality of life issues, such as chemo brain. They frequently prescribe antidepressant medications to patients, and these can actually increase mental fog or disrupt sleep, which, in turn, worsens symptoms.The “medical-lite” literature today tells chemotherapy patients not to be concerned because, presumably or according to some narrow research, the symptoms go away within two years. More recent research, however, that extends beyond the patient complaint, indicates that some damage is permanent. And two years is a long time to wait, particularly when strategies are available to minimize damage and to speed up recovery.Patients who continue to work during treatment become fearful of losing their jobs or not receiving promotions, and may be afraid to admit-even to themselves-that they are experiencing this life-altering side effect. Help is needed to minimize long-term damage and to accelerate recovery. Currently, the best conventional medicine has to offer is stimulant medications typically prescribed for attention disorders.Frankly, I’m very concerned about introducing more chemical agents into the brain.Chemotherapy drugs already interfere with the cell cycle or the cell’s DNA, and the disruption caused additional interference with the brain’s normal functions could have severe, unintended, negative consequences. Everyone’s biochemistry is different, and chemotherapy alters it. When the number of drugs in a person’s body increases, so do the potential interactions of those drugs. Doctors have a difficult time understanding more than 2-drug interactions. When that number increases, so does the potential for problems.As a provider of assessment and neurofeedback services, I have observed first-hand the effects of a variety of medications and conditions on the functioning of the brain. Antidepressants, for example, generally increase the alpha wave (8-11 Hz) activity in the frontal lobes, which can increase the symptoms reported as “mental fog.” I am not suggesting that severely depressed patients forego these medications; rather, I believe that oncologists freely dispense antidepressants to patients who express mild to moderate symptoms that can be attributed to the diagnosis alone.As a Stage III breast cancer and chemotherapy survivor, I experienced acutely the desire to return to my “normal” self– my daily routines, my intellectually demanding work, and running, golfing, and generally enjoying a high activity level. I did try antidepressants to help me cope with the overwhelming change in my life, but found that it took me even further away from the self I was comfortable with and wanted to return to being.Nutritional supplements proved to be better performing alternatives. I’ll be publishing a series of articles to help chemo brain sufferers and cancer survivors address their recovery needs. Readers are permitted to email me with questions at [email protected].