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Life After Cancer A Roadmap for Cancer Survivors

Mental (Cognitive) Changes in Survivors
Patricia Fobair, LCSW, MPH

Changes in thought processes are not uncommon due to cancer, its treatment, and/or complications from treatment. Additional factors are the effects of aging, emotional problems, and drug usage. Changes in the way one's mind works can occur at any time from diagnosis to treatment to post-treatment, and can be progressive or can resolve anywhere up to the end of life. This has been called chemo-brain.

Clinicians agree that there is little doubt that even subtle mental impairment can be a real complication of chemotherapy and brain radiotherapy. Mood changes are also associated with mind dysfunctions.

A recent study concluded that mental impairment from chemotherapy (chemo-brain) is usually a temporary complication. Survivors should know that mental impairment could happen so that it won't cause unexpected additional anxiety. Another recent study shows that the drug Modafinil may improve memory in breast cancer survivors suffering from chemotherapy related cognitive problems.

Thinking changes are often seen in children following brain irradiation and intrathecal (spinal canal) chemotherapy, and are a result of neurotoxicity. Hormone manipulations, chemotherapy, radiation and biologic response modifiers are also common causes of cognitive problems.

Factors such as fatigue, insomnia, and depression contribute to mental changes. If you are experiencing any of these symptoms, bring them to the attention of the medical team. Psychiatric evaluation may help to identify treatments that will improve or correct them if possible. Unfortunately, there otherwise is little to offer, for now, except support programs and reassurance.

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