Chemobrain

Chemobrain describes a cognitive impairment felt by cancer patients after chemotherapy . A concise German term for the clinical picture does not yet exist; the medical term post-chemotherapy cognitive impairment (PCCI) is rarely used in the German literature.

Symptoms

Symptoms that chemobrain patients struggle with include:

• Memory lapses
• Reduced retention, misplacing and losing wallets, keys, etc.
• Extremely reduced ability to do more than one task at a time
• Problems dealing with new situations and unforeseen stresses
• Poor concentration
• Disorganization
• Slowed thinking and decision-making

The symptoms, which sometimes last for a short time, but often last for years, affect the patients in their professional and above all in their private life, since their difficulties are often not understood after they have obviously overcome the underlying illness.

causes

Current research no longer suspects the direct physical effects of chemotherapy alone, but a mixture of several factors, including:

• Cytostatics reduce cell formation in the hippocampus . It is assumed that chemotherapy, which has a holistic effect on the body, also affects precisely those cells of the brain that are responsible for the deficits recognized.
• The cancer itself
• Bad blood work
• sleep disorders
• Hormonal changes
• Pain and side effects from pain medication
• The traumatic experience of diagnosing and treating the potentially fatal disease

The catalog of causes and possible interrelationships are therefore very similar to those of fatigue , another cancer-related disease.

According to the latest studies, the aspect of psychological stress in particular seems to be of particular importance for the development of chemobrain symptoms: the psychological processing of the drastic and threatening experience of the illness and its likewise stressful treatment may occupy the patient so much internally that they only have other tasks can cope even to a lesser extent.

A study carried out in 2008 revealed evidence of damage to glial cells by the cytostatic 5-fluorouracil.

Treatment approaches

A treatment specially tailored to chemobrain effects does not yet exist. The focus is on relieving aids such as brain training, making notes as a memory aid, fixed daily routines, avoiding stress and sufficient rest. In view of the growing number of cancer patients who are physically largely symptom-free in the long term or who can even be cured, doctors also recommend preparing both patients and their partners and relatives psycho-oncologically for possible problems caused by chemobrain effects. This is intended to make it easier for those affected and their closest relatives to regain a high quality of life despite the impairments and to keep new emotional burdens from the long-term effects as low as possible.

The involvement of partners and relatives is important because unexpected stressful situations can occur just as often in private life as in professional life and often have a higher emotional impact. In addition, the patient cannot comply with some of the changes in behavior that relieve him of the burden without understanding his social environment.

literature

• JS Wefel, AE Kayl, CA Meyers: Neuropsychological dysfunction associated with cancer and cancer therapies: a conceptual review of an emerging target. In: British Journal of Cancer . Volume 90, number 9, May 2004, pp. 1691-1696, doi : 10.1038 / sj.bjc.6601772 , PMID 15150608 , PMC 2410277 (free full text) (review).

Individual evidence

1. ^ American Cancer Society - Chemo Brain. Retrieved April 28, 2011 . 
2. ↑ New hippocampal cells through training. Retrieved October 16, 2012 . 
3. ↑ Chemobrain? The cognitive performance of breast cancer patients before and during neoadjuvant chemotherapy. (PDF; 2.2 MB) Retrieved May 1, 2011 . 
4. ↑ How 5-fluorouracil damages the brain  ( page no longer available , search in web archives )  Info: The link was automatically marked as defective. Please check the link according to the instructions and then remove this notice.  
5. ↑ Chemo-Brain - cognitive disorders after chemotherapy. (No longer available online.) Archived from the original on March 24, 2016 ; accessed on March 16, 2016 . Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.