Chemo Brain?

I was invited to participate in a study studying the effects of chemotherapy and estrogen levels on cognitive function of premenopausal women with breast cancer. The study will examine how my chemo treatment might affect things like my memory, concentration, mood, sleep quality, and fatigue. Some patients experience a negative change in these characteristics, the result of which is often slangily called "chemo brain." These can somtimes be traced to another, easily remedied side effect of the chemo drugs, like anemia. But other patients have continued to struggle with memory lapses and attention deficits for months after their chemo treatments end.

Several women in my online group have shared some of their most embarrassing chemo brain moments, like trying to cook dinner in the dishwasher, putting refrigerated groceries into the cupboards, using the wrong words (one cancer-patient nurse told a patient she was treating that he had hemorrhoids instead of a hemorrhage - big difference!), and so on. It's humorous when you absent-mindedly toss the chicken into the laundry hamper, but chemo brain can be dangerous, too, like when women blank on driving rules or turn on the wrong stove burner.

Doctors aren't quite sure exactly what causes chemo brain, so they don't currently have a way to help women deal with it. The study that I am participating in will forward the medical conversation around this issue, so that future steps can be taken to treat and/or minimize chemo's effects on various thought processes.

I had the baseline evaluation this morning to test my memory, attention, and movement skills, which was an enjoyable way to distract myself on this day-before-chemo. It was IQ-type games and puzzles stuff. There were even colored markers involved! One of the hardest exercises required me to reorganize a spoken series of letters and numbers into numbers first, then letters, each in order. For example, if the researcher said, "B-7-J-2," I would say, "2-7-B-J." The series went up to eight letter/number combinations, so it got tricky, though I was pretty proud of my memory for holding its own all the way to the end! A similar test asked me to repeat a list of twelve words; I got six tries to remember all twelve, with a prompt from the researcher at the end of each attempt for the words I missed. It took me three times to get them all. Let's see how many I can still remember: throw, lily, film, discrete, beef, street, helmet, snake, dug, pick, loft...one more. Not too bad! For another test I had to flip through a book of pictures and name them, tree, broom, pelican, trellis, and so on. I did fine, until "protractor." Geez, I haven't said that word since elementary school, probably! Then I had to look at and reproduce from memory some simple shape drawings, and then copy a more complicated geographic pattern, using the picture as a guide. (That's where the markers came in!)

The movement tests were fun, too. One was like a telegraph clicker that I had to press as many times as I could in, I think, 15 seconds. We timed my right hand and my left hand separately. Poor little lefty. He just can't click as fast as his twin. Another test used the "grooved peg board": a board that fits, instead of round pegs, ones with notches on them, like old skeleton keys. The holes are arranged in a grid, but the notches are turned in all different directions. Again, we timed my right hand and then my clumsy left hand, which dropped a few pegs early in the game, but recovered for a strong finish. There were some other tests, too, verbal and on paper and computer, and a long questionnaire - the whole thing took about two hours.

I'll go back two more times after the chemo is over to repeat all of the tests for comparison. They'll also be taking some blood to monitor my hormone levels, since part of the study is to determine how my premenopausal condition might factor into any cognitive changes. (They've already completed a similar study with post-menopausal women with breast cancer.) And I get paid, too: $300. Just enough to cover the spa day I vowed to treat myself to halfway through chemo. So, if anyone wants to join me for grooved peg board practice, let me know!