In a recent article published by Cancer Network (Journal of Oncology digital platform) some of the causes of chemo brain were explored. The American Cancer Society describes chemo brain as a decrease in mental “sharpness” before, during, and after cancer treatment. Many things have been shown to contribute to chemo brain – including cancer itself, chemotherapy, medications used for nausea and pain, hormone treatments, and surgery. Even stress, fatigue, anxiety and depression, and sleep disturbance have been implicated in the cause of chemo brain.
There has also unfortunately been some small studies, including a twin study comparing twins “in which one sibling had cancer while the other did not. When compared with their cancer-free twins, cancer patients were shown to be more likely to experience cognitive dysfunction and dementia. Despite the lack of statistical significance in the odds ratio, there was a two-fold increase in dementia in the cancer survivor group vs the cancer-free twin group.”
There are no currently approved treatments for chemo brain, and the medications that have been proposed are the same as those used for ADHD and Alzheimer’s disease, which are called psychostimulants. In a study titled Psychostimulants for cancer-related cognitive impairment in adult cancer survivors: a systematic review and meta analysis that was published June 28, 2019 in the Journal Supportive Care in Cancer they concluded that of 6 studies reviewed, 3 showed cognitive improvement and none demonstrated increased quality of life. Fortunately when we review the factors that contribute to chemo brain there are many natural treatments that have shown great benefit in managing these conditions.
Exercise has been shown to improve sleep and cognition in patients, as well as mood and chemotherapy side effects. Mindfulness based stress reduction has also shown to improve mood and sleep. In addition to advice about these interventions there are many supplements and intravenous nutrients that impact the many causes of chemo brain.
Many patients are overwhelmed by the number of pills they need to take, especially when treatment related nausea is a factor, so the option of doing intravenous treatments is frequently requested. Some intravenous therapies that have shown improvements in cognition include repleting deficient vitamins and minerals as well as nutrients such as:
Carnitine – Badrasawi M, Shahar S, Zahara AM, Nor Fadilah R, Singh DK. Efficacy of L-carnitine supplementation on frailty status and its biomarkers, nutritional status, and physical and cognitive function among prefrail older adults: a double-blind, randomized, placebo-controlled clinical trial. Clin Interv Aging. 2016 Nov 17;11:1675 1686. eCollection 2016.
Resveratrol – Cao W, Dou Y, Li A. Resveratrol Boosts Cognitive Function by Targeting SIRT1. Neurochem Res. 2018 Sep;43(9):1705-1713. doi: 10.1007/s11064-018-2586-8. Epub 2018 Jun 25.
CoQ10 – Sandhir R, Sethi N, Aggarwal A, Khera A. Coenzyme Q10 treatment ameliorates cognitive deficits by modulating mitochondrial functions in surgically induced menopause. Neurochem Int. 2014 Jul;74:16-23. doi: 10.1016/j.neuint.2014.04.011. Epub 2014 Apr 26.
Alpha lipoic acid (ALA) – Zhang Y, Lv YL, Si YN, Zhou J, Qian Y, Bao HG. α-lipoic acid attenuates spatial learning and memory impairment induced by hepatectomy. Exp Ther Med. 2019 Mar;17(3):2329-2333. doi: 10.3892/etm.2019.7202. Epub 2019 Jan 25.
To discuss your options and reduce the likelihood of treatment related cognitive decline, or chemo brain, sit down with a naturopathic physician focusing in cancer care to create your personalized protocol.