Understanding how our brains function has always been a fascination for me. It has become even more so as chemotherapy drugs circulate in my bloodstream, contributing to a temporary cognitive condition called chemo brain fog.

I am intrigued by how this “mastermind organ” that runs my body is affected while I’m undergoing chemotherapy treatments. My mind migrates to other places these days as it deals with subtle shifts in behavior that have come about because of chemo.

Each day, I am learning to be gentle with myself during this altered brain state. I remind myself that I am dealing with cancer, mastectomy surgery, the cumulative effects of chemotherapy and other cancer related treatment drugs, illness stress, low blood cell counts, fatigue, and some memory loss that naturally comes with aging. It is feasible that these factors may have joined forces to affect my memory in contributing to the brain fog.

I have wondered if the brain fog I am experiencing has resulted from my brain selectively choosing to shut down some of the information trying to be absorbed in my mind. Maybe it is my brain’s way of helping me to get through the overwhelming experience of living with cancer.

Chemo brain fog is not an imagined problem, but a medical mystery. Cancer patients will tell you that the symptoms they experience in their reduced brain function are real. The changes can be so slight that only the patient or their family members may notice them. It is a disconcerting cancer side effect.

Chemo brain fog is gaining more interest amongst medical researchers around the world, as they grapple with unlocking its mystery to help cancer patients learn how to better manage this peculiar phenomenon. The good news is that chemo brain fog departs over time, after all treatments are finished and patients recuperate from the toll their bodies have taken to get well.

During my second last chemo treatment earlier this week, I learned that the two chemo concoctions being used to aggressively attack my cancer rank amongst the most potent chemo cocktails in use today to treat cancer patients. This cocktail also has some of the worst side effects cancer patients will encounter while in treatment.

Some brain fog research results are showing that patients who receive high dosage, aggressive chemotherapy treatments are at greater risk of developing cognitive problems than patients who are being treated with lower dosage chemo drugs. Breast cancer patients are part of the high dosage, aggressive chemo treatment population.

As the potent chemotherapy cocktail pulses in the bloodstream throughout my body, the broad-spectrum distribution of the drugs kills good healthy cells along with fast growing “bad” cancer cells. It makes me ask: how could chemotherapy not destroy some of the good cells in my grey matter? Alcohol consumption destroys brain cells, so it makes sense to me that the potency of chemo drugs could be more powerful than booze is when it comes to affecting the brain’s function.

Brain fog in cancer patients is so common that our local cancer treatment organization recently introduced an eight-week rehabilitation session for cancer survivors. The goal of the sessions is to assist cancer patients with learning how to regain their memory and other brain functions so that their minds can return to their pre-treatment state. I plan to enroll in the course after my treatment is finished.


Multi-Tasking Mayhem

When actors are on stage, they each have a role to play to reveal the complete story to the audience. This is similar to how the brain works—six separate parts of the brain interplay with each other to make the mind work in its entirety.

I definitely have noticed a change in brain function since chemo treatments started. I have trouble planning a sequence of movements that are needed to multi-task. I encounter difficulties with problem solving, focusing, and flexible thinking. At times, I find it hard to express myself in conversations. I had never imagined that this slight loss of brain function would be a downside of cancer therapy.

Prior to treatment, I took pride in my ability to perform complicated multi-task functions all day long at work and at home. These days, it is a struggle to finish a task before proceeding to the next one. Activities have to be limited to one at a time, so that I can complete all the sequential steps in the task without interruptions.

I now live in a world that is quite different than in the past. The outcome is not always predictable.

Here is an example of my altered brain function while in cancer treatment. A few weeks ago, I ran some shopping errands. I bought some items at the grocery store and some craft supplies elsewhere. I brought both bags into the house together.

The second purchase was smaller, so I thought I took it to the spare bedroom and put it in
a spot that my brain would easily remember in context with where the other craft supplies are housed. The craft bag never made it to its intended destination.

After turning the house upside down to find it, a few minutes later it was located away in a cupboard in the other bedroom with the purchased toiletries. I didn’t remember putting away the toiletries with the crafts. It was so illogical.

When cancer patients are going through chemo brain fog, medical caregivers will tell them that a helpful thing to do is to make lists to keep track of information and tasks. I have been a notorious list maker forever at home and at work, so this was easy for me to do.

On Tuesday morning, I made a list of the few errands we needed to run before being rendered housebound for the next two weeks following my chemo infusion in the afternoon. One part of my brain told me to put the list in a place where I would readily recall placing it. I thought that putting it either in my wallet, chemo treatment tote, or purse would be obvious choices.

The last thing I remember was tearing the list off the notepad. I thought I had put it in the usual list place in my purse. While on route, I checked my wallet, purse, chemo supply tote, and jacket pocket to fetch the list and strike off the errands. The list was never found. I have no idea what happened to it.

This was a simple task that had an unintended outcome. I know I am in a poor mental state when I am told to make a list, do so, and cannot remember where I put the list to help organize my thoughts.

It would be frightful to be working now with this lack of memory and the inability to focus. I could not function in my demanding job under these current conditions. Living in the world with chemo brain is certainly perplexing.


At a Loss With Words

I am a writer by training and trade. Words have been my biz for over 30 years.

With chemo brain fog, I am not always able to find the right word during a conversation. I am forced to stop and search for words needed to convey my thoughts. I find myself grasping for words mid-stream in chats, when in the past I would have quickly chosen words with fluidity. It is embarrassing and frustrating.

Because of this language difficulty, I want to be more reclusive. There is a pull to protect myself, and have guarded conversations only with people close to me who are patient and understand what I am going through. It is yet another distancing symptom to cope with, in addition to the low white cell counts and high infection risks that already keep me away from others.

Recently visiting with my mom and my son, I mentioned to them how eager I had once been to tackle a stack of books waiting to be read while I am on sick leave. I love to read, particularly if the house is quiet and I can concentrate without distractions.

Six months into my treatment, the stack of lovely books I have received as gifts still remains untouched. I am having trouble comprehending and absorbing the new thoughts these books present. I cannot process the words well, and struggle with linking them back to personal experiences that may relate to my life through the written words in front of me.

There is one particular author I have read for over 15 years whose prose I always enjoy. I like his writing because his words lift me up as he draws on stories from his life that relates to mine. When I have been well, I can blast through a book of his in a few hours because I cannot put it down. I am laboring to get through one of his recent books. At present, all I can do is read a few pages occasionally and hope I will absorb some of what he has said.

I started to read another book on cancer, which was loaned to me in early spring. It still sits waiting to be completed. I cannot comprehend the concepts the “doctor” author is raising in his well-written medically based book on his experiences as a cancer survivor.

Do not ask me to recall what either author has said in their work, I will not remember. My short-term memory loss blocks my ability to do so, and is magnified with the chemo induced brain fog.

I understand the difficulty with reading while in cancer treatment. What I do not understand is that I am able to continue writing. I can still put words to paper and create a blog, which is good mental therapy for me. What is puzzling though, is that this brain function can be impaired by chemo brain fog as it goes hand in hand with reading.

Perhaps I am able to keep writing because it is a learned behavior from years of rote and repetition. Perhaps I am able to keep writing because it is a craft that has been well honed over three decades, as it has formed the base for my communications career.


Other Brain Bumps

Our brains control all the regulation of our body temperature, digestion, and sleep. For a day or two after chemotherapy, my body cannot warm up. At times, I have to put on three to four layers of clothing just to stay warm to regulate my core body temperature. It takes several hours to warm up.

My digestion is severely impacted by chemo due to its effects on the fast growing cells in the lining of the stomach. There are times when my stomach aches as if I had been retching all night because of the chemo drugs in my body.

I have never been a great sleeper since my first pregnancy 27 years ago. Disrupted sleep became a part of life. As the kids grew up, my sleep patterns improved. But as life got more complicated, the sleep-deprived nights remained a reality. Those former sleep disruptions were nothing compared to the poor sleep patterns that have now formed with my cancer treatment.

My brain’s sleep command centre is trying to cope with new forms of insomnia concurrent with my cancer diagnosis and treatment. For me, a good night’s sleep now is three solid hours of uninterrupted slumber.

While on steroids for chemo, sleep disruption climbs to a whole new level. I wake up in the middle of the night hyper and wide-awake. Dry mouth complications with chemo are also causing fitful sleep, as nightly rest is interrupted to hydrate the lining of my mouth.

This chronic lack of sleep further contributes to my chemotherapy fatigue. Regrettably, my doctor has placed me on medication so that I can sleep more soundly to combat fatigue, and to aid in healing and recovery. I’ve never used sleeping pills and fear becoming addicted to them. They are helping; I only get up twice a night now instead of four to five times.


Bonus Time: Parts of My Brain Do Work

I have no problem getting into the car and traveling anywhere in the city without getting lost or forgetting where I was going. I can still navigate streets and make it home safely. My physical movements, balance, and coordination remain intact. It is comforting to know that with the brain dysfunction I am experiencing, there are still some fully functioning parts in my brain.

I am tackling the cognitive challenges of chemotherapy in the same way that I have tackled the physical changes taking place in my body since my cancer diagnosis. I continue my fight for life each day with Strength, Courage, and Determination.