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Clearing the confusion about brain fog

There is some confusion over the causes of brain fog in cancer patients, but one thing is clear: this condition can be devastating.

Cancer Answers“It’s life altering. It can severely affect a person’s quality of life,” says Dr. Heather Palmer (PhD), Founder and Director of Cognitive Rehabilitation at Maximum Capacity: Strategies for Cognitive Enhancement, a centre headquartered in Bradford, Ont. Centre staff help individuals maximize their cognitive capacity in a fun, friendly, and interactive way.

The symptoms of brain fog can be numerous and varied. They may include changes in memory, multi-tasking, difficulties with verbal skills, compromised attention and concentration, and less coordinated motor function. “Those affected describe a lack of clarity and sharpness, which has a number of consequences. For example, they can’t find the right word or they tend to zone out during conversations, movies, etc.,” says Dr. Palmer, who recently gave a presentation on brain fog as part of CCNS’s Cancer Answers lecture series.

Often brain fog occurs on the road to recovery, she notes. “People discover they don’t have the thinking capacity they once had and start to worry that the cancer has spread to their brain or that they’re losing their mind.”

It is not yet known what causes brain fog. It may be linked to genetics, cancer-related treatments, or even the cancer itself. “The auto-immmune systems response ot the cancer may be one culprit,” says Dr. Palmer. “The body is naturally trying to fight this, causing all kinds of physiological changes.”

Many people also call the condition “chemo-fog” because of its potential association with this form of cancer treatment. But chemotherapy is not the sole cause of brain fog, says Dr. Palmer. “We know there are more causes because people who have never had chemotherapy or haven’t started chemo can have brain fog too.”

Treatment involves cognitive rehabilitation – techniques to help people cope and adjust. While the strategies used will vary from person to person, they include assistance with memory skills, task management, and psychological well-being.

“To help improve memory, the goal is to teach individuals how to encode information in deeper and more meaningful ways,” says Dr. Palmer. This might include using such internal strategies as story making, visual imagery, and putting information into categories.

For task management, techniques such as reducing feelings of being overwhelmed, promoting being focused on the present situation, and reducing susceptibility to distractions and interference can be helpful.

Psychological well-being – how a person feels about themself – is an important part of addressing brain fog. “It is helpful to be positive and proactive, to set goals and stick to them,” says Dr. Palmer.

“Typically people will get better over time,” she adds. “Most people can get back to normal levels within two years. Others may take longer.”

It is important for health professionals to accept the reality of brain fog, stresses Dr. Palmer. “Recognize the condition exists and validate the concerns people have. Brain fog is still not widely recognized as a condition, although imaging data support the notion that brain-related changes do occur.”

As we learn more about brain fog, better tests will be developed to identify individual changes. Until then, says Dr. Palmer, “we have to take the person’s word. We need to help them. It’s like pain. We don’t have any true measure of pain, but we know it’s there – and it hurts.”

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