Chemo Brain & 18 Long-Term Chemo Side Effects You Never Hear About

The first chemotherapy (chemo) agents appeared in the first world wars and were used as mustard gases to kill soldiers. (1) Since then, cancer patients from all over the world have opted to use chemo as part of their cancer treatment plan.

Cancer cells grow faster than healthy cells. Chemo destroys these fast-growing cells and helps to keep them from becoming back. Chemo drugs can’t tell the difference, and they also kill healthy cells, causing many different side effects during treatment. (4,5)

Different treatments can cause many kinds of side effects that can happen during chemo or immediately after, such as:

• Fatigue
• Pain
• Headaches
• Mouth sores
• Metal taste in your mouth
• Nausea
• Vomiting
• Diarrhea
• Constipation
• Flatulence
• Anemia
• Leukopenia (raising the risk of infection)
• Dizziness
• Neuropathy
• Vertigo
• Cognition issues aka “Chemo Brain”
• Sexual dysfunction
• Fertility issues
• Weight gain
• Weight loss
• Hair loss.

For me, some of the worst side effects I experienced during chemo treatment were hair loss, neuropathy, vertigo, and bone pain.

The Long-Term Side Effects of Chemo

A study published in Breast Cancer Research found that chemotherapy “causes long-term immune system damage, reducing levels of key immune cells in breast cancer patients for at least nine months after treatment, leaving them vulnerable to potentially life-threatening viral and bacterial infections.” (2)

The Canadian Cancer Society provides an extensive list of late and long-term side effects of cancer treatment (3):

• Fatigue
• Pain
• Learning and memory problems
• Nervous system changes
• Lymphedema
• Osteoporosis
• Mouth and teeth problems
• Vision changes
• Weight changes
• Decreased thyroid function
• Menopausal symptoms
• Fertility problems
• Digestive problems
• Bladder problems
• Bowel problems
• Heart problems
• Lung problems
• Second cancers.

One of the most frustrating long-term side effects, especially for adolescents and young adults is Chemo Brain. According to the American Society of Clinical Oncology (ASCO), up to 75% of cancer patients have these cognition issues during chemo treatment, and 35% continue long after treatment has ended. (6)   

According to Dr. Heather Paulson, ND, FABNO, “there are several reasons why doctors think Chemo Brain happens, and even more causes of Chemo Brain are being discovered. The main contributors at this time are inflammation, oxidative stress, and damage to brain cells.”

Chemo Brain can include:

1. Fogginess
2. Memory lapses
3. Forgetting things
4. Trouble focusing and concentrating
5. Short attention span
6. Trouble remembering common details
7. Difficulty multi-tasking
8. Taking longer to finish everyday tasks
9. Disorganization
10. Slower processing
11. Losing words and train of thought
12. Trouble learning new tasks
13. Difficulty retaining new information.

I was the kid who sat in the front of the class with my hand always up ready to share the correct answer. I have always prided myself on being smart and having a great memory. I could multi-task and juggle and never miss a beat. I climbed the corporate ladder into high-level positions of authority. Everyone counted on me, and I never let them down.

Then cancer and chemotherapy happened. And menopause. And Hashimoto’s. I felt like my mind was in outer space with the brain fog. I had zero focus and concentration. I could barely remember something from the time I thought of it until I could get a pen and paper to write it down. There were days that a simple 15-minute task would take me over two hours to complete. I felt like I had literally lost my mind. My brain was broken.

Chemo Brain: A Particular Concern for Adolescents and Young Adults

While the side effects of cancer treatment are traumatic for anyone, they pose particular challenges for adolescents/teens and young adults (TYA). For TYA ages 15-24, cancer is the leading cause of death. (9) Three of the most prevalent challenges for TYA who have received chemo are decreased neurocognitive function, fatigue, and social issues.

Decreased Neurocognitive Function

From school to climbing the corporate ladder, TYAs are in the prime cognition years of their lives. A new study shows that chemotherapy is toxic to the central nervous system, causing severe neurotoxicity, cognitive decline, and neurological problems. (10) Another “study of more than 2500 cancer patients aged 11-21 identified deficiencies in emotional regulation, memory and task efficiency.” (9)

Fatigue

Cancer-related fatigue is defined as a “distressing, persistent, subjective sense of physical, emotional, and/or cognitive tiredness or exhaustion related to cancer or cancer treatment that is not proportional to recent activity and interferes with usual functioning.” Cancer-related fatigue can be especially problematic in TYA, especially during the years this population should have the most amount of energy during their lives. (9)

Social Issues

TYAs are in a unique place socially. They are going through puberty, dating, going to high school and college, and getting married. One study of TYA cancer survivors found that half of the cohort studied reported cognition difficulties with work and school. In fact, over 60% experienced a negative impact on their financial situation. (9)

While I was much older when I was diagnosed (39 years-old), I was newly engaged and at the top of my career. I was trying to be a sexy fiancé while sick, bald, full of flatulence, and smelling like chemo-funk. Even with great insurance, cancer treatment cost $20,000 out of pocket. I lost income from being out of work and then decided to take a step-down from my high-stress management position to be able to focus on my health and new family. In the last eight years, cancer and the subsequent health issues cost us over $300,000 in medical bills and lost wages. Fortunately, we made it through. I can’t even imagine how devastating this could be for a TYA.

Further latent learning and cognitive impairments can include: (10)

• Lower IQ score
• Lower academic achievement test scores
• Problems with memory and attention
• Poor hand-eye coordination
• Behavior problems.

Certified Nutritionist, Cancer Survivor and Cancer Mentor, Kirstin Nussgruber CNC EMB offers three steps which she uses to help her clients cope with the effects of chemo brain:

1. Lower your mental productivity expectations and educate your school or work place about the existing research around the acceptable condition known as chemo brain. Trying to deal with this condition in private only adds to unnecessary stress you do not need right now.
2. Eat a variety of colorful fresh and organic vegetables and fruits, healthy fats such as extra-virgin olive oil, avocado, nuts and seeds, as well as all the colorful herbs and spices such as cilantro, parsley, chives, turmeric, cloves, cardamom and many more as this reduces the oxidative stress your body is under while going through treatment. A daily smoothie is a great way of getting this done.
3. Allow time to rest, sleep but balance this with regular exercise to the best of your ability to optimize your body’s ability to recuperate and keep energy levels up to support your mental alertness.

How to Help Recover from Chemo and Combat Chemo Brain

While it may feel like dealing with Chemo Brain is helpless, there are some things you can do that may help to alleviate some of these symptoms. This includes:

• Exercise
• Rest
• Weight management and nutrition
• Supplements
• Reduce Stress
• Reduce/Eliminate tobacco use
• Reduce/Eliminate alcohol.

Exercise

It’s common knowledge that exercise is good for you, and lowers your risk of certain diseases, including cancer. Specifically, exercise may help to: (14)

• Lower hormone levels, and the subsequent growth factors that have been associated with cancer development
• Prevent weight gain and obesity
• Reduce inflammation
• Improve immune system function
• Improve overall quality of life including self-esteem, stress, and anxiety
• Prevent cancer recurrence.

Many studies provide evidence that physical activity is linked to lowering your risk of several cancers. A recent study from the American Cancer Society and the National Cancer Institute of over one million participants “links exercise with a lower risk of 13 specific types of cancer.” (14)

Cancer survivors who exercise may experience: (12)

• Increased strength and endurance
• Fewer signs and symptoms of depression
• Less anxiety
• Reduced fatigue
• Improved mood
• Higher self-esteem
• Less pain
• Improved sleep
• Lower risk of cancer recurring.

Rest

According to the Mayo Clinic, “getting enough sleep is an important part of your recovery. Sleeping gives your mind and body time to rejuvenate and refresh to help you function at your best while you’re awake. Getting good sleep can boost cognitive skills, improve hormone function and lower blood pressure. It can also just make you feel better in general.” (12)

Various ways to optimize your sleep include:

• Avoid caffeine after noon
• Go to bed at the same time every night
• Minimize blue light (TV, computer, smartphone) before bedtime
• Keep your bedroom dark
• Minimize alcohol before bedtime.

Weight Management

The Gerson Diet became popular for eating and drinking 13 servings of vegetables a day. While that is virtually impossible for the average person, the research is clear that a diet high in fruits and vegetables is one of the key factors in cancer prevention. (14)

One study found that vegetarians have about half the risk of cancer as traditional meat eaters. Plant-based diets have been known to reduce the occurrence of breast, skin, lung, stomach, liver, pancreatic, and colorectal cancers. (14)

Aim for nine servings of fruit and vegetables to your diet. A plant-based diet provides fiber, bioflavonoids (from berries), phytochemicals, antioxidants, and other enzymes that fight cancer cell growth. (14)

Supplements

Nootropic supplements affect the brain’s neurotransmitters, boost brain chemicals, balance hormones, and aid in the growth and regrowth of neurons, but they are not a miracle pill. (15) These types of supplements may help to: (16)

• Banish brain fog
• Sharpen memory
• Heighten attention
• Increase focus
• Boost energy
• Provide mental clarity
• Speed up mental processing.

One of the top brain-boosting supplements is Alpha & Omega. According to Evan DeMarco, CMO of Omax Health, “Cancer and its treatments represent a daily battle, both physically and mentally. That battle can take its toll on the brain leading to what many call Chemo Brain. The ingredients in Alpha & Omega have been used to treat cognitive decline for decades and can help those suffering from chemo brain replenish vital brain nutrients lost in that daily battle.”

Reduce Stress

The British journal Psychology and Psychotherapy published a 10-year-long study in which “emotional stress was more predictive of death from cancer or cardiovascular disease than from smoking.” (14)

We, as a society, are stressed out to the max. Stress is both psychological and physical. Chronic stress increases cortisol and decreases immune function. Both of these are linked to cancer formulation. (14)

When a thought triggers an emotion, neuropeptides transmit those feelings and connect with cellular receptors. According to Candace Pert, one of the pioneers of PNI, “the chemicals that are running our body and our brain are the same chemicals that are involved in emotion.” (14)

There are many methods to help alleviate stress:

• Pray and/or meditate
• Deep breathing exercises
• Keep a gratitude journal
• Forgive yourself and others
• Emotional Frequency Technique (EFT) tapping
• Tai Chi
• Massage
• Exercise
• Walking
• Yoga.

Reduce/Eliminate Tobacco Use

We all know that smoking not only causes cancer but other health conditions and diseases. Yet, there are still plenty of individuals who still light up. It’s not too late and stopping now can possibly reduce your risk of developing cancer and cancer recurrence.  (12)

Reduce/Eliminate Alcohol

While drinking certain alcohols in moderation may reduce your risk of heart disease, drinking alcohol may also increase your risk of certain cancers. (12) According to the American Society of Clinical Oncology (ASCO), “between 5-6% of new cancers and cancer deaths globally are attributed to alcohol. Alcohol use – whether light, moderate, or heavy – is linked with increasing risk of several cancers.” (14)

Exercise Your Brain

Chemo Brain is not going to disappear overnight, but with a few brain hacks, your condition may improve. Neuroplasticity is the malleability of neural circuits, otherwise known as reorganizing of your brain. By engaging the brain, introducing new stimuli, and keeping it alert, you can help to rebuild those connections once lost.  (13)

Just like everything in life, there are going to be apps that jive with your vibe, and apps that don’t. Don’t force yourself to conform to an app that doesn’t fit with your mojo. Check out a few and see what works best for you. These two apps MAY actually help to build neuroplasticity in the brain. (13)

Memory Match

Do you remember the original Memory game? The one you played as a kid with the cards you turn over to find the match? The Memory Match app is designed for the preschool crowd. Don’t laugh. Don’t judge. This app is one of my favorite games. It’s so simple. And it has the nostalgic value of the old school game. I use the free version and the animals are my favorites. (13)

Luminosity

The Luminosity app is a “comprehensive brain training program with 30+ brain games.” Used by “over 85 million people worldwide,” it has daily workouts to challenge 5 core cognitive abilities. I like Luminosity. But you actually really have to think! Which… I guess that’s the point, right? (13)

Cancer is a rough train to be on, and the long-term effects can be devastating. Chemo Brain is one of the most frustrating side effects to manage and often gets pushed down on the list when more critical health conditions are pressing. By implementing some of the suggestions offered in this article, you might very well be on the road to recovery.