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Treatments and drugs
By Mayo Clinic staffIt's not clear what causes chemo brain, and no cure has been identified. In most cases, cancer-related memory problems are temporary, so treatment focuses on coping with symptoms until they eventually subside.
No standard treatment has been developed for cancer-related memory problems. Because symptoms and severity differ from person to person, your doctor can work with you to develop an individualized approach to coping.
Controlling other causes of memory problems
Cancer and cancer treatment can lead to other conditions, such as anemia, depression, sleep problems and early menopause, which can contribute to memory problems. Controlling these other factors may make it easier to cope with these symptoms.
Learning to adapt and cope with memory changes
A neuropsychologist, who specializes in diagnosing and treating conditions that affect memory and thinking, can create a plan to help you cope with chemo brain symptoms. Doctors sometimes refer to this as cognitive rehabilitation or cognitive remediation.
Learning to adapt and cope with memory changes may involve:
- Repetitive exercises to train your brain. Memory and thinking exercises may help your brain repair broken circuits that may contribute to chemo brain.
- Tracking and understanding what influences memory problems. Carefully tracking your memory problems may reveal ways to cope. For instance, if you become more easily distracted when you're hungry or tired, you could schedule difficult tasks that require extra concentration for the time of day when you feel your best.
- Learning coping strategies. You may learn new ways of doing everyday tasks to help you concentrate. For instance, you may learn to take notes or make an outline of written material as you read. Or a therapist may help you learn ways of speaking that help you commit conversations to memory and then retrieve those memories later.
- Stress-relief techniques. Stressful situations can make memory problems more likely. And having memory problems can be stressful. To end the cycle, you may learn relaxation techniques. These techniques, such as progressive muscle relaxation, may help you identify stress and help you cope.
Medications
No medications have been approved to treat chemo brain. But medications approved for other conditions may be available if you and your doctor agree they may offer some benefit.
Medications that are sometimes used in people with these symptoms include:
- Methylphenidate (Concerta, Ritalin, others), a drug approved for attention-deficit/hyperactivity disorder (ADHD)
- Donepezil (Aricept), a drug used in people with Alzheimer's disease
- Modafinil (Provigil), a drug used in people with certain sleep disorders
More study is needed to understand how or if these drugs may be helpful for people with these types of memory problems.
- Vardy J, et al. Cognitive function after chemotherapy in adults with solid tumors. Critical Reviews in Oncology/Hematology. 2007;63:183.
- Vardy J, et al. Evaluation of cognitive function associated with chemotherapy: A review of published studies and recommendations for future research. Journal of Clinical Oncology. 2007;25:2455.
- Definition of a neuropsychologist. National Academy of Neuropsychology. http://www.nanonline.org/NAN/Files/PAIC/PDFs/NANPositionDefNeuro.pdf. Accessed Aug. 27, 2010.
- Vardy J, et al. Cancer and cancer-therapy related cognitive dysfunction: An international perspective from the Venice cognitive workshop. Annals of Oncology. 2008;19:623.
- Taillibert S, et al. Chemobrain: Is systemic chemotherapy neurotoxic? Current Opinion in Oncology. 2007;19:623.
- Hurria A, et al. Renaming "chemobrain." Cancer Investigation. 2007;25:373.
- Improving your concentration: Three key steps. CancerCare. http://www.cancercare.org/pdf/fact_sheets/fs_chemobrain_concentration.pdf. Accessed Aug. 30, 2010.
- Combating chemobrain: Keeping your memory sharp. CancerCare. http://www.cancercare.org/pdf/fact_sheets/fs_chemobrain_memory.pdf. Accessed Aug. 30, 2010.
- Cognitive problems. Cancer.Net. http://www.cancer.net/patient/All+About+Cancer/Treating+Cancer/Managing+Side+Effects/Cognitive+Problems. Accessed Aug. 30, 2010.
- Ginkgo. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Aug. 30, 2010.
- Vitamin E. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Aug. 30, 2010.
- Brown PD, et al. Neurocognitive effects. In: DeVita TJ Jr, et al. DeVita, Hellman, and Rosenberg's Cancer: Principles & Practice of Oncology. 8th ed. Philadelphia, Pa.: Wolters Kluwer Health Lippincott Williams & Wilkins; 2008:2751.
- Ganz PA. Cancer Survivorship: Today and Tomorrow. New York, N.Y.: Springer; 2007:59.
- Ferguson RJ, et al. Management of chemotherapy-related cognitive dysfunction. In: Feuerstein M. Handbook of Cancer Survivorship. New York, N.Y.: Springer; 2007:287.
- Chang G, et al. Mental status changes after hematopoietic stem cell transplantation. Cancer. 2009;115:4625.
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