Cancer Survivor\'s Guide to Chemo Brain and Recovery
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Transcript of Cancer Survivor\'s Guide to Chemo Brain and Recovery
Susan Hardwicke, PhD
www.vabion.com
804-308-1956
Chemo Brain and Recovery
A Guide for Survival
©Copyright Susan Hardwicke, Ph.D. 2009. All rights reserved.2
Purpose To summarize recent findings on the brain To understand the effects of chemotherapy treatment
on the brain To detail a research-based program you can begin
today to improve post-chemotherapy cognitive health To answer your questions
I’m a Stage III breast cancer survivor who has experienced and recovered from chemo brain.
©Copyright Susan Hardwicke, Ph.D. 2009. All rights reserved.3
Personal Experience Past: Six chemotherapy infusions Sept -
Dec 2002 Chemo brain symptoms began with first
infusion Short-term memory loss Memory formation loss Motor function loss Word retrieval difficulties/expressive language
difficulties Difficulty making decisions
Present: Full recovery of chemo brain symptoms
©Copyright Susan Hardwicke, Ph.D. 2009. All rights reserved.4
“What is Chemo Brain?”
Symptom list1. Mental fog2. Memory deficits (new or worsening)3. Slower processing speed4. Inability to maintain focus, concentration5. Language difficulties (word retrieval, in particular)6. Motor difficulties (navigation, geographic memory)
©Copyright Susan Hardwicke, Ph.D. 2009. All rights reserved.5
“Why did Chemo Brain take so long to be recognized as a problem?”
1. Emphasis on saving life, not on quality of life2. Brain assumed to be static, and function
declines with age3. Blood brain barrier was supposed to protect
brain cells from chemotherapy agents4. Patients reluctant to report symptoms5. Symptoms could be attributed to stress,
aging
©Copyright Susan Hardwicke, Ph.D. 2009. All rights reserved.6
20 Years of Brain Research
New field of cognitive neuroscience helps understand the functions of different brain areas
Neurology and neuroscience expand knowledge of types of cells
Exploded myths about brain: Brain cells communicate with each other “Blood brain barrier” does not protect against
chemotherapy Brain can regenerate skills, rewire itself Brain/thoughts affect physiological functions
©Copyright Susan Hardwicke, Ph.D. 2009. All rights reserved.7
Neurogenesis: The Formation of New Neurogenesis: The Formation of New Brain CellsBrain Cells
Pluripotent stem cell
Multipotent
stem cell/Neural Stem Cell
Undifferentiated neurons
Neurons
Glial cells
©Copyright Susan Hardwicke, Ph.D. 2009. All rights reserved.8
Anatomy of a NeuronDendrites- receive electrical and chemical impulses from other cells
Cell body- contains the nucleus of the cell’s DNA blueprint for division and replication, and RNA for protein synthesis
Axon- long extension from the cell body that conducts electrical impulses, transports enzymes/chemicals
©Copyright Susan Hardwicke, Ph.D. 2009. All rights reserved.9
Neurotransmitters Chemical compounds
(amines and amino acids) and polypeptides* manufactured in the neuron or human body
Excitatory and inhibitory Regulate mood, activity,
and storage of information Stored in vesicles near
axons Role: transfer informational signals across the synapse, then return (through reuptake process) to original site
>60 neurotransmitters!
©Copyright Susan Hardwicke, Ph.D. 2009. All rights reserved.10
Cell Cycle Normal cells
Contact inhibition Cell cycle control Cell differentiation Programmed cell
death: apoptosis
Cancer cellsUncontrolled growth (malfunction of programmed cell death)
©Copyright Susan Hardwicke, Ph.D. 2009. All rights reserved.11
Chemotherapy: Effects Patient information: Chemotherapy kills
cancer cells because they divide so fast. What really happens: Chemotherapy
kills ALL cells that are dividing (= ALL cells) It kills cancer cells because they divide
much faster than normal cells Other cells that divide quickly include
immune/blood, mouth, digestive, skin, hair, and BRAIN
©Copyright Susan Hardwicke, Ph.D. 2009. All rights reserved.12
Chemotherapy Damage
Research provides solid evidence of damaging side effects: Brain atrophy (smaller size
for 2 years) Delayed degenerative
damage to stem cells (5-FU)
©Copyright Susan Hardwicke, Ph.D. 2009. All rights reserved.13
The Effects of Chemotherapies
Research shows the damage caused by select chemotherapies.
©Copyright Susan Hardwicke, Ph.D. 2009. All rights reserved.14
“How much cognitive damage do you have?”
Self-assessment of pre- and post-chemo performance
Inventory available:• Memory• Language• Focus• Processing• Decision-making• Mood
©Copyright Susan Hardwicke, Ph.D. 2009. All rights reserved.15
Chemo Brain Recovery Model
©Copyright Susan Hardwicke, Ph.D. 2009. All rights reserved.16
Rationale for Model
Achieve clear sense of purpose Take advantage of recent research and
promote new brain cell growth (neurogenesis) Improve the quality of new brain cells Enhance intercellular communications Enhance brain’s biochemistry Reinforce or develop pathways in the brain
©Copyright Susan Hardwicke, Ph.D. 2009. All rights reserved.17
Start with Emotional/Spiritual
1. Make a conscious decision to improve your health
2. Achieve a more positive emotional state DAILY3. Reflect on your core spiritual beliefs4. Build your sense of purpose5. Increase your enjoyment of being alive every day
©Copyright Susan Hardwicke, Ph.D. 2009. All rights reserved.18
Diet and Supplements: Principles
Remember: What you ingest is used to construct cells and in cell communications
Do not ingest toxins-- eliminate chemicals, additives, and artificial flavors and sweeteners
Decrease unhealthy fats and increase healthy fats
Increase protein Add folic acid, probiotics, and other
supplements that directly benefit the brain in particular, and energy in general
*See Diet Tips Handout
©Copyright Susan Hardwicke, Ph.D. 2009. All rights reserved.19
Physical Exercise
EXERCISE STIMULATES THE FORMATION OF NEW BRAIN CELLS!! Cardio Weight training
Unless you formerly worked out, start with walking (preferably outdoors)
©Copyright Susan Hardwicke, Ph.D. 2009. All rights reserved.20
Mental Exercise
15 minutes a day, every day. Repeat the same type of game for several weeks to build pathways in the brain. Concentration/memory puzzles and games Sudoku Trivial pursuit Online memory games Cranium
Reduce or eliminate television Fill moments of “dead time” by deliberate
thinking or reading, not allowing your mind to wander.
Get enough sleep to help your brain reorganize
©Copyright Susan Hardwicke, Ph.D. 2009. All rights reserved.21
Audio Therapy
Specially designed ambient music changes brainwave profile at least temporarily
Can reduce “stress” waves and “fog” waves Case study:
QuickTime™ and a decompressor
are needed to see this picture.
©Copyright Susan Hardwicke, Ph.D. 2009. All rights reserved.22
Audio Therapy
Pre-audio measures Hi-beta = 18.7 Theta = 11.8 Alpha = 14.4
During-audio measures
Hi-beta = 6.9 Theta = 10.4 Alpha = 17.2
©Copyright Susan Hardwicke, Ph.D. 2009. All rights reserved.23
And what if you need more help?
Look for new website: www.HealthAfterChemo.com Chemo brain blog Chemo brain and survivor community Other resources
Do NOT accept suggestions that “you should be happy you are alive”
Evaluate your medications for potential side effects on brain function
©Copyright Susan Hardwicke, Ph.D. 2009. All rights reserved.24
Handouts
Self-assessment questionnaire
Diet tips for post-chemotherapy
For additional copies, contact me at [email protected]