By: Kim Seyferth, Education and Outreach Intern
We have all misplaced our keys, forgot why we walked into a room, or have been distracted by something other than our task at hand; however, what if these became an everyday occurrence after successfully battling cancer? Unfortunately, for many cancer survivors, this is an issue that is all too real.
At the January grantee round table meeting for Komen Austin, we were fortunate enough to have speaker, Dr. Heather Becker of The University of Texas at Austin School of Nursing come to speak with us on “Cognitive Survivorship for Breast Cancer Survivors.” During the presentation, Dr. Becker discussed the changes that occur with the cognitive function in cancer survivors, along with ways to best cope with these new challenges.
It has been reported that approximately 75% of cancer survivors state they have experienced cognitive impairment at some point after diagnosis.
This “mental fog” is most prevalent during treatment, however, for some patients, it does not just disappear once they go into remission. They indicate having some short-term memory loss and attention deficit, which makes doing tasks they once considered mundane to be more difficult and time-consuming. This is especially true with ‘executive functions’, which are the functions we use to plan and sequence a task.
While many health professionals still consider this phenomenon to be “Chemo brain,” it is vital to understand that for many patients it is much more. Aside from going through treatments that affect their bodies, patients often experience trouble sleeping, fatigue, depression, and in the case of certain cancer treatments, changes in hormone levels. The combination of these factors can cause a change in a patient’s ability to mentally focus the way they once were able to, even after treatment is completed.
Aside from causing a feeling of annoyance in their activities of daily living, this change in cognitive function can cause employment issues. Supervisors may express frustration with these changes in focus once the cancer survivor returns to work post-treatment, and survivors may feel ‘guilty,’ as they feel they are creating additional problems for others. Survivors may also not understand that under the Americans with Disabilities Act (ADA), they have the right to request reasonable accommodations to be made at their workplace, such accommodations could include moving to a quieter workspace or asking for extended deadlines, as a diagnosis of cancer is considered a disability under the ADA. If the survivor works in an organization with a human resources department, it could be very beneficial to sit down and discuss any concerns or difficulties with the department, as they are more likely to be aware of how to improve the situation for everyone involved.
The question then becomes what can each of us do as friends, family members, healthcare professionals and cancer survivors?
The most important first step for everyone involved is to validate that this is a real struggle for many survivors and to remember that while there may not be a ‘cure’, there are several ways people can make things easier on themselves, or for those they care about.
Friends and family members should continue to act as a support system for their survivors, even after treatment is completed. They should remember that it will take time for survivors to adjust back to their routines again, and that some may have a harder time than others.
As healthcare professionals, it is vital to ask survivors about any cognitive issues they may be experiencing during follow up visits. Explaining to them that it is fairly common to experience these issues, as well as providing suggestions of ways to deal with them, will make the transition easier and may help to reduce frustration for the patient.
As a survivor, understanding that you are not alone is of the utmost importance. It is also important to discuss any issues with your support system, employer and doctor so that everyone around you understands what you are going through, especially because everyone’s experience is different. Coming up with new ways to accomplish tasks may be useful. This can include developing new habits such as leaving your purse, keys, etc. in the same place each night to let your brain go on autopilot and ‘rest’, or working on projects at a different time of day when you may be more focused. In addition, exercising, eating well, attending support groups and incorporating new activities such as yoga and meditation have all been recognized as being helpful in coping with this ‘mental fog.’ Finally, challenging your brain with new activities such as working on crossword puzzles, using online programs such as Lumosity or learning a new instrument can also have some very positive effects. The best plan of action is to decide what works best for you!
While it may be difficult to accept that life may not return to normal right away after fighting such a horrendous battle, survivors should remember that with time and patience things will get better.
Dr. Becker put it best by stating that, if you came across a roadblock or flooding on your way home from work, you wouldn’t just give up. You would find a detour to make it to your destination.
In other words, while it may take some time to adjust making these changes along the way will hopefully give you similar results in the end.