“Your Brain After Chemo: A Practical Guide to Lifting the Fog and Getting Back Your Focus”
by Dan Silverman, MD, PhD, and Idelle Davidson
Da Capo Press (Perseus Books Group)
Let me start out by saying I loved this book. Chock full of important and useful information about chemotherapy and other factors in cancer treatment that can affect memory and the ability to function…all good. Even now, a few years after publication, the information appears to hold up to the test of time.
I say this as an educator, who has some background in how the mind learns, and sometimes relearns information. Having worked with students who have a wide range of learning and behavioral disabilities, I know that the brain can be a complex and challenging organ.
As a former librarian, who regularly compiled bibliographies on subject matter, I would put this book on just about any cancer book list, but especially on one for people interested in breast cancer and lymphoma material. The authors really focus a lot of attention on how these patients endure the cognitive difficulties of chemotherapy, often due to specific medications used to treat certain types of these cancers.
Dr. Dan Silverman has an extensive background in the field of neuronuclear imaging, as well as molecular and medical pharmacology, and is involved in brain studies that seek to demystify neuropsychiatric symptoms of dementia, depression, and even the effects on hormones on the mind. His research aims to better optimize cancer treatments on a biochemical level, while minimizing the invasive impact on cancer patients.
Idelle Davidson, an award-winning journalist who has experience in reporting on health and medicine, had a first-hand encounter with the cognitive difficulties involved in undergoing chemotherapy, and she clearly uses this as a means to help her give voice to cancer patients with similar difficulties.
One thing I’ve had several cancer patients share with me is just how hard it was to experience the mental fog, only to be told it’s nothing to worry about. If cancer patients find it to be a problem, it’s a problem. It’s sometimes tempting to think that endurance is key in surviving cancer and that patients must take the bad with the good. Some doctors may take a “wait and see” view and expect patients to just sweat it out, but by approaching the subject of how the brain is affected during and after cancer treatment, the authors open a new pathway for treating the whole person. For that reason, I can see this book as being an extremely helpful resource to oncology professionals, including patient navigators in cancer centers.
What sets this book apart? Many people today have gone from talking about “chemo brain” to talking about a generalized “cancer brain”. When Dr. Silverman and Ms. Davidson talk about how the specific drugs affect specific regions of the brain, they don’t stop there. The authors peel back the layers of scientific research, citing many studies that identify specific chemotherapy agents and measure changes they create in cognitive function. They also produce information on changes that can be directly attributed to hormone therapy for cancer patients. What is measurable? What is not? When you understand that the authors are using hard data to formulate their conclusions about how the brain is affected by cancer, you can appreciate the solid, scientific approach.
For a newly-diagnosed cancer patient and caregiver, this book may start off on the intense side, especially when reading chapters such as the “Q and A With Your Doctor”. I personally found all the chemotherapy information a bit daunting, not because it wasn’t solid and useful, but because there was so much of it. And yet, when I got further into the book, it all began to make wonderful sense.
My experience as a caregiver for a lung cancer patient put me at somewhat of a disadvantage in understanding this subject matter as it pertains to breast cancer patients, because of differences in the type of chemotherapy regimens. Most breast cancer patients can cite their numbers (HER-2, etc.), their chemotherapy drugs, and even the specifics of their hormonal treatments. In order to better understand, I asked for some perspective from a circle of cancer activists I know, to find out if they would do things differently, had they known what might happen to their cognitive functioning because of cancer treatment. One woman told me she was relieved to find out she wasn’t losing her mind, because it felt like that for her. Another said she’s just really glad she’s alive and it was all worth it for her. She cited Dr. Patricia Ganz as an expert she respected in the field. Ironically, Dr. Silverman also cited Dr. Ganz as one of his trusted resources on the subject.
As the authors explain later in the book, one of the reasons why there is so much material on breast cancer and lymphoma patients is because these are the long-term survivors who are alive to participate in studies of people most affected by “chemo brain”. That’s a very important point in understanding the value of this book. Cancer that is managed over years can be stressful, and having a strategy that addresses long-term goals, especially in recovering from cognitive disability, is life-changing.
Dr. Silverman and Ms. Davidson offer a nine-step daily program of activities that will help re-pattern the brain to function more effectively and efficiently, as a means to recover what was lost to cancer treatment. They also offer advice on healthy choices. I especially liked the information on nutrition because the authors explained how the nutritional intake affects the mental processes in terms of firing up the brain, the role of protein and amino acids, and even why milk is a good choice of liquid to drink. Their list of resources provides readers with contact information and types of services offered.
One of the strengths of this book is that the authors recognize many cancer patients are emotionally overwhelmed by their experience with the disease, and there is much information on the types of psychological support that can help, while cautioning that some issues are actually the result of how the medication works in the body, thus creating a physiological issue that may masquerade as a psychological one. I found the discussion of the role of the thyroid gland helpful, because of its regulatory abilities within the body, including mental processing. What kinds of psychiatric drugs can minimize the despair or help patients concentrate better? What can yoga, meditation, and even reconnecting with nature do for patients? Some people get swallowed up in “learned helplessness” and that sense of futility when cancer strikes. What can cognitive therapy do for them? The authors guide readers through this maze in depth.
The authors present information on a number of programs that address options to train, retrain and/or strengthen the brain, such as “Memory and Attention Adaption Training”. This is a light at the end of the very long tunnel. When a reader learns that there are steps that will help a cancer patient recoup mental fluidity and understands that the process takes time, it’s possible to begin to set realistic goals in cancer recovery.
In the future, perhaps treatment for cognitive difficulties will become standard protocol for every affected patient, through physical and occupational therapies. The more we understand about how the brain is changed by cancer treatment, the better we can work to prevent the damage. This book goes a long way towards making that happen.
Note — I received a copy of this book from the author, Idelle Davidson. She offered it to me as professional reading in my capacity as the Practical Caregiver. I felt compelled to share my thoughts on it in the form of a review, not because I received any kind of compensation, but because I found it has worth for cancer families and health care professionals.
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Idelle Davidson shares more on the subject at her blog, Your Brain After Chemo. It’s well worth stopping by, especially if you or someone you love is struggling with “chemo brain”.