After six rounds of chemotherapy for Stage 4 breast cancer, Amanda Dufour has noticed changes in her brain.
As a stay-at-home mom and a former retail manager, she's used to juggling different jobs all at once. Now, she has trouble multitasking and sometimes forgets simple tasks.
"I'm a much slower reader than I used to be," said Dufour, 33. "It would take me a week at most to finish a book. Now I'm lucky to finish it in two months."
A study that measured the electrical activity of cancer patients' brains by University of British Columbia researchers published online in the journal Clinical Neurophysiology last month shows chemotherapy can lead to excessive mind-wandering and an inability to concentrate. The phenomenon, known as chemo brain, can affect the daily lives of cancer patients in many ways: They may have trouble remembering words, people's names or concentrating on assignments.
"With a healthy brain, sometimes we're paying attention and sometimes we're not," said Todd Handy, a psychology professor at UBC and a co-author of the study. "With chemo brain, even when patients said they were paying attention, their brains looked like they were wandering."
Although the concept of chemo brain is not new, researchers hope that by gaining a better understanding of how chemotherapy affects the brain of cancer patients, it will lead to better therapies and support.
The UBC researchers looked at a new way of testing patients with chemo brain using a electroencephalogram (EEG) to show whether their brains wandered or remained focused while performing tasks on a computer. They examined whether 19 breast cancer survivors performed differently from a healthy control group of 12.
While performing a task for a period of time, the participant's brain activity was monitored using EEG and they were periodically asked to report their attention level.
Future research will look at whether physical exercise can improve the ability of cancer patients to maintain their mental focus, said Kristin Campbell, associate professor for UBC's department of physical therapy and lead author of the study.
Lori Bernstein, a neuropsychologist who works for the department of supportive care with Princess Margaret hospital in Toronto, believes the study is helping people who have gone through chemotherapy.
"Many people who go through cancer treatment suffer from persisting side effects, and this is one of them. It can impact people's quality of life if they return to work or resume previous activities that involve thinking," she said. "We don't understand what exactly happens … we're devoting a lot to people living after cancer, now we want people to live the best way they can."
Although Bernstein appreciates the study and believes there's more to discover about chemo brain, she would have liked to see a larger sample size.
Rehabilitation centres for cancer patients have already found a need to help people affected with chemo brain.
Heather Palmer is the director of cognitive rehabilitation at Maximum Capacity, a company from Bradford, Ont., that helps individuals improve or maintain their cognitive abilities. In 2007, she started Brain Fog, a cancer-related program that helps address the cognitive changes that survivors will experience as a result of their journey.
It's a multidimensional program that focuses on memory, task management and psychological well being, Palmer said. Cancer patients are given exercises, homework assignments and group activity to help apply the in-class strategies and concepts in their everyday lives.
In one exercise, participants were asked to say what they were doing out loud, Palmer said. When a person is speaking, their thought process is slower because people can't speak as fast as they think, and if they're in the middle of a task, it will help them remember what they were doing if they forget.
More than 6,000 survivors have participated in the program that first started at Wellspring, a support network group for cancer patients in Ontario and Alberta, and has since expanded to different cancer centres across the country and the United States.
The UBC study received funding from the Canadian Breast Cancer Foundation.