Arizona Advanced Medicine Clinic

Chemo Brain - AKA Cognitive Dysfunction - Is It Treatable?

Put "chemo brain" into Google as a search term, and a multitude of other terms comes up: how long does chemo brain last, chemo brain treatment, chemo brain symptoms, chemo brain disability, chemo brain fog, lung cancer brain, chemo brain in children, chemo brain cancer. I found the term "chemo brain in children" particularly poignant.

The concept of chemo brain is not something commonly addressed at oncology appointments. In fact, one of the articles in the recent literature apparently felt it important to admonish physicians who provide chemotherapy services: "acknowledgement by physicians that cognitive change may, indeed, be a consequence of chemotherapy treatment, and reassurance that improvement over time is anticipated, can be valuable for patients who may be concerned about the effects they are experiencing."[i]

A 2004 paper published in 2004 in the Journal of Clinical Experimental Psychology states: "Although patients who received chemotherapy (with and without tamoxifen) performed worse than those treated with surgery only on several domains, neither group was significantly different from demographically matched comparison subjects without a history of breast cancer."[ii] This paper did not discuss whether the study had enough patients in it for the conclusions to be statistically valid.

A 2006 article in the British Journal of Cancer states: "a few women experienced objective measurable change in their concentration and memory following standard adjuvant therapy, but the majority were either unaffected or even improve [sic] over time."[iii]

A 2010 study reports what many of us in the integrative cancer field have seen for years: "Standard dose systemic chemotherapy is associated with decline in cognitive function during and shortly after completion of chemotherapy. In addition, delayed cognitive dysfunction occurred in a large proportion of patients."[iv]

A 2012 paper in the Journal of Clinical Oncolgy reports: "Survivors of breast cancer treated with adjuvant CMF chemotherapy more than 20 years ago perform worse, on average, than random population controls on neuropsychological tests."[v]

One 2013 study examined both structural and functional effects of chemotherapy, and concluded that "Memory dysfunction, cognitive complaints, and oxidative DNA damages were increased in [breast cancer survivors] compared with [healthy controls]."[vi] Another 2013 study concluded that "subjective cognitive complaints in part reflect objective NP performance, although their etiology and biology appear to be multifactorial, motivating further transdisciplinary research."[vii]

So... are we causing an entire generation of our population first to have cancer, and then adding insult to injury, to have brain fog as a result of the treatment? A review of the literature would suggest this is the case. A review of statistic provided by the Centers for Disease Control would also suggest at least a suspicious temporal association, if not absolute causality.

I think we all agree that cancer cells need to be killed, since we have not yet found a way to turn their metabolism back around to becoming normal cells. Cancer cells do not die when they become ill - when their mitochondrial metabolism changes. Cancer cells perpetuate themselves almost indefinitely. What's more, they mutate rapidly, thus avoiding destruction by the chemotherapeutic drugs we throw at them. Hence, the use of chemotherapy, targeted at rapidly dividing cells.

Unfortunately, the chemotherapy also targets normal cells - particularly cells of the bone marrow, the GI tract, the hair, and all mucus membranes. The natural result of chemotherapy is loss of white blood cells and destruction of the immune system, anemia, diarrhea, bladder inflammation, mouth ulcers, and baldness.

Is there anything that can be done to mitigate the damage caused by chemotherapy?

The best that conventional medicine can come up with so far is to use amphetamines to stimulate the brain (and incidentally the entire cellular metabolism) - drugs like Focalin®, a methamphetamine.[viii] Seems like flogging a dying horse to force it to complete the race, doesn't it?

We do know that cancer cell mitochondria (the energy factories within the cell) are abnormal. They require glucose for their metabolism. They cannot survive on other fuels. Fortunately other cells in the body are able to use different molecules as fuel - they can use fatty acids like coconut oil.

So the first thing we do is recommend low glycemic, low carbohydrate, low starch, low sugar food choices to all our cancer patients. Almost everyone can live well on such food choices, while simultaneously starving their cancer cells.

Next we recommend antioxidant therapies, to rescue those normal cells which have been damaged by chemotherapy. We recommend both pills and intravenous therapies - sometimes the nausea from chemotherapy is so bad that oral supplements are simply not tolerated. Glutathione, n-acetyl cysteine, lipoic acid, Poly-MVA, Coenzyme Q-10, the fat-soluble vitamins A, D and E are some of the treatments we use, sometimes in very high dose.

We also recommend oxidizing therapies, because we know that healthy cells can withstand oxidative stress better than cancer cells - so if we push the healthy cells with, for instance, very high dose Vitamin C, in levels which are known to kill cancer cells, we know that the vitamin C will not have any kind of bad effect on the remaining cells in our bodies.

We use ozone to supply more oxygen and ozonides to our healthy cells - but also to either improve mitochondrial metabolism of the cancer cells to where they act more like normal cells, or to put such oxidative stress on the cancer cells that they die.

We also use Insulin as a biologic response modifier, so that drugs can be delivered to cancer cells in higher concentration at lower dose, thus resulting in fewer so-called "side effects".

We use bioenergetics treatments to help our patients out of the energetic treadmill in which they often find themselves, so that they can begin to take a fresh look at their lives, and their choices, and begin to see their way clear to making different choices.

There is life after cancer, and it does not have to be a life of illness. It can be a good life, travelling down a different path. If the body has been too damaged in this lifetime, rescue may not be possible. But rescue is always worth a try - and at the very least will provide a quality of life which is significantly lacking with standard cancer therapy. At the very best, we may make it impossible for cancer cells to survive in the milieu which we are creating.

https://www.linkedin.com/pulse/article/20140921185445-31072896-chemo-brain-aka-cognitive-dyfunction?published=t]


[ii] Castellon SA1, Ganz PA et al. Neurocognitive performance in breast cancer survivors exposed to adjuvant chemotherapy and tamoxifen.J Clin Exp Neuropsychol. 2004 Oct;26(7):955-69.

[iv] Wefel JS1, Saleeba AK et al. Acute and late onset cognitive dysfunction associated with chemotherapy in women with breast cancer.Cancer. 2010 Jul 15;116(14):3348-56. doi: 10.1002/cncr.25098.

[v] Koppelmans V, Breteler MM et al. Neuropsychological performance in survivors of breast cancer more than 20 years after adjuvant chemotherapy.J Clin Oncol. 2012 Apr 1;30(10):1080-6. doi: 10.1200/JCO.2011.37.0189.

[vi] Conroy SK, McDonald BC et al. Alterations in brain structure and function in breast cancer survivors: effect of post-chemotherapy interval and relation to oxidative DNA damage.Breast Cancer Res Treat. 2013 Jan;137(2):493-502. doi: 10.1007/s10549-012-2385-x.

[vii] Ganz PA, Kwan L et al. Cognitive complaints after breast cancer treatments: examining the relationship with neuropsychological test performance.J Natl Cancer Inst. 2013 Jun 5;105(11):791-801. doi: 10.1093/jnci/djt073.

[viii] Lower EE, Fleishman S et al. Efficacy of dexmethylphenidate for the treatment of fatigue after cancer chemotherapy: a randomized clinical trial.J Pain Symptom Manage. 2009 Nov;38(5):650-62. doi: 10.1016/j.jpainsymman.2009.03.011.

Chemo Brain - AKA Cognitive Dysfunction - is it treatable?

[i] Moore HCF. An Overview of Chemotherapy-Related Cognitive Dysfunction, or 'Chemobrain'. Oncology. Sept 15, 2014.

[ii] Castellon SA1, Ganz PA et al. Neurocognitive performance in breast cancer survivors exposed to adjuvant chemotherapy and tamoxifen.J Clin Exp Neuropsychol. 2004 Oct;26(7):955-69.

[iii] Jenkins V, Shilling V et al. A 3-year prospective study of the effects of adjuvant treatments on cognition in women with early stage breast cancer.Br J Cancer. 2006 Mar 27;94(6):828-34.

[iv] Wefel JS1, Saleeba AK et al. Acute and late onset cognitive dysfunction associated with chemotherapy in women with breast cancer.Cancer. 2010 Jul 15;116(14):3348-56. doi: 10.1002/cncr.25098.

[v] Koppelmans V, Breteler MM et al. Neuropsychological performance in survivors of breast cancer more than 20 years after adjuvant chemotherapy.J Clin Oncol. 2012 Apr 1;30(10):1080-6. doi: 10.1200/JCO.2011.37.0189.

[vi] Conroy SK, McDonald BC et al. Alterations in brain structure and function in breast cancer survivors: effect of post-chemotherapy interval and relation to oxidative DNA damage.Breast Cancer Res Treat. 2013 Jan;137(2):493-502. doi: 10.1007/s10549-012-2385-x.

[vii] Ganz PA, Kwan L et al. Cognitive complaints after breast cancer treatments: examining the relationship with neuropsychological test performance.J Natl Cancer Inst. 2013 Jun 5;105(11):791-801. doi: 10.1093/jnci/djt073.

[viii] Lower EE, Fleishman S et al. Efficacy of dexmethylphenidate for the treatment of fatigue after cancer chemotherapy: a randomized clinical trial.J Pain Symptom Manage. 2009 Nov;38(5):650-62. doi: 10.1016/j.jpainsymman.2009.03.011.

Categories: