Do you have chemobrain?

Editor's Note: PRCS is posting the following post on behalf of the University of Washington Memory Health Program.

Are you a cancer survivor who is struggling with concentration, word and name recall, or keeping track of things? You are not alone.

Millions of cancer survivors are living with memory or thinking difficulties often referred to as “chemobrain.” Many survivors find this impairment so severe that it interferes with basic activities of daily living.

The prevalence of chemobrain is hard to pin down, with estimates of cancer patients affected ranging from about 14 percent to as high as 85 percent. While researchers agree that its occurrence is much more dependent on the type of treatment than on the specific type of cancer, little is known about who is most likely to suffer a long-term deficit or how to guard against it. Source.

At the University of Washington Memory Health Program, we are searching for new ways to address daily thinking difficulties in cancer survivors. We are conducting workshops to learn how to improve thinking and memory abilities. In the workshops, we provide resources and offer practical, everyday solutions.

This program consists of 7 one-hour group-based workshops and pre- and post-workshop memory tests. If the group-based memory skills workshops are effective, participants may experience improved thinking abilities. Additionally, taking part in research provides participants with a unique opportunity to contribute to new ways of promoting health and treating disorders.

We generally hold our workshops in Seattle, but we are currently searching for eligible participants in the South Sound so that we can conduct workshops in Olympia or Tacoma. If you are interested in participating (in Seattle or South Sound), please contact us at (206) 277-1041 or toll free at 866-577-1913 or email us at wellness@uw.edu.

7 'take charge' tips from our new breast cancer navigator, Andrea Potter, RN

Welcome breast cancer navigator Andrea Potter, RN!Many of you may already know or recognize me because I have been caring for cancer patients in the community for the past eight years. The Providence Regional Cancer System is like family to me. I began my nursing career here and know the doctors, the staff and the community.

In recognition of Breast Cancer Awareness month, I want you to feel empowered as your own health advocate. Remember that you are not just a patient, but that you are the customer and should be made comfortable and happy. Here are some ‘take charge’ tips:

• Simplify things by keeping a journal and calendar to track symptoms and appointments.
• Be honest with your doctor about how you’ve been adhering to your treatment plan.
• It’s ok to seek a second opinion.
• Keep your own medical file and request copies of your records.
• Let me help you with practical problems that can get in the way like temporary housing, transportation or financial support.
• Take care of your emotional health by using counseling or integrative therapies.
• Keep up on changes in breast cancer research.

I am here for you throughout this journey, and the sky’s the limit to the resources I can help you access and support I can provide.

Boosting your gut - Probiotics and chemotherapy

There’s a good body of research around probiotics helping with the side-effects of cancer treatment—especially those currently undergoing chemotherapy.

What are probiotics?
Formally, probiotics are live microorganisms existing in the human body. Informally, probiotics are the good bacteria found in our gut. While that may seem harsh, consider this. When our bodies are functioning correctly there is actually more good bacteria living inside us than there are actual human cells.

So how does this affect chemotherapy?
Chemotherapy is like a really big antibiotic treatment. Its mission is to try and kill as many rapidly dividing “things” in our body—which, unfortunately, includes probiotics. This is a common reason why those undergoing chemotherapy suffer from diarrhea.

There is evidence that a huge dose of probiotics following a chemotherapy session could reinvigorate your gut helping to get your body back on track.

Probiotics is in no way a universal cure for cancer, but it can drastically help the person going through the cancer.

If you think probiotics can help you talk with your doctor about how to safely build probiotics into your cancer treatment plan.

You might also like:

• A few guiding principles around food ...
• Integrative care basics and what others are saying
• Hirsch Holistic Family Medicine Blog (external link)

You don't have to put up with cancer-related fatigue

Fatigue is a common problem and also one of the most distressing symptoms associated with cancer and its treatment, yet it has been consistently under-reported. Many patients believe that feeling weak, tired or exhausted is a necessary evil when your body is fighting cancer. Cancer-related fatigue profoundly affects the quality of life of patients and their families through physical, psychosocial, and economic/occupational aspects.

The most important factors contributing to cancer-related fatigue are:

• treatment with chemotherapy or radiation therapy (RT)
• anemia
• pain
• lack of exercise
• sleep disturbance
• poor nutrition
• emotional distress

Anemia is the most common reversible cause of cancer-related fatigue, particularly among patients receiving chemotherapy. Treatment includes red blood cell (RBC) transfusion, or using erythropoietin stimulating agent such as procrit.

Pain: Pain in cancer patients is also considered under-reported. If you are in pain talk with your doctor, it could be contributing to your cancer-related fatigue.

Lack of exercise: To avoid fatigue, cancer patients often are advised to rest and down-regulate their daily activities. However, because inactivity can induce muscular wasting, prolonged rest can lead to further loss of physical strength and endurance. Although you may not think so, physical exercise training programs can increase your functional capacity, leading to reduced effort in performing usual activities and a decreased sense of fatigue. Again, talk with your doctor to develop a program that is right for you.

Emotional distress and sleep disturbance: Sleep disturbance associated with fatigue is often difficult to treat and manage. It may be influenced by numerous factors including daytime naps, depression, anxiety, medication, sleep interruption because of nocturia or hot flashes, and evening food and/or beverage intake. Cognitive-behavioral therapy and stress reduction may help insomnia and sleep disorders.

Poor nutrition: One of the most common side effects of cancer is a change or loss of appetite which results in fatigue. However, your body has never needed proper nutrition more. It may be helpful to keep a journal of what you are eating. When you speak with your doctor next you can go through it together and make sure your diet is providing your body with all the essential nutrients it needs.

Medication:Psychostimulants (methylphenidate, dexmethylphenidate, or modafinil) and antidepressants may be useful if the above methods do not improve fatigue.

If you are suffering from cancer-related fatigue don’t just assume that being exhausted “goes with the territory.” Talk with your doctor to develop a plan and get you functioning at your best level.

Soup ladies warm hearts of cancer patients

Madeleine (left) and Gail (right) volunteer their time and resources to help brighten the day of patients receiving chemotherapyEvery other Wednesday, without fail, Gail and Madeleine pack up their soup and travel to Providence Regional Cancer System in Lacey, WA. There is no monetary gain and no formal accolades, simply the feeling that they are doing something special for patients receiving chemotherapy.

When asked why they go to all the trouble of cooking soup from scratch, individually packaging (to meet the health department’s guidelines) and driving the soup to the center their answer is simple: “Sometimes this is the only place cancer patients will eat.”

Gail and Madeleine are two wives who have lost their husbands to cancer. Gail’s husband, Jack, fought a hard battle with brain cancer, passing away 5.5 months after diagnosis. Madeleine’s husband, also Jack, lost his battle with Stage 4 kidney cancer 6.5 years after diagnosis. During this time Madeleine also fought and won her personal battle with Non-Hodgkin’s Lymphoma. So perhaps no one is more qualified to know what cancer patients need.

“My Jack was a terrible eater, even in his health,” says Gail, “he never sat down and ate a full meal, just picked at his food. When he got sick, getting him to eat became an even bigger struggle. I started to notice that he was always hungry after receiving his chemotherapy and I was so grateful for the food the center had available for patients.”

What the women didn’t like though, was the selection. Most of the food was what they called “snack foods” and not wholesome or hearty. “We pay a lot of attention to the way our soup looks and smells on top of making sure that the soup is made with quality products,” says Madeleine, “We even take requests, vegetarian and minestrone are some of the favorites.” Patients have been known to request chemotherapy on Wednesday, just to be around for the soup.

“These women are unsung heroes,” says Georgia Akin, RN, OCN in the chemo-infusion clinic. “They love and care for all our patients. They do not stick around and wait for signs of appreciation. They know what and how the patients are feeling and doing, because they too, have been there, done that.” During this month of Thanksgiving we would just like to say, “Thank You” to our soup ladies, we are grateful for you.