How to Heal Chemo Brain After Childhood Cancer

Childhood cancer is heartbreaking. No child should ever have to endure such a dreadful disease. Sadly, an estimated 10,470 kids under the age of 15 will receive a cancer diagnosis in 2022, according to the American Cancer Society. Fortunately, thanks to advances in treatment, 85% of kids with cancer will survive at least 5 years. Many will live for decades. However, chemotherapy, one of the primary treatments used to fight childhood cancer, can have a negative impact on the developing brain that leads to lasting cognitive dysfunction. Up to 75% of cancer patients treated with chemotherapy struggle with “chemo brain.” These impairments can have a significant impact on a cancer survivor’s quality of life and can lead to problems at school, in the workplace, in relationships, and with self-esteem.

CHEMOTHERAPY-INDUCED BRAIN CHANGES IN CHILDHOOD CANCER

Chemotherapy treatment for childhood cancer can lead to many negative changes in the brain, including:

• Reduced processing speed
• Decreased executive function
• Damage to nerve cells in the hippocampus (the primary center for learning and memory)
• Changes to white matter (the fatty protective covering that wraps around nerve cells to promote optimal signaling)
• Inflammation
• Damage to blood vessels

The brain SPECT imaging work on tens of thousands of patients at Amen Clinics, including many childhood cancer survivors, shows the negative effects of chemotherapy on the brain. SPECT is a brain imaging technology that measures blood flow and activity in the brain. SPECT scans reveal areas of the brain with healthy activity, too little activity, and too much activity. The scans of Amen Clinics patients who underwent chemotherapy treatment for cancer often show a pattern called scalloping, or overall decreased activity.

SYMPTOMS OF COGNITIVE DYSFUNCTION IN CHILDHOOD CANCER SURVIVORS

Children who have undergone chemotherapy treatment for cancer are at increased risk for many symptoms of cognitive dysfunction, such as:

• Trouble with concentration and paying attention
• Short-term, long-term, and working memory problems
• Impulsivity
• Disorganization
• Difficulty with planning and follow-through
• Decreased problem-solving
• Slow learning
• Disinterest in academic or recreational activities that require mental focus
• Poor academic performance
• Developmental delays
• Heightened anxiety
• Mood issues or depression

Some research also suggests that genetics may contribute to the cognitive dysfunction seen following childhood cancer treatment with chemotherapy. A study in the Journal of Clinical Oncology found that among survivors of childhood acute lymphoblastic leukemia, those with certain genetic polymorphisms were more at risk for cognitive problems.

WHAT CAUSES COGNITIVE DYSFUNCTION AFTER CHEMOTHERAPY?

Contributors to cognitive dysfunction following chemotherapy treatment include:

Toxicity of chemotherapy:

There is compelling evidence that chemotherapy drugs are potent neurotoxins that can cause brain injuries. For example, a 2019 study published in Cancer Chemotherapy and Pharmacology suggests that the underlying causes of cognitive issues following treatment with the chemotherapy agent, doxorubicin, may be related to disruptions in the immune system’s response, a reduction in neurotransmitter levels, oxidative stress, and inflammation in the brain.

Chronic stress:

Having cancer is a major stressor that can elevate levels of the stress hormone cortisol. When cortisol levels get stuck on high, it also causes a spike in blood sugar and insulin levels. This leads to detrimental changes in the brain, including a drop in the calming neurotransmitter serotonin, leading to a range of psychological issues. Researchers from the University of California, Berkeley, found that chronic stress generates other disruptive changes in the brain that contribute to a higher incidence of brain health/mental health disorders later in life. In particular, chronic stress produces more white matter and fewer neurons (gray matter) than normal, skewing their balance and interfering with communication within the brain. Ultimately, high levels of cortisol increase the likelihood of developing lasting psychiatric conditions, such as anxiety or depression, or PTSD, according to research in Scientific Reports.

Poor diet:

Many parents understandably want to soothe their children to decrease stress. However, giving kids sugary treats and other types of junk food can further drain the brain and can negatively impact focus and attention, moods, and mental clarity.

Gut bacteria imbalances:

Cancer treatment can mess with gut health. A 2019 study in BMC Cancer shows that chemotherapy adversely impacts the gut microbiota and can lead to gut dysbiosis, an imbalance in gut bacteria. It is also associated with an increased likelihood of leaky gut, which occurs when the lining of the intestines becomes excessively porous. Leaky gut is associated with an increased risk for mood disorders, anxiety disorders, and ADD/ADHD.

7 WAYS TO TREAT COGNITIVE DYSFUNCTION AFTER CHEMOTHERAPY

After more than 30 years of helping people at Amen Clinics to change their brain and change their life, it is clear that you are not stuck with the brain you have. If you are a childhood cancer survivor, or if you have a child who is undergoing or has undergone cancer treatment, there is hope to enhance and heal the brain. Here are 7 science-backed ways to manage cognitive dysfunction following chemotherapy treatment for childhood cancer.

1. Practice stress reduction:

Chronic stress harms the brain, so it’s important to learn how to calm stress at any age. Even small children can learn how to use effective stress-management techniques, such as deep breathing. Simply inhale for 4 seconds, hold it for 1 second, exhale for 8 seconds, and repeat 10 times. This can induce a greater sense of relaxation almost immediately. Getting out in nature is another great stressbuster, but if that is not possible, try listening to nature sounds. One study found that listening to water sounds effectively lowered stress.

2. Eat a brain-healthy diet:

Focus on clean protein, foods rich in omega-3s (such as avocados, nuts, and cold-water fish like salmon and tuna), and in particular, choose foods that are high in antioxidants. Colorful vegetables and fruits are full of brain health benefits, and they boost the level of antioxidants in your body, which reduces the risk of developing cognitive impairment and depression. Antioxidants neutralize the production of free radicals in the body, which play a major role in many illnesses, including Alzheimer’s disease, according to research in Neuropharmacology, and depression, based on findings in Plos One. Research also shows that increasing antioxidants has been found to help many conditions, including anxiety and depression.

3. Hyperbaric oxygen therapy:

HBOT is a non-invasive therapy that uses the power of pure oxygen to accelerate healing. HBOT promotes healing after insults to the brain. Before-and-after brain SPECT imaging studies on people who have undergone HBOT treatment have shown dramatic improvements in blood flow to the brain. Better blood flow enhances brain function.

4. Nutritional supplements:

Nourish the brain with nutraceuticals, such as antioxidants, including glutathione, quercetin, vitamin C, astaxanthin, and green tea extract.

5. Individualized education plan (IEP):

If your child needs academic accommodations, check into an IEP. Having specialized education and services that fit your child’s needs can be very beneficial for school performance, self-esteem, and more.

6. Interactive metronome training:

The human brain has an internal clock that helps its billions of cells communicate effectively. Injuries and other insults to the brain can disrupt this internal timing mechanism. Interactive metronome training (IM) is a unique intervention that helps reset the timing in the brain and to boost activity in the cerebellum. IM training has been found to have beneficial effects on focus and concentration, working memory, executive functions (planning, judgment, and forethought), self-control, organization, and more.

7. Neurofeedback:

This noninvasive form of brain training has been reported to help with focus, anxiousness, moods, cognitive function, and more. A 2019 study found that cancer survivors reported improved quality of life after neurofeedback therapy. And an exciting 2022 pilot study from UCLA researchers shows that neurofeedback may be beneficial in improving the chemotherapy-induced cognitive deficits—“chemo brain”—facing many cancer survivors.

It is never too early or too late for a childhood cancer survivor to start improving brain health after chemotherapy. When you have already won the fight for your life, it’s time to begin the ongoing fight for your brain health and quality of life.

Cognitive dysfunction and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.