JALBCA ANNUAL COURTHOUSE ALERT COCKTAIL PARTY
On September 13, 2017 JALBCA hosted a reception to kick-off JALBCA’s mobilization of dozens of mammography scan vans that will provide free screening to hundreds of uninsured and underinsured women in their own communities.
TEAM JALBCA – 27TH ANNUAL KOMEN GREATER NYC RACE FOR THE CURE
Hon. Shirley Werner Kornreich and Sandy Lespinasse, successfully organized another group of JALBCA participants for the September 10, 2017 event. Team JALBCA had 51 registered participants, which included JALBCA’s co-president, Michael Katz, and his wife, Meredith. The JALBCA team, clad in their charcoal and pink t-shirts, joined thousands of others on a beautiful Sunday morning. Komen Greater NYC helps the medically underserved women and families in our community get access to screening, treatment education and support and contributes to national research to fund a cure.
CHEMO BRAIN AND COPING WITH COGNITIVE CHANGES AFTER TREATMENT- NYU LECTURE
As part of its Cancer Survivorship Learning Series, the NYU Langone Perlmutter Cancer Center presented a lecture on September 19 on “Chemo Brain and Coping with Cognitive Changes After Treatment”. The term “chemo brain” has come to refer to chemotherapy-associated changes in memory, learning, concentration, reasoning, executive function, attention and visuospatial skills during and after discontinuation of chemotherapy. Dr. Marleen Meyers, clinical assistant professor in the Department of Medicine’s Division of Hematology and Medical Oncology and director of the Survivorship Program at Perlmutter Cancer Center, led a discussion on tools to help you manage the effects of chemo brain, keep these effects from interfering with your ability to carry out day-to-day tasks, and stay on top of your life.
Dr. Meyers started by explaining that, since “we are our brains,” it is an entirely different matter to have your brain change than to have another part of your body change. Chemotherapy can alter the brain. The objectives of the lecture were several – to understand and dispel myths about chemo brain, identify symptoms of chemo brain, discuss the causes of chemo brain and discuss what you can do about it.
Chemo brain is not preventable and can be permanent. Not everyone who gets chemotherapy, however, gets chemo brain. Hormone therapy can also contribute to chemo brain. But it is possible to ameliorate the condition and decrease risks. There also may be a predisposition to getting chemo brain. Many studies have shown that adjuvant chemotherapy is associated with cognitive impairment. While most patients rebound in cognitive function by one year after ending chemotherapy, cognitive decline may persist even a decade later. Dr. Meyers indicated that there is increasing prevalence of the condition with increased survivorship. The condition has been studied more with breast cancer survivors than with survivors of other cancers.
Cognitive impairment can be measured. For example, it is possible to measure when brain electrical activity is altered, if the thickness of brain’s gray matter is reduced and if there is a reduction in brain white matter (“connecting cables”). The development of cognitive difficulties may depend on individual risk factors (e.g., stress and coping styles).
Symptoms of chemo brain are many and include the following: being unusually disorganized, confusion, difficulty concentrating, difficulty finding the right words, difficulty learning new skills, difficulty multi-tasking, fatigue, a feeling of mental fogginess, a short attention span, short-term memory problems, taking longer to complete routine tasks, trouble remembering conversations, trouble with visual memory, and situations where people often say “you already told me that.” Dr. Meyers explained that the condition feels very much like dementia.
Contributing causes to chemo brain are several. Dr. Meyers briefly reviewed these causes: the trauma of a cancer diagnosis, certain chemicals produced by cancers, certain cancer treatments (e.g., steroids, anti-anxiety medication), certain chemotherapy agents (e.g., adriamycin, cyclophosphamide, methotrexate, and 5-fluorouracil), and complications of treatment. Complications of treatment that may have cognitive impacts might include anemia, fatigue, infection, menopause, nutritional deficiencies (e.g., deficiencies in vitamins B or D), sleep problems and pain. Until these complications are addressed, cognitive impairment cannot be attributed to chemo brain. There are also other risk factors for chemo brain and these include anxiety/depression/stress, an inherited susceptibility to the condition, pain medications, brain metastases, a younger age for cancer diagnosis, and advanced age (since an elderly patient would already have a loss of neurons).
There is no definitive test to diagnose chemo brain, Dr. Meyers explained. People often score within a normal range on memory tests and imaging is both costly and inaccurate. She mentioned that usually the first test taken is the FACT-Cog, which refers to the Functional Assessment of Cancer Therapy Cognitive Scale.
Finally, Dr. Meyers reviewed treatment and prevention options. She reminded the audience that the mind-body connection is extremely powerful. Exercise is critical. People should track what influences their memory problems (e.g., hunger, fatigue), learn coping strategies (e.g., using reminder notes), and pursue stress relief techniques such as meditation. There are apparently no approved medications available to treat chemo brain. She also identified lifestyle changes that can be considered. These refer to controlling the work environment (e.g., someone on arimidex cannot concentrate well in an office that is too hot), sleeping well, being organized (e.g., doing tasks at a certain time of day), minimizing distractions, taking frequent breaks, exercising both the mind and the body, and discussing your concerns with a health care provider. As for coping with chemo brain, Dr. Meyers reminded everyone to remember that memory problems happen to everyone and being forgetful does not mean that you have lost your intelligence. She suggested that people adopt a minimum exercise routine of 30 minutes, 5 days per week and muscle strengthening exercises at least twice a week. She also recommended, as coping techniques, to take time to relax, use memory lists, and be honest with others about your symptoms.