From the Guidelines
Chemotherapy-induced cognitive impairment can be improved with exercise and brain training programs, but full restoration to pre-chemotherapy levels may not always be possible. According to a recent study published in the BMJ in 2023 1, no treatments are approved for cognitive impairment associated with cancer therapy, but assessing the usefulness of exercise or brain training programs for patients is recommended.
Key Strategies for Improvement
- Engage in regular physical exercise, aiming for at least 150 minutes of moderate aerobic activity per week, to improve cognitive function and overall well-being.
- Consider cognitive rehabilitation exercises, such as memory games, puzzles, and brain-training apps, used for 15-30 minutes daily.
- Adopt a healthy diet rich in omega-3 fatty acids, antioxidants, and B vitamins, which support brain health.
- Ensure adequate sleep, aiming for 7-9 hours per night, and practice stress-reduction techniques like meditation or yoga for 10-15 minutes daily.
Medications and Ongoing Care
While medications like modafinil or methylphenidate may show promise in improving cognitive function, they should be used under close medical supervision due to potential side effects, as noted in the study 1. Regular follow-ups with a healthcare provider are essential to monitor progress and adjust the treatment plan as needed. Consistent application of these strategies over time, typically several months to a year, is often necessary to see substantial improvements.
From the Research
Repairing Chemotherapy-Induced Cognitive Impairment
There are several strategies that may help repair chemotherapy-induced cognitive impairment, including:
- Pharmacologic options, such as those used to treat attention-deficit/hyperactivity disorder and neurodegenerative diseases 2
- Neurocognitive training and rehabilitation, which can help improve cognitive function and quality of life 3
- Exercise, which has been shown to have a positive effect on cognitive function and overall health 3
- Management of symptoms such as fatigue, anxiety, and depression, which can contribute to cognitive impairment 3
- Removal of drugs that may be associated with neurocognitive side effects, such as anti-epileptic drugs 3
Potential Mechanisms of Chemotherapy-Induced Cognitive Impairment
Research suggests that chemotherapy-induced cognitive impairment may be caused by:
- Cytotoxicity and neurotoxicity of anti-cancer drugs, leading to structural and functional changes in the brain 4
- Excessive cytokine release by cytotoxic agents, leading to inflammation and damage to the brain 5
- Effects on the visual system, including visual-spatial function and visual memory 6
Treatment and Management
Treatment and management of chemotherapy-induced cognitive impairment may involve:
- A collaborative approach, bringing together international specialists to develop management strategies and attenuate the effects of cognitive impairment 2
- Multidisciplinary expertise to evaluate the influence of each variable and plan appropriate support and intervention 3
- Early post-operative neurocognitive rehabilitation, which can produce rehabilitation outcomes equivalent to those seen in other conditions, such as stroke and head injury 3