A Practical Guide to Lifting the Fog and Getting Back Your Focus
by Dan Silverman, MD, PhD and Idelle Davidson

Reviewed by Yeong Sek Yee & Khadijah Shaari

As we were reviewing this book, we had a firsthand encounter with an old classmate with “chemo-brain.” This lady has undergone 8 cycles and is currently undergoing another series of 18 cycles of chemotherapy treatment for cancer of the pancreas which has spread to the liver. Recently we (and some other old classmates) made arrangements to visit her on Sunday 18^th Aug at 3.00 pm, but this was subsequently changed to Tuesday at 11.00 am. When the group arrived at her house on Tuesday at 11.00 am, this lady insisted that our rendezvous was supposed to be at 3.00 pm and not 11.00 am

The above is a good illustration of what “chemo brain” is. The mental fog and forgetfulness are no figment of the patient’s imagination. It is very real.

The book is co-authored by Dr. Daniel Silverman, head of neuronuclear imaging and Associate Professor of Molecular and Medical Pharmacology at the David Geffen School of Medicine at UCLA and award-winning journalist and breast cancer survivor Idelle Davidson.

This book validates what cancer patients and survivors have been telling doctors for a long time and that is, chemotherapy can cause significant cognitive dysfunction – even years after treatment. Until recently, oncologists often discounted or trivialized “chemo brain.” The authors gave 2 clear examples:

Barbara, unemployed related the following story….”my oncologist said there are no data out there about chemo brain. He discounted it, saying I’m fifty, the whole menopause thing. He patted me on the back, made me feel like I’m an idiot.”
Jessica, an office manager related….I was halfway through my chemo regimen, and I felt dull, like I was running on all cylinders. My oncologist said…”well, we’ll put you on an antidepressant; that should take care of everything.” Jessica was so taken aback that she remarked to the oncologist….”I am not crazy or deeply depressed.”

But the authors present plenty of evidence to the contrary. This well-researched book provides alarming-but-necessary information on chemotherapy’s effect on patients’ cognitive abilities. A significant number of patients reported concentration losses, multitasking problems, attention deficits, as well as many types of memory loss.

However, Dr Silverman and Davidson do acknowledge that there is a fine line between a patient who has cognitive impairment and one who has depression, pointing out that mood can also affect cognitive functioning and vice versa. The book highlights that depression, anxiety, and cognitive impairment are sometimes all intertwined. For example, according to the authors, when people are depressed, “they also struggle with memory, attention, and concentration problems.”

The authors also guide readers through the kinds of questions about chemotherapy that patients can ask their doctors. Silverman and Davidson also provide excellent information on methods that might work to alleviate depression – such as cognitive therapy, yoga, acupuncture, and meditation.

The book also covers foods that can help foster a healthy mind, as well as ways of coping with insomnia, fatigue, inattention, and problems concentrating. The authors devoted CHAPTER 6 to explaining the type of BRAIN FOODS that cancer patients should avoid/consume in order to improve their brain functions. Briefly, these are:

Avoid all saturated and trans fats—cheese, whole milk, butter, lard, etc all can cause a “brain attack” or the death of brain cells caused by poor blood flow.
Also avoid all Omega 6 products besides the above—these are essentially fried foods, mayonnaise, cookies, cakes, chips, crackers, cereals, seeds and nuts and refined oils such as soybean, safflower, sunflower, cottonseed and corn oils.

(Omega-6 promote inflammation and causes chronic inflammation)

Omega-3 fatty acids are crucial to brain development and in maintaining optimal brain function and vision….main sources are oily cold-water fish and plant sources like flaxseed, flaxseed oils and walnuts.

(Omega -3 fatty acids help promote healthy mental processing)

Consume some “brain-friendly antioxidants” such as beta-carotene, lycopene, Vitamin E, selenium and Vitamin C. Other phytochemicals recommended are Vitamin D, Vitamin B12, Coenzyme Q10 and gingko biloba.

Good nutrition is not just about the body. What we consume has a direct relationship to our cognitive well-being. Omega-3 fats are linked to good brain (and heart) health and protect against neurodegenerative diseases and may help with mood, learning and memory. When we nourish the brain, we feed the mind.

Did your doctor/oncologist recommend to you any of the above or did he just prescribe you some anti-depressants just like Jessica??

Filled with personal stories from many cancer survivors, the authors present many long-term strategies that anyone can use to start recovering from chemobrain. Included is a daily nine-step program that should boost your brain functioning over time. You will learn how and why to sleep well, watch your diet, be careful of what you drink, do regular exercise, monitor your mood, and stay healthy. As your memory and other strategic thinking processes return, you will feel better about yourself and regain confidence.

For further information, do visit the authors’ blog at:

http://yourbrainafterchemo.blogspot.com/

Another book in the same category as this one reviewed is ChemoBrain: How Cancer Therapies Can Affect Your Mind by Ellen Clegg (Author), Dr. Steward Fleishman, MD .

The brain fog that afflicts many people who have undergone standard or high-dose chemotherapy is known as “chemobrain.” In this clear, concise guide for cancer patients, survivors, families, friends, and caregivers, journalist Ellen Clegg provides the latest information on this much-discussed but poorly understood side effect of chemotherapy treatment.

Based on interviews with physicians and scientists who have treated and studied this problem, Clegg explains in understandable terms how chemotherapy works at the most basic biological level and also provides practical tips for coping with the aftermath of chemotherapy treatment. Website: http://www.chemobraininfo.org/

If you are keen on more information on chemobrain, just follow the following links:

RELATED REFERENCES:

1) Scientists Find ‘Chemo Brain’ No Figment Of The Imagination

Link: http://www.sciencedaily.com/releases/2006/10/061006072544.htm

2) Scientific Basis for Cognitive Complaints of Breast Cancer Patients

Link: http://www.sciencedaily.com/releases/2013/04/130419132613.htm

3) Neuroscientist Sheds Light On Cause for ‘Chemo Brain’

Link: http://www.sciencedaily.com/releases/2013/02/130221115922.htm

4) ‘Chemo Brain’: Researchers Identify Physiological Evidence of Chemotherapy-Induced Changes in the Brain

Link: http://www.sciencedaily.com/releases/2012/11/121127003324.htm

5) Breast Cancer Survivors Struggle With Cognitive Problems Several Years After Treatment

Link: http://www.sciencedaily.com/releases/2011/12/111212093738.htm

6) Chemobrain: The Flip Side Of Surviving Cancer

Link: http://www.sciencedaily.com/releases/2009/09/090917111518.htm

SOME VIDEOS ON CHEMO BRAIN

1) WHAT IS CHEMO BRAIN?

Link: https://www.youtube.com/watch?v=EbKYn4ZtQcA

2) Chemo brain after cancer treatment – Dana-Farber Cancer Institute

Link: https://www.youtube.com/watch?v=iK1UqTnD5GI

3) Cure for Chemo Brain / Brain Fog

Link: https://www.youtube.com/watch?v=PXKbYaYk3ys

4) Deanna’s Discovery: Chemo brain

https://www.youtube.com/watch?v=GRa_LvBZjS4

5) Chemo Brain

Link: https://www.youtube.com/watch?v=Q5NPh1u4N9U

Our interview with Siti was done in 2005. She had been taking our herbs for the past five years.

All these are God’s blessing.

Husband: We are indeed grateful to Razuddin who “pushed” us so many times to come and see you. At first we were hesitant.

Because you did not believe in what we do?

H: Yes indeed – I don’t believe in your herbal therapy. But then Razuddin kept insisting and one day we fixed an appointment in my office. Then I relented and he drove us to Penang to see you.

Siti: When we came I was till undergoing my chemo.

H: She already had two cycles and was going on to the third. I still remember you tell me, “If you want to go for chemo, you can then take the Chemo Tea.” My wife took the Chemo Tea and she felt the difference! Before the herbs, she had pains, fevers and was unable to sleep due to the chemo. Before she started on the third cycle of chemo she took the Chemo Tea – three days before and three days after the chemo. She was alright – no problem. This result started to make us believe in what you are doing.

Well, as I have said, you are blessed. Whatever it is you received this blessing. There are people who missed on this. At CA Care we are not “hunting” for people to come and see us. Those who need our help can come – those who want us to help them, we will help. Those who don’t need our help – that’s fine.

H: I am indeed grateful to Razuddin for his insistence to bring us here to see you. If not for this repeated insistence we would not know you. It’s indeed God’s blessing. So the truth is, we started off being very skeptical about what you are doing – and we did not believe your therapy.

(Note: Razuddin is our colon cancer patient. He underwent surgery but refused chemo absolutely. He immediately started on our therapy and has been doing fine for many years now).

Siti, when you came to Penang that day, did you believe us at all?

I was doubtful – not sure at all. But after I started taking the herbs, I felt better and my health improved. I started to believe you.

After you started on the herbs, you gave up after the third cycle of chemo. Why did you give up chemo?

(Laugh)

H: She was getting better. There is no reason why we should go for anymore chemo.

The doctor was not angry with you for not continuing? Did he not call you to come back for the fourth shot?

Yes, the doctor kept calling me but I just did not turn up.

After taking the herbs, did you really feel better?

Yes, I felt my body was healthier. I have no more pains. I had more strength.

H: My wife had Stage 4 cancer. Most of my friends knew this. But after taking your herbs, these friends were really surprised to see her so well and healthy. Some of them were asking where to find your herbs. Some of these people have relatives who had undergone chemo – only one died recently.

Siti: My friend told me that I don’t look like a cancer patient. I don’t look like I am having cancer because I looked so well and healthy.

H: She did not show any symptoms that she had cancer.

How long were you on the herbs before you could feel that you were doing well?

After taking the herbs for about a year.

Apart from our herbs, did you take any other herbs or medication?

Only vitamin supplements. No other medication. Even when I was undergoing the third cycle of chemo, I did not take the doctor’s medication. I threw them away. I just took Dr. Chris’ herbs.

H: One more positive point. After taking the herbs we also went for the blood tests. The results were good. We repeated the test a few months later. The results were also good. So that increased our confidence in what you are doing. Now we are confident.

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