During your recovery there could be times when you find certain mental tasks more difficult than you once did. This could include difficulty remembering appointments, recalling the names of people or objects, and concentrating in general.
These problems are known as cancer related cognitive changes (CRCCs) because they affect the way we recall and process information. They often go hand in hand with fatigue and many patients find they experience more CRCCs when their fatigue is also bad.
CRCCs are often referred to as either ‘chemo brain’ or ‘chemo fog’. They are more general terms that were first used to describe how breast cancer patients felt after chemotherapy. They are slightly misleading because we now know they can be caused by other cancer treatments and factors.
It’s difficult to say how many people experience CRCCs after their stem cell transplant because different studies define them in slightly different ways. However, it could be as high as 50%.
‘There is a connection with chemo brain and physical fatigue that we see in patients. It's really important to acknowledge and should be discussed with the same emphasis.'
Hayley, Anthony Nolan Lead Nurse
Although the effects of CRCCs can be frustrating, most patients will only experience mild symptoms that don’t have serious long-term consequences for their health. In fact, many patients aren’t aware of these problems until they return to work or education and start multi-tasking regularly. If you’re affected by CRCCs, you might experience problems with the following:
Side effects – Common stem cell transplant-related side effects such as anaemia (low red blood cells) and infections have been linked to CRCCs.
Conditioning therapy – The chemotherapy, and possibly radiotherapy, you had before your transplant removed the cells causing your illness. However, it also affects other cells in your body, including your brain cells. This can lead to problems performing certain mental tasks.
Emotions – Recovering from a stem cell transplant can be a very emotional experience. If you are coping with feelings of stress or anxiety, it can affect your concentration, attention and memory.
Most people will find their symptoms have either improved or gone completely in the first five years after their transplant. But some people will experience difficulties for longer.
‘I found that taking 30 minutes at the end of each work day to think about things and reflect on what I've done was helpful. Just taking more time to think, I guess, allowed that space.'
Ashling, who had a stem cell transplant in 2012. You can read about her experience in our chemo brain blog.
Research into CRCCs is ongoing but, despite some promising early results, there isn’t any established treatment for it yet. However, there are lots of tips you can take advantage of to manage your situation. Here are a few to consider:
Generally living a healthy lifestyle that includes regular exercise, sleeping well and a good diet will lift your mood and help your brain to function better. Relaxation techniques such as Mindfulness or other therapies such as cognitive behavioural therapy (CBT) may also help you to cope with any problems as they happen.
‘I find that walking is a big help. I try to walk as much as I can, because it helps clear my head and gives me something nice to look forward to.'
Ceinwen, who had a stem cell transplant in 2010. You can read about her experience in our chemo brain blog.
Information published: 13/11/18
Next review due: 13/11/21