TCBY

Maybe that title made you think of the frozen yogurt company, with their catchy little four-note jingle.

That’s the tune I’m singing for something far less fun than frozen yogurt: PCCI.

Say it with me: Post-chemotherapy cognitive impairment.

AKA, Chemotherapy-associated cognitive impairment (CACI), Chemotherapy-related cognitive impairment (CRCI), AKA chemobrain.

I can’t summarize this any better than Dana Farber’s page on the issue (perhaps because I’m having problems finding words):

Symptoms may include decreased short-term memory, problems finding words, short attention span, and difficulty concentrating and multitasking.

I have EVERY SINGLE ONE of those symptoms. My difficulty concentrating also manifests as a discomfort with crowds–not just major crowds, but even party-sized crowds. It takes great effort to have a conversation right now, and if there are more than a couple people in the conversation, I’m so easily distracted that it becomes uncomfortable and even a little anxiety-producing.

On the up side, I have a really great excuse for being a total flake.

But the whole experience is pretty maddening. I can barely remember conversations that I’ve had hours (and let’s face it, sometimes minutes) afterward. I often find myself saying to people, “I just read, or maybe heard, or had a conversation with someone recently where they said xxx, but I just can’t remember where I heard/read this thing.” And sometimes I’m not even sure if I actually heard/read/had the conversation or if I just imagined it.

The International Cognition and Cancer Task Force reported that “neuropsychological studies have shown cognitive dysfunction in 13-70%” of chemotherapy patients. This wide range, according to the Task Force, is a function of different definitions of cognitive impairment and highly varied approaches toward evaluating the effects.

(Not for nothin’, but perhaps they want to start by finding one single clinical term for this so we’re not stuck with PCCI, CACI, CRCI, and however many other ways people have found to describe chemobrain in the medical literature…)

Interestingly (you know, interesting in one of those completely fucking annoying ways), women may be more susceptible to chemobrain than men, and some types of chemo seem to cause chemobrain more than others. Guess what? Taxol is one of the chemobrain culprits. Yay.

Studies of breast cancer patients have shown that those who reported cognitive impairment actually had changes in the resting states of their brain activity on MRI scans. Generally, these researchers think the brain’s network, the huge collection of neural synergies that characterize normal brain activity, becomes disorganized by chemo, reducing the efficiency of information transfer.

That’s all well and good, but the reality is that chemobrain is very poorly understood in terms of its near and long-term effects. Some people continue to feel these effects up to a year after treatment and 10-20% of patients experience them for many years.

I am desperately hoping that my biological freakishness doesn’t extend to this particular domain.

So, if you haven’t seen me for a while, or if I decline your party invitation, keep this in mind. And please remind me that I already told you this if I start explaining it again. 🙂

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TCBY

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