Confronting the Mental Challenges of Cancer Treatment

by Richard Saltus

Living with cancer is a physical and emotional challenge, but people may also find it hampers their thought processes and memory. Often the deficits are temporary, but sometimes they persist or appear months or years later as delayed effects.

Cognitive difficulties, says Clare Humphreys, PhD, a neuropsychologist at Brigham and Women’s Hospital, “are caused not just by the direct effect of cancer, but also the effects of treatment, as well as factors like pain, disrupted sleep, anxiety, and depression.”

Fortunately, experts such as Humphreys, who sees many patients from the Dana-Farber/Brigham and Women’s Cancer Center for Neuro-Oncology, are skilled at uncovering likely causes and suggesting a variety of treatments and coping strategies.

Claire Humphreys, PhD
Claire Humphreys, PhD

“I think in the majority of cases, people improve substantially over time,” she notes. “And with the addition of strategies that we recommend, many people are able to return to work, to school, to their jobs, and their daily lives.”

Humphreys often cares for patients who complain of problems in processing information, planning, remembering, and concentrating , as well as women frustrated by foggy thinking, or “chemo brain,” caused by chemotherapy for breast or gynecologic cancers. “We are learning more and more about the long-term impact of treatments on quality of life.”

The first step in addressing cognitive issues involves tests designed to assess attention and memory, reasoning and problem-solving, visual-spatial functions, and language functions.

Based on the results, Humphreys recommends specific strategies to bolster memory, such as mnemonic devices, repeating information multiple times, and aids like electronic organizers. In some cases,also  patients have been helped by stimulant or memory-enhancing medications, she says. Cognitive rehabilitation therapy, the relearning of cognitive skills or learning new ones to compensate, also can be very useful, Humphreys says.