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How Stress Affects the Immune System

Sep 26

We have known for some time that stress affects our immune systems. Many studies have shown that stress can suppress the immune system, but other studies have shown boosts in the immune system under stress. A July 2004 meta-analysis of 293 studies conducted over the past 30 years puts the pieces of the puzzle together. Psychologists Suzanne Segerstrom, Ph.D., and Gregory Miller, Ph.D. found the following:

Stress does indeed affect the immune system in powerful ways.
Short-term stressors boost the immune system. It seems that the “fight or flight” response prompts the immune system to ready itself for infections resulting from bites, punctures, scrapes or other challenges to the integrity of the body.
Chronic, long-term stress suppresses the immune system. The longer the stress, the more the immune system shifted from they adaptive changes seen in the “fight or flight”¹ response to more negative changes, first at the cellular level and later in broader immune function. The most chronic stressors – stress that seems beyond a person’s control or seems endless – resulted in the most global suppression of immunity. Almost all measures of immune system function dropped across the board.
The immune systems of the elderly or those already sick are more subject to stress-related changes.

In reaching these conclusions the authors looked at the effects of the various stressors on different immune responses, such as “natural” and “specific” immunity. They summarized the results of the studies that looked at each of these types of stress:

Natural immunity produces quick-acting, all-purpose cells that can attack many pathogens; they bring fever and inflammation.

The body takes a few days to mount a more specific attack on particular invaders with specific immunity. This response includes lymphocytes (T-cells and B cells). Specific immunity has both cellular responses, which fight pathogens that get inside cells (such as viruses), and humoral responses, which fight pathogens that stay outside cells, such as bacteria and parasites. Segerstrom and Miller were able to assess how different types of immune response correlated with different types of stress because researchers have identified the blood markers of these different immune responses.

They divided stressors into different types:

Acute time-limited stressors: lab challenges such as public speaking or mental math.

Brief naturalistic stressors: real-world challenges such as academic tests.

Stressful event sequences: a focal event such as loss of a spouse or major natural disaster gives rise to a series of related challenges that people know at some point will end.

Chronic stressors: pervasive demands that force people to restructure their identity or social roles, without any clear end point – such as injury resulting in permanent disability, caring for a spouse with severe dementia, or being a refugee forced from one’s native country by war.

Distant stressors: traumatic experiences that occurred in the distant past yet can continue modifying the immune system because of their long-lasting emotional and cognitive consequences, such as child abuse, combat trauma or having been a prisoner of war. Much of their analysis goes on to review the similarities and differences among the 293 studies that they examined. These studies included a total of 18,941 subjects. “Stressful event sequences” appeared to be weakly associated with different immune consequences, depending on the type of event. There appeared to be different patterns for grief than for trauma, for example, but the associations weren’t strong enough for the authors to make new claims. They recommended further study.

The authors did find that the most chronic stressors - those which change people’s identities or social roles, are more beyond their control and seem endless - were associated with the most global suppression of immunity. In such situations almost all measures of immune function dropped across the board. The longer the stress, the more the immune system shifted from potentially adaptive changes (such as those in the acute “fight or flight” response) to potentially detrimental changes, at first in cellular immunity and then in broader immune function. This analysis suggests that stressors that turn a person’s world upside down and appear to offer no hope for the future probably have the greatest psychological and physiological impact.

The authors also found that age and disease status affected a person’s vulnerability to stress-related decreases in immune function. It seems that illness and age make it harder for the body to regulate itself.

This is a ground-breaking meta-analysis that helps us understand the complex relationship between stress and the immune system. It should lead to new treatments and to better stress management programs, especially for patients with HIV or other disorders that compromise immunity.

Reference: Segerstrom & Miller, 2004. Psychological Stress and the Human Immune System: A Meta-Analytic Study of 30 Years of Inquiry Psychological Bulletin, 130, 4.

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Loss Of Sleep, Even For A Single Night, Increases Inflammation In The Body

Sep 26

ScienceDaily (Sep. 4, 2008) — Loss of sleep, even for a few short hours during the night, can prompt one’s immune system to turn against healthy tissue and organs.

A new article in the September 15th issue of Biological Psychiatry, by the UCLA Cousins Center research team, reports that losing sleep for even part of one night can trigger the key cellular pathway that produces tissue-damaging inflammation. The findings suggest a good night’s sleep can ease the risk of both heart disease and autoimmune disorders such as rheumatoid arthritis.

Specifically, the researchers measured the levels of nuclear factor (NF)-?B, a transcription factor that serves a vital role in the body’s inflammatory signaling, in healthy adults. These measurements were repeatedly assessed, including in the morning after baseline (or normal) sleep, after partial sleep deprivation (where the volunteers were awake from 11 pm to 3:00 am), and after recovery sleep. In the morning after sleep loss, they discovered that activation of (NF)-?B signaling was significantly greater than after baseline or recovery sleep. It’s important to note that they found this increase in inflammatory response in only the female subjects.

These data close an important gap in understanding the cellular mechanisms by which sleep loss enhances inflammatory biology in humans, with implications for understanding the association between sleep disturbance and risk of a wide spectrum of medical conditions including cardiovascular disease, arthritis, diabetes, certain cancers, and obesity. John H. Krystal, M.D., Editor of Biological Psychiatry and affiliated with both Yale University School of Medicine and the VA Connecticut Healthcare System, comments: “The closer that we look at sleep, the more that we learn about the benefits of sleeping. In this case, Irwin and colleagues provide evidence that sleep deprivation is associated with enhancement of pro-inflammatory processes in the body.”

“Physical and psychological stress brought on in part by grinding work, school and social schedules is keeping millions of Americans up at night,” said Dr. Irwin, lead author and director of the Cousins Center for Psychoneuroimmunology at the Semel Institute. “America’s sleep habits are simply not healthy. Our findings suggest even modest sleep loss may play a role in common disorders that affect sweeping segments of the population.” In other words, sleep is vitally important to maintaining a healthy body. And as Dr. Krystal notes, “these findings provide a potential mechanistic avenue through which addressing sleep disturbance might improve health.”

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Cancer pain: Relief is possible

Sep 26

Cancer pain: Relief is possible

From MayoClinic.com
Special to CNN.com

Not everyone with cancer experiences cancer pain, but one of out three does. If you have advanced cancer — cancer that has spread or recurred — your chance of experiencing cancer pain is even higher.

Cancer pain strikes in many ways. Your pain may be dull, aching or sharp. It could be constant, intermittent, mild, moderate or severe. Timothy Moynihan, M.D., a cancer specialist at Mayo Clinic, Rochester, Minn., offers some insight into cancer pain, reasons why people might not get the pain treatment they need and what they can do about it.

What causes cancer pain?

Cancer pain can result from the cancer itself. Cancer can cause pain by growing into or destroying tissue anywhere near the cancer. Cancer pain can come from the primary cancer itself — where the cancer started — or from other areas in the body where the cancer has spread (metastases). As a tumor grows, it may put pressure on nerves, bones or other organs, causing pain.

Recent research has shown that cancer pain may not just be from the physical effect of the cancer on a region of the body, but also due to chemicals that the cancer may secrete in the region of the tumor. Treatment of the cancer can help the pain in these situations.

Cancer treatments — such as chemotherapy, radiation and surgery — are another potential source of cancer pain. Surgery can be painful, and it may take time to recover. Radiation may leave behind a burning sensation or painful scars. And chemotherapy can cause many potentially painful side effects, including mouth sores, diarrhea and nerve damage.

How do you treat cancer pain?

There are many different ways to treat cancer pain. The ideal way is to remove the source of the pain, for example, through surgery, chemotherapy, radiation or some other form of treatment. If that cannot be done, pain medications can usually control the pain. These medications include:

Analgesics, such as aspirin or acetaminophen (Tylenol, others)
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin, others)
Weak opioid (derived from opium) medications, such as codeine
Strong opioid medications, such as morphine, oxycodone, hydromorphone, fentanyl or methadone

These drugs can often be taken orally, so they’re easy to use. However, it you’re unable to take medications orally, they may also be taken intravenously, rectally or through the skin using a patch.

In September 2006 the Food and Drug Administration approved a new form of the opioid fentanyl (Fentora) that dissolves in your mouth. This medication may be particularly effective for intermittent pain episodes, which are sometimes called “incident pain.” These fentanyl tablets dissolve rapidly, and the drug is absorbed through the lining of your mouth.

Specialized treatment, such as nerve blocks, also may be applicable. Nerve blocks are a local anesthetic that is injected around or into a nerve, which prevents pain messages traveling along that nerve pathway from reaching the brain. Other therapies, such as acupuncture, acupressure, massage, physical therapy, relaxation, meditation and humor, may help.

In your experience, what are some reasons for not receiving adequate treatment for cancer pain?

Unfortunately cancer pain is often undertreated. There are many factors behind that, some of which include:

Physician knowledge. One factor has to do with a physician’s knowledge and ability to treat and recognize pain. Some physicians and other health care professionals may not specifically ask about pain, which should be a normal part of every cancer patient’s visit. Cancer patients should be asked if they are having any pain. If they are, the physician should stop there and deal with the issue. Some doctors don’t know enough about proper pain treatment. If this is the case, your doctor might refer you to a pain specialist.
Patient reluctance. A second factor might be a patient’s own reluctance. Some people might not want to “bother” their doctors with the information, or they may fear that the pain means that their cancer is getting worse. Some are reluctant to report it or report it as thoroughly as they should because they’re worried about what doctors or other people might think of them if they complain. They might feel that because they have cancer, they’re supposed to have pain and be able to deal with it. That simply isn’t true.
Fear of addiction. Another factor might be a person’s fear of becoming addicted to the pain medications. This is something that we know doesn’t typically happen if you take medications for pain. If you take them when you’re not in pain or to get high, then, yes, you can get addicted. But the risk of addiction for people who take pain medications in an appropriate fashion — for pain — is very low, so this shouldn’t be a concern.
Fear of side effects. Some people fear the side effects of pain medications. Many are afraid of being sleepy, unable to communicate with family and friends, acting strangely, or being seen as dependent on medications. People are also sometimes afraid that taking morphine may shorten their life. There is no evidence of any of these happening if the medication is dosed appropriately. And although strong pain medications can cause drowsiness when you first take them, that side effect usually goes away with steady dosing.

What side effects can you expect from cancer pain treatment, and what can you do about them?

Each pain treatment may be accompanied by its own unique side effects. For example, radiation treatments may cause redness and a burning sensation of the skin. And, depending on what part of the body the radiation is applied to, the radiation may cause diarrhea, mouth sores or other problems, such as fatigue. Chemotherapy certainly can cause side effects, such as nausea, fatigue, infection and hair loss, but it can be effective in relieving pain if it shrinks the tumor. There are medications to help with nausea. Relaxation techniques also may help.

Pain medications each have their own unique side effects that should be reviewed with your physician before taking them. One of the common side effects of the stronger pain medicines is constipation — common to opioids. It can be treated with appropriate bowel regimens as prescribed by your doctor, such as adding a stool softener and something to stimulate the bowels. Preventing constipation is much easier than treating it, so anyone who takes these strong pain medications should automatically begin a regimen to keep their bowels moving. Some of the other side effects of the strong pain medications include confusion, lethargy and sleepiness. The severity of these effects varies from person to person and commonly occurs with the first several doses. But once a steady amount of the medicine stays in your body, the side effects usually resolve. Hallucinations and behavior changes are uncommon.

The less potent pain medications actually may have more side effects, which also should be discussed with your physician before taking them. For instance, anti-inflammatory drugs might damage your kidneys, cause ulcers or increase your blood pressure. Aspirin can cause gastrointestinal bleeding, and acetaminophen (Tylenol, others) can cause liver damage if you take too much.

When should you discuss cancer pain with your doctor, and what points should you bring up?

Report any bothersome pain to your physician. If there is a minor pain that goes away, don’t worry about it. But if the pain interferes with your life or is persistent, it needs to be reported and should be treated. Although no one can guarantee that all pain can be completely eliminated, most pain can be lessened to the point where you can be comfortable.

It may help to keep track of your pain by noting how strong it is, where it’s located, what makes it worse, what brings it on, what makes it better and anything else that happens when you have the pain. A pain-rating scale from 0 to 10 — with 0 being no pain and 10 being the worst pain you can imagine — may be helpful in reporting pain to your doctor. In addition, pay attention to what happens when you attempt to relieve your pain. If you take medicine, do you feel any ill effects from it? If it’s a massage or something physical that relieves the pain, those therapies are important to report, too. Note whether they cause any ill effects.

What steps can you take to make sure you’re receiving adequate cancer pain treatment?

First, you need to talk to your doctor or health care provider if you’re having pain. Second, you and your doctor should set a goal for pain management and monitor the success of the treatment against that goal. Your doctor should track the pain with a pain scale, assessing how strong it is. The goal should be to keep the pain at a level with which you’re comfortable. If you aren’t achieving that goal, talk to your physician. If you’re not getting the answers you need, request a referral to a facility more skilled in the care of pain, particularly a major cancer center. All major cancer centers have pain management programs. For the most part, the medications and treatment for pain are covered by standard insurance.

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Fatigue Affects Breast Cancer Patients Even Before First Chemotherapy Treatment

Apr 25

ScienceDaily (Apr. 27, 2007) — A University of Nebraska Medical Center study has found that even before women with breast cancer undergo chemotherapy, they experience fatigue and disruptions in sleep and activity levels. Researchers say their findings suggest health professionals should address fatigue following breast cancer surgery.

Researchers say controlling fatigue after surgery — before starting chemotherapy — is important because fatigue typically increases during chemotherapy. Between 70 to 95 percent of breast cancer patients experience fatigue while undergoing chemotherapy.

The study was published in the current issue of the Journal of Pain and Symptom Management. Having studied 130 women with early stage breast cancer (stage I, II, IIIA), it the largest study to document the prevalence of fatigue associated with altered sleep and activity patterns before chemotherapy treatment. The data confirms what was reported in a previous smaller study funded by the National Institutes of Health.

“We found women are not going into chemotherapy in the best possible shape,” said Ann Berger, Ph.D., Niedfelt Professor of Nursing, UNMC College of Nursing, who has conducted several studies over the past 15 years related to fatigue in cancer patients. “It makes it that much more difficult to reduce the fatigue during treatment. If you start out with some fatigue, it will probably increase.”

“We as health professionals need to address potential fatigue and sleep issues sooner,” said Dr. Berger, principal investigator of the study. “If women are having sleep problems after surgery, we need to address this symptom before women begin chemotherapy. “What we’ve learned might explain why we’re having problems reducing fatigue in breast cancer patients during chemotherapy.”

The published study comes from initial results of a five-year, $1.5 million grant Dr. Berger and her team received in 2003. The purpose of the study, which was funded by the National Institute of Nursing Research, a division of the National Institutes of Health, was to determine the best ways to reduce fatigue during chemotherapy and to prevent chronic fatigue after treatment.

Researchers measured sleep and activity patterns during the 48 hours prior to the first chemotherapy treatment using wristwatch-sized activity monitors called actigraphs.

Fatigue, the most prevalent and distressing symptom for breast cancer patients receiving chemotherapy, has long been accepted by health professionals and patients alike as a side effect of treatment. Researchers say there are ways to intervene, and now they have found it may be important to intervene during the recovery period after breast cancer surgery.

Researchers say disrupted sleep, low daytime activity and/or reduced activity are likely to contribute to mild fatigue before chemotherapy and moderate to severe fatigue after chemo. They say fatigue should be addressed before and after surgery. Women typically begin chemotherapy three to four weeks after surgery.

Dr. Berger said because inactivity contributes to fatigue, she and colleagues say though women need to rest for several days after surgery, they should try to regain activity when they’re able. “We’ve been telling patients for years to rest and take it easy, but in some cases, we’re finding the patients who remain inactive are the one who report higher fatigue.”

Cancer-related fatigue can have a profound impact on an individual’s life, with significant physical, emotional, social, and economic consequences that may persist for months or years after completing treatment. Even after treatment ends, between 30 and 50 percent of patients say their fatigue remains at least six months or doesn’t ever go away.

Fatigue related to cancer treatment is described as a distressing, persistent, sense of tiredness or exhaustion that is not proportional to activity. The factors associated with fatigue are the presence and severity of anxiety, pain, lower sleep quality, physical inactivity, and poor performance status, leaving little desire to work or socialize.

Dr. Berger said the findings provide an important benchmark to begin looking for interventions to reduce cancer-related fatigue.

The study was undertaken to further establish values for sleep, wake, activity, rest, circadian rhythms and fatigue and how they interrelate in women before and during the first year after chemotherapy.

University Of Nebraska (2007, April 27). Fatigue Affects Breast Cancer Patients Even Before First Chemotherapy Treatment, According To Study. ScienceDaily. Retrieved December 4, 2007, from http://www.sciencedaily.com /releases/2007/04/070426135536.htm

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Nervous System Changes

Apr 25

Nervous System Changes

What they are and why they occur

Chemotherapy can cause damage to your nervous system. Many nervous system problems get better within a year of when you finish chemotherapy, but some may last the rest of your life. Symptoms may include:

Tingling, burning, weakness, or numbness in your hands or feet
Feeling colder than normal
Pain when walking
Weak, sore, tired, or achy muscles
Being clumsy and losing your balance
Trouble picking up objects or buttoning your clothes
Shaking or trembling
Hearing loss
Stomach pain, such as constipation or heartburn
Fatigue
Confusion and memory problems
Dizziness
Depression

Ways to manage

Let your doctor or nurse know right away if you notice any nervous system changes. It is important to treat these problems as soon as possible.
Be careful when handling knives, scissors, and other sharp or dangerous objects.
Avoid falling. Walk slowly, hold onto handrails when using the stairs, and put no-slip bath mats in your bathtub or shower. Make sure there are no area rugs or cords to trip over.
Always wear sneakers, tennis shoes, or other footwear with rubber soles.
Check the temperature of your bath water with a thermometer. This will keep you from getting burned by water that is too hot.
Be extra careful to avoid burning or cutting yourself while cooking.
Wear gloves when working in the garden, cooking, or washing dishes.
Rest when you need to.
Steady yourself when you walk by using a cane or other device.
Talk to your doctor or nurse if you notice memory problems, feel confused, or are depressed.
Ask your doctor for pain medicine if you need it.

Let your doctor or nurse know right away if you notice any nervous system changes. It is important to treat these problems as soon as possible.

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Chemobrain: When cancer treatment disrupts your thinking and memory

Dec 05

From MayoClinic.com http://www.chemobraininfo.org

For years people undergoing cancer treatment have described their minds as being in a fog — unable to concentrate and remember details about their everyday lives. Doctors and researchers knew something was wrong, but they couldn’t pinpoint what it was.

Research now shows that what these people are experiencing is called mild cognitive impairment — the loss of the ability to remember certain things, learn new skills and complete certain tasks. The cause of mild cognitive impairment during cancer treatment still isn’t clear, nor is it clear how often it happens or what may trigger it. Doctors aren’t sure what they can do about it.

But that doesn’t mean there isn’t any hope. Recognize mild cognitive impairment and its association with cancer treatment, and talk to your doctor about your symptoms or concerns. Taking small steps can help you cope with changes in your memory during treatment.

What is chemobrain?

The terms “chemobrain” and “chemofog” refer to cognitive changes during and after cancer diagnosis and treatment. Though these terms imply a relation to chemotherapy, it isn’t clear that chemotherapy is responsible. Women with breast cancer who underwent chemotherapy were the first group to bring these symptoms to light, as more started mentioning their symptoms to their doctors. It isn’t clear whether chemotherapy, or other factors such as stress and hormonal fluctuations, cause the changes in memory and thinking. What is clear is that some people with cancer do notice increased difficulties with certain mental tasks during and after cancer treatment.

In general, researchers have found that chemotherapy can affect your cognitive abilities in the following ways:

	Word finding. You might find yourself reaching for the right word in conversation.
	Memory. You might experience short-term memory lapses, such as not remembering where you put your keys or what you were supposed to buy at the store.
	Multitasking. Many jobs require you to manage multiple tasks during the day. Multitasking is important at work as well as at home — for example, talking with your kids and making dinner at the same time. Chemotherapy may affect how well you’re able to perform multiple tasks at once.
	Learning. It might take longer to learn new things. For example, you might find you need to read paragraphs over a few times before you get the meaning.
	Processing speed. It might take you longer to do tasks that were once quick and easy for you.

About 20 percent to 30 percent of people undergoing chemotherapy will experience cognitive impairment, though some studies report that at least half the participants had memory problems. One study found 35 percent of women with breast cancer had memory problems before beginning chemotherapy, so it’s not clear how or if memory changes are related to cancer treatment. Signs and symptoms of these memory changes can last for a year or two after your treatment.

Changes in memory during and after treatment may be very subtle. You might notice changes during your everyday tasks and as you start working again after treatment. The memory changes are often so subtle, in fact, that researchers find that people who report having memory difficulties tend to score in the normal ranges on tests of their cognitive ability. That makes it more difficult to understand, diagnose and treat the memory changes.

What causes the memory changes?

Doctors don’t know what causes the cognitive changes associated with chemotherapy. It was previously thought that chemotherapy drugs didn’t enter your brain, but were kept out by the blood-brain barrier, which separates chemicals that should be in your brain from those that shouldn’t. But some researchers now suspect some chemotherapy drugs may be able to slip past the blood-brain barrier. This could potentially affect your brain and your memory.

It isn’t clear which chemotherapy drugs are more likely to cause memory changes or if higher doses pose a bigger risk than do smaller ones. And it isn’t possible to predict who’s more likely to have cognitive impairment after chemotherapy.

A number of factors can cause temporary memory problems in people undergoing chemotherapy — making it difficult to identify the so-called chemobrain from the normal stresses of treatment. Temporary memory problems can, for the most part, be treated. Causes include:

	Low blood counts. If your blood counts are low, you might feel tired, making it difficult to concentrate.
	Stress. Being diagnosed with cancer and starting treatment is stressful. Stress also makes concentrating difficult.
	Medication to treat side effects. Certain medications for treating side effects including nausea and vomiting may cause drowsiness. When you’re tired, it may take longer to complete tasks.
	Lingering depression. Depression is common in people with cancer. If your depression continues after your treatment, you might find it difficult to pay attention.
	Lingering fatigue. Fatigue is a side effect of several types of cancer treatment, including chemotherapy. Your fatigue might end when your cancer treatment ends, though it also can continue after treatment.
	Hormonal changes. Many cancer treatments may alter the normal hormonal balance in your body, causing cognitive changes. Hormonal changes are a side effect of some treatments and, with other treatments, are the intended way to treat your cancer.
	Pain medications. Some pain medications cause drowsiness and difficulty concentrating. For most people, these side effects diminish or disappear once a proper dose of pain medication is established.

Talk to your doctor about your memory problems. If your symptoms are caused by medications or stress, your doctor can treat those symptoms and help get your mind back on track.

How are memory changes treated?

If you have impaired memory, your doctor may first try to rule out other causes of memory problems, such as stress and depression. Currently no medications exist to treat cognitive impairment associated with cancer and its treatment. Researchers are investigating whether medications for such disorders as depression, attention-deficit hyperactivity disorder (ADHD) and dementia could prove effective.

You can help yourself cope with the changes in your memory by taking a few simple steps. You might want to:

	Exercise your body. Aerobic exercise helps your mood and can make you feel more alert. Both can help you when it comes to concentrating.
	Exercise your mind. Give your mind a workout by learning a new skill, such as a new language. Take a class, participate in a book club or try crossword puzzles.
	Track your memory problems. Keep a detailed diary of your memory problems throughout your day. Carry your diary with you and take quick notes on what medications you take and when. Note the time of day your memory problems occur and the situation.
	Target specific problems. Use your daily diary to determine what influences your memory problems. If they tend to crop up in the early afternoon, you may be able to prepare yourself by not scheduling meetings or deadlines at that time of day.
	Take notes. Make a list of everything you need to accomplish today and use it as a guide. Take detailed notes of things you need to remember.
	Start a routine. Put your keys or other commonly misplaced objects in the same place every time you set them down. Try to keep the same schedule every day.
	Talk about your problems. Be open with your friends and family about what you’re experiencing. Let them know your mind is moving a little slower these days and explain how they can help you. This can help you relax and make it easier for you to think and process information.

Find the coping method that’s best for you and stick to it. Talk to your doctor about your concerns. He or she might have some other suggestions.

What other types of cancer treatment might cause cognitive impairment?

Chemotherapy isn’t the only cancer treatment that may cause memory and thinking problems. Other treatments that might affect your brain include:

	Hormone therapy. It isn’t clear whether women undergoing hormone therapy that alters the amount of estrogen in their bodies experience memory problems. Some studies link memory function to the amount of estrogen in the brain. Other studies haven’t found this link.
	Immunotherapy. This experimental therapy stimulates your body’s own defenses to fight your cancer. Treatment with cytokines — a type of protein that causes inflammation in your body — may cause problems with memory, multitasking and processing information.
	Radiation therapy. Radiation to your brain can impair your memory and your motor function, as well as your ability to learn new things and to multitask. Older adults and people receiving high doses of radiation are at a greater risk of memory problems. If you receive both chemotherapy and brain radiation, your risk is also higher.

As research continues, doctors expect to better understand which cancer treatments cause cognitive impairment and what they can do to limit their side effects.

Take note of any memory problems

If you’re currently undergoing cancer treatment or you’ve already been through treatment, take note of any problems you have remembering certain things or concentrating during certain tasks. Talk to your doctor about your signs and symptoms.

If you’ve yet to start your treatment, talk to your doctor about the risks of treatment, including cognitive impairment. Understanding your risks can help you make more informed decisions about your treatment.

October 13, 2006 http://www.chemobraininfo.org

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