Managing Stress and Memory Lapses After Breast Cancer Diagnosis
After a diagnosis of breast cancer, it is certainly understandable that women are stressed about their treatment plan and the ultimate outcome. A new study finds that women who were unable to cope with stress were more likely to experience cognitive declines – “chemo brain” even before chemotherapy started.
The term “chemo brain” refers to a mental fog that many cancer patients experience before, during and after chemotherapy. Patients describe memory lapses (forgetting things they would normally have no trouble recalling), difficulty concentrating and taking longer to finish a task, and are less likely to be able to do more than one thing at a time. Patients who undergo radiation often experience similar types of problems, but doctors are recognizing that patients experience these symptoms even before their treatments start.
Stephanie Reid-Arndt, an associate professor and chair of the Health Psychology Department in the University of Missouri School of Health Professions, examined 36 women with breast cancer who had undergone surgery but had not yet received chemotherapy or hormone-replacement therapy. The women completed neuropsychological testing and psychological questionnaires.
Patients who were stressed and had passive coping strategies to deal with their stress (ie: denial, disengagement, helplessness) were more likely to experience cognitive declines and performed lower on memory and attention tests. For example, twenty-seven percent of the women displayed deficits on at least one measure of verbal fluency.
The body responds to stress by releasing hormones such as epinephrine (also called adrenaline) and cortisol. These hormones increase blood pressure, heart rate and blood sugar levels. Chronic stress is also thought to weaken the immune system.
In the brain, cortisol interferes with the function of neurotransmitters, the chemicals that brain cells use to communicate with each other. Excessive stress hormone levels can make it difficult to think or retrieve long-term memories.
"Teaching patients proactive ways to deal with stress can help them improve their quality of life as well as maintain their cognitive function," Reid-Arndt said. She notes that too often, women receive a breast cancer diagnosis and immediately begin treatment without having much time to emotionally prepare. Health care providers should identify patients who are experiencing psychological stress and offer effective ways to manage it. Women, too, should be encouraged to acknowledge that they are overwhelmed and need help from family, friends, and other support systems.
In addition to opening up to a trusted friend, yoga and meditation techniques have been shown to be powerful stress reducers. One such type of training studied in breast cancer patients is called the “Mindfulness-Based Stress Reduction” program that blends meditation, yoga, and physical awareness. Jane Armer, one of the founders of MBSR, says that the practice gives breast cancer survivors a “new way of thinking” that improves long-term health outcomes from helping women gain more control over their lives.
In addition to managing stress, yoga has been shown to improve feelings of persistent fatigue, which occurs in at least one-third of breast cancer patients, improve physical mobility and relieve pain.