Chemo Brain: Post-chemotherapy cognitive impairment by Dr. Sthal's Case Study

"So, there is a case study about chemo brain. It is still a controversial topic because not much scientific research has been done. Some people are skeptical and question how the brain could be called as chemo-brain.

"A lady who was a lawyer, a highly functional person, was diagnosed with breast cancer. She underwent surgery followed by chemotherapy and radiotherapy. After the treatments, she experienced a rapid decline in her cognitive abilities."

"The doctors tried a couple of medications for her. The first one was Donepezil, also known as Aricept, which is an acetylcholinesterase inhibitor. This medication works to increase acetylcholine levels in the brain, a neurotransmitter strongly linked to memory and learning."

"Donepezil was found to be the most effective medication for her. However, even with this treatment, she couldn’t fully recover from her cognitive decline. The doctor then tried other medications, including Wellbutrin and second-generation antipsychotics, to stabilize neurotransmitters like dopamine, serotonin, and norepinephrine. Unfortunately, these medications, along with Modafinil—designed to boost dopamine without addictive risks—were not effective for her. Even stimulant medications didn’t work in her case."

Some people might be skeptical about chemo brain because it’s a relatively new concept and lacks extensive scientific research. Others may believe the symptoms are caused by factors like stress, fatigue, or the cancer itself, rather than the treatments. The controversy often stems from the complexity of pinpointing a single cause for cognitive decline.

"Even after long-term treatment, about five years, the patient didn’t see much improvement. Donepezil was the most effective medication, but she continued to struggle with cognitive issues. Based on my perspective, I think her brain might be affected by a combination of chemicals, stress, and hormonal changes, all collectively impacting her cognitive function.

What’s encouraging in this case is the concept of neuroplasticity, which suggests that even though chemotherapy temporarily affects the brain, there is still potential for positive change. While medication has had limited success, I believe the best way to restore and reconstruct her brain is not through more chemicals. Instead, a holistic approach might be more beneficial. She should spend more time with family, engage in nature, and focus on activities that promote positive and constructive changes to her brain structure."