Evidence Update: Chemobrain & Breast Cancer
…Not Your Imagination Cognitive impairment, often termed “chemobrain”, occurs in 10-40% of all cancer patients, and is an emerging target of cancer survivorship research. A recent study reviewed published studies to explore the impact of chemobrain on the quality of life of breast cancer survivors. The authors reviewed 457 papers, and found 7 studies that were relevant to breast cancer survivors and met their study requirements. Using a systematic approach, data from the 7 studies was extracted and then synthesized. The authors found that chemobrain, or mild cognitive impairment, is commonly reported by breast cancer survivors who receive chemotherapy. Women report chemobrain to be a struggle with short and long term memory, information processing speed, attention span, concentration and language skills. The experience may be compounded by fatigue, mood changes, change in hormonal or menopausal status and lack of social support. Breast cancer survivors describe chemobrain as frustrating, upsetting and frightening. Most report that the onset is during chemotherapy, and most reported that they continue to have issues after completion of treatment. Chemobrain affects all aspects of life, including roles at home and at work and in social situations. Breast cancer patients often found healthcare providers to be insensitive and they did not validate women’s experiences with chemobrain. Patients suggest that more support would have helped them recognize and prepare for cognitive changes. Instead, women were left to find their own strategies to help them cope with daily living and work function, including opting for healthy lifestyle, physical and mental activities, practical reminders, technology. Current research on women’s experiences with chemobrain provides consistent support that it is real, persistent and has detrimental impacts on quality of life. The authors conclude that a greater awareness of the effects of chemobrain with improved functional assessment and interventions is warranted. Having problems with chemobrain? Talk to our TurningPoint counselor to develop a plan to manage the impact of chemobrain on your life! Selamat, MH et al. Chemobrain experienced by breast cancer survivors: a meta-ethnography study investigating research and care implications. PLoS One. 2014 Sep 26;9(9):e108002. doi: 10.1371/journal.pone.0108002. eCollection 2014.
May Patient Perspective
Lynn Stoudt It was still a very surreal moment when I was told that I had breast cancer, despite having multiple biopsies over the past 20 years. The next 6 weeks I was overwhelmed with appointments, procedures and decisions about my treatment plan and surgeon while still trying to function at work and home. I was incredibly fortunate to have family, friends, neighbors and colleagues that supported me in so many ways – meals, calls, cards, surprise packages, flowers, and visits. My daughter from San Francisco flew home to help. Among my siblings, I have a set of younger twin sisters who really stepped up with a game plan to give me something to look forward to upon completion of every stage of the process, including trips to the beach and Disneyland. Post-surgery, I had a lot of difficulty with range of motion and pain. While I had excellent treatment and care from my surgeon and health care providers, this did not seem to be a focus, and I assumed it was the “new normal”. At my last follow up, I expressed frustration with this to my surgeon, and he referred me for Physical Therapy. Having had PT for frozen shoulders before, I was skeptical as I was already trying some of those exercises without success – but my sister who is a Physical Therapist in Alabama suggested researching PT specialties – and I was incredibly fortunate to find TurningPoint. I sent her the link along with a couple of others that were closer to home, and she was very impressed with TurningPoint’s experience and focus and insisted this was the place to be! I am so grateful for the treatment and encouragement I have received from everyone at TurningPoint, but especially my PT team of Anita and Lauren. They always know exactly what to do to keep me progressing along. Now, instead of constant pain, I have infrequent pain, and I know what stretches to perform to get fast improvement. My range of motion is so much better that I no longer feel limited in daily activities. I actually feel stronger now than before I was diagnosed because I am actively focused on stretching and strengthening. I am able to enjoy life more because I have more energy. With the motivation and preparation of my TurningPoint team and my athletic and competitive (unlike me) twin sisters, I completed a 5K in January. My sisters’ first 15K of 2015 was the Hot Chocolate Race in Atlanta – given that I love chocolate, and the reward at the end of the race is a mug of hot chocolate, and a bowl of chocolate fondue with various items to dip in it – I figured what better event for me to try to participate in, and signed up for the 5K. We had a lot of fun preparing for the event and I was able to stay on the required pace of 15 minute miles – and in fact was by no means the last one to finish! I also took my first yoga class recently and am looking forward to practicing weekly! Through the motivation and success of my TurningPoint treatments, I am now enjoying my work-life balance by adding new activities to my schedule. Coming to TurningPoint has literally been a life changer for me!
Nutrition Q&A: “Super” grains
Q: I know that quinoa is one of the new “super” grains, but I have yet to find a recipe that I like. Do you have a favorite you can share? A: While quinoa is considered a whole grain, it is actually a seed. This nutty flavored seed can be prepared like whole grains such as rice or barley and has the highest protein content of the “whole grain” family. The following recipe is one of my favorites from Ellie Krieger, Registered Dietitian, and host of the Food Network Show Healthy Appetite. It’s quick and easy and is delicious hot or cold. Quinoa Pilaf with Pine Nuts Ingredients: 2 Cups low-sodium chicken/vegetable broth 1 Cup quinoa, rinsed ¼ cup pine nuts 1 Tablespoon olive oil ½ large onion, chopped 1/3 cup chopped fresh parsley leaves Salt and pepper Directions: Put broth and quinoa in a medium saucepan and bring to a boil. Reduce heat to a simmer, cover and cook 15-20 minutes, until liquid is absorbed and grain is tender. Meanwhile, toast the nuts in a dry skillet over medium-high heat until golden brown and fragrant, stir frequently. Remove nuts from pan and set aside. Heat oil in the same skillet over medium high heat. Saute onions, stirring occasionally, until the onions soften and begin to brown, about 6 minutes. When the quinoa is done, fluff with a fork and transfer to a large serving bowl. Stir in the pine nuts and onion, and season with parsley, salt, pepper and serve. Download this recipe here
Evidence Update: The Benefits of Massage for Patients with Breast Cancer
A systematic review of 203 research articles related to the usefulness of complementary therapies to manage treatment side effects and improve quality of life was published recently in the Journal of the National Cancer Institute Monographs. The study found that there is substantial research to support the benefits of massage, yoga and energy conservation techniques for stress reduction, anxiety, depression, fatigue and improved quality of life. The report concludes that these interventions are safe, effective and useful to be included in clinical practice guidelines. Massage therapy has been shown to be a benefit to breast cancer survivors, and the benefits last long after the massage session. This month, TurningPoint’s massage therapists, who are experts in the field of massage for patients going through breast cancer treatment, will lead an interesting and informative education event on massage and breast cancer Greenlee et al. Clinical practice guidelines on the use of integrative therapies as supportive care in patients treated for breast cancer. J Natl Cancer Inst Monogr. 2014 Nov;2014(50):346-58.
