Dr. Ruham Nasany, medical director of the neuro-oncology program, joins the pink champions support group to talk about "chemo brain”

Introduction:

Dr. Ruham Nasany is a neuro-oncologist who joined Upstate University Hospital and Cancer Center in Syracuse, New York in 2020 as the medical director of the neuro-oncology and brain tumor multidisciplinary program and assistant professor in the department of neurology. She is dual board certified in neurology and neuro-oncology.

Neuro-oncologists like Dr. Ruham Nasany have training in neurology as well as in oncology which put them in a unique position that allows them to treat cancers involving the nervous system (brain tumors, spinal cord tumors, and peripheral nerves tumors) as well as neurological complications attributed to different types of cancer and the different treatment modalities used to treat those cancers including chemotherapy, radiation therapy, and immunotherapy.

Pink Champions is a breast cancer support group based out of Upstate Cancer Center with the mission of supporting the breast cancer cause. They hold monthly meetings that include networking, support, education, advocacy, awareness and fun for breast cancer patients, survivors, and their caregivers.

Dr. Ruham Nasany met with the pink champion group on September 8th, 2021 to lead the discussion on the topic of choice for that month; “chemo brain". The group shared their personal experience with "chemo brain" and asked questions regarding its definition, cause, and ways of management.

What is chemo brain?

Chemo brain is a common phenomenon experienced by many cancer patients undergoing chemotherapy, explained Dr. Nasany. Many describe it as a decrease in mental “sharpness”, however, symptoms such as confusion, fogginess, difficulty in multi-tasking, and word finding difficulties are also described.

Dr. Nasany shared with the group that while there isn’t one test that can diagnose this condition, the clinical presentation can be enough for the provider to identify the problem.

What are the causes for chemo brain?

Dr. Ruham Nasany explained that while the exact cause of “chemo brain” is unknown, there are many factors that can attribute to it. Dr Nasany listed some of these risk factors:

• Metastatic cancer involving the brain.

• Certain chemotherapy agents with high toxicity rates.

• Older age.

• Radiation therapy to the brain.

• Longer course of disease and treatment leading to more exposure to chemotherapy.

Is everyone’s experience the same?

Dr Nasany shared with the group that while some of the symptoms sound similar, everyone’s experience might be slightly different. The severity of these symptoms and their duration can vary as well.

While some patients can continue to carry on their normal lives with minimal interruption, others might need to put in extra effort to get some tasks done and might even need more help from others.

Is chemo brain a treatable condition?

While there is no clear medication or method to treat chemo brain, neuro-oncologists do recommend regular exercise, keeping a healthy diet, and meditating as ways to help patients through their symptoms.

There are some medications that have been suggested to help with chemo brain as well with various results when tested in the past, and the patients can discuss these with their doctors to see whether they would benefit from them depending on their individual needs.

Cognitive rehabilitation is another method that helps patients in their recovery and is offered at Upstate University Hospital and other academic institutions.

Dr Nasany advised that it might take up to a year after the completion of chemo for the patients to feel close to their normal selves, however, studies have showed that there is a percentage of patients who continue to deal with some of these symptoms to a degree for a long time afterwards.

For these patients, Dr. Nasany advised to talk to their providers who can refer them to multitude of services who can help them in managing their symptoms, including neuro-oncology here at Upstate Cancer Center.