Today’s New York Times has published another of its fantastic articles about cancer and coping with cancer. Today’s article, written by Jane Brody, discusses chemo brain. Until a short time ago, many doctors denied that it even existed, but today it is pretty much accepted as being real.

One is said to suffer from chemo brain when the drugs and treatments for cancer impair cognitive abilities. Chemo brain may last for extended periods of time even after the treatment has stopped. Most of what is written about chemo brain is specific to ovarian and breast cancer, but as is the usual situation, prostate cancer treatment, specifically hormone therapy and Taxotere in men is not discussed.

Suffering with chemo brain is by itself is exhausting and scary. It is for many of us a life changing experience where we are faced with a host of new challenges and obstacles. Most of us are not warned about the possibility of having it, so not only are we forced to deal with the actual symptoms, but we are also scared that that we have developed another different medical problem, or perhaps developed a met in the brain.

When suffering with chemo brain we need to find ways to cope with our new reality and figure out how to get our lives back on track. It is clear that those of us who are aware about what we facing with chemo brain will not have to experience the panic caused by the thoughts of facing a new disease or a progression of our cancer. Schedules can be adjusted, we can get help from caretakers and colleagues and we can develop system interventions to mitigate the situation.

In Jane Brody’s NYT article, she offered a number of suggestions on how to deal with the effects of chemo brain. I want to share the “strategies for staying on track” that she wrote about.

“The symptoms of chemo brain — commonly mental fogginess that can cause problems with memory, concentration, word retrieval, number processing, following instructions and multitasking — are widely known. In addition, the effects, the causes of which are still unclear, are sometimes long lasting.

In an excellent new book, “Your Brain After Chemo,” Dr. Daniel H. Silverman and Idelle Davidson quote a 52-year-old woman who was treated four years ago with drugs and radiation for breast cancer:

“Ever since I got lost in the shopping mall garage and couldn’t find my car, I always write down the level number and color code, etc., on the back of my parking ticket,” she told the authors. “And I always place parking tickets in the same section of my purse so I know where to find them. For extra measure, I’ll play a word game. If I’m parked on B1, for example, I’ll make up a cue like: Be one with the universe.”

Dr. Silverman, a leading researcher in the field, and Ms. Davidson, a health journalist and former cancer patient, offer a long list of suggestions to help people who are struggling with the cognitive effects of chemotherapy. Even though I don’t have chemo brain, several of their tips already help me keep track of a complex life despite an aging memory. And while I’m not yet ready to buy a personal digital assistant, I plan to adopt several other strategies.

Prioritize. Because multitasking can be overwhelming to people with chemo brain, it helps to list tasks in order of their priority and concentrate on one at a time.

Develop routines. Prepare the night before for the next day. Review your calendar, lay out clothes, pack your briefcase, perhaps even set up breakfast and prepare a brown-bag lunch. Take medications and exercise at the same time each day.

Rehearse. On the way to a meeting where you will have to be on top of your game, visualize the room or the people who will be there and practice what you will say.

Use word associations or rhymes. Maybe Harry has lots of hair and Mrs. Gold lots of money. Perhaps your daughter-in-law’s birth date is 2-4-68 or the combination on your gym lock is 2 (times) 6 (equals) 12.

Rely on more than one sense. Try to link people and places with their scents, tastes, textures or unusual characteristics. Maybe Henry always wears a hat, or Rose’s front door is red.

Use a notebook to record information. My surroundings are covered with sticky notes, and I search frantically for something I know I wrote down somewhere. The authors suggest a single notebook so that everything is in one place, and dating the pages as you use them. They say, “This frees your desk and your mind from clutter.”

Post a checklist by the front door. Leave yourself a note of things to remember when you are going out — keys, wallet, walk the dog, close the windows, turn off the hose, check the faucets, lock the door.

Write phone numbers on your phones. It does not take chemo brain to forget a phone number, and I’ve noticed that many people don’t know their own cell phone number. Program as many contacts as you can into your cell phone, and keep a list of frequently dialed numbers next to your landline.

Use a day planner. Write down all appointments immediately, with times, places and contact phone numbers. If you spend most of the day at a computer, you can use the calendar feature that alerts you to appointments. As a backup, I record things on a wall calendar and keep a paper tickle file, but this works well only if you check it regularly.

Leave messages for yourself. If you have voice mail or an answering machine, you can use it to remind yourself of appointments or tasks you have to do. But again, this works only if you check it regularly.

Timers can be lifesavers. I never put anything on the stove, in the oven or on the grill without setting a timer to warn me when to turn the heat down or off. I also have several 24-hour timers that I use as a wake-up alarm and to remind me when to move the car, pick up the grandchildren at school or put the laundry in the dryer.

Get adequate rest. Even without chemo brain, fatigue is a memory destroyer. Don’t skimp on sleep, and when you feel your brain dragging, take a 20-minute nap. Stress impairs brain function, so practicing relaxation techniques like meditation and yoga can be very helpful as well.

Let Others Help

Finally, don’t bite off more than you can chew. Until and unless your brain recovers fully, simplify your life. Follow Mrs. Wick’s example if you can and reduce your workload or your hours. Perhaps even take a vacation or a leave of absence. Less work done well is better than a lot done poorly.

If those options seem like luxuries you cannot afford because you need to work, this is the time to rely on friends and family. Delegate chores. Say yes to people who offer to cook meals. Tell family members, especially, what coping tips you’re using so they don’t inadvertently derail your efforts. In as many ways as possible, give yourself a break.

For those who still claim that chemo brain is not an issue for men with advanced prostate cancer I will share a little about my personal experience.

1- I could not remember information I read from one day to the next. I was unable to follow a complex story line and I could not remember what the characters in a story did or thought from one reading to the next.

My solution – I gave up trying to read anything even slightly complex. I went to the bookstore and purchased an adolescent adventure novel (for about $4.95) about tall sailing ships and each night I read the first few chapters. Each night the story was refreshing, I could understand it and the story was brand new each night. I later told my wife that it was the best $4.95 I have ever spent!

2- I would go on the subway or in my car and half way to my destination; I realized that I no longer knew where I was going or why I was going.

My solution – I always wrote down on a piece of paper where I was going, how to get there and why I was going, so if I forgot I could easily look up the information as I traveled.

3- I would get on the subway and get confused on how to end up at my destination. I found I was unable to “see” the signs that said which train was an express and which was a local train, even though they were right in front of me.

My solution – I always carried a cell phone with my wife’s telephone number and my home number in an auto dial slot (I could not remember the numbers). I would call and describe to them what I saw and so they could give me specific instructions.

Chemo brain is real and men on hormone therapy or using Taxotere may suffer from it. Doctors need to warn their patients about the potential of experiencing chemo brain and we all need to figure out ways to cope with its effects.

Joel T Nowak MA, MSW