Memory and Cognitive Changes

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Now is the time to think about thinking. Cognitive abilities - your capacity to think, reason, and process information - can be affected by a tumor and its treatment. The location of the tumor, the protocols used to treat it, and your unique physiology will all play a part in whether cognitive ability is affected, how severely it is affected, and which therapies can be used to overcome any impairment.

 

Separate from reasoning and thinking is memory that can also be impacted by tumors and treatment. Memory and cognitive ability support each other and if one is impaired the other is also affected. 

 

There are two different kinds of memory. Short-term memory serves as a holding tank for information for only a couple of seconds. Long-term memory stores information in your infinite personal archive, for later retrieval.  It is not uncommon to lose short-term memory function and still retain an excellent long-term memory. 

 

These are just a few of the things that can impact your cognitive and memory function:

  • The tumor. If it’s in your brain, chances are it will affect some function, either directly or indirectly.
  • Treatment. Surgery, radiation and chemotherapy can all interfere with your memory and your thinking/reasoning skills, at least temporarily.
  • Fatigue. One of the most common side effects of dealing with a tumor, major fatigue can deplete the energy required for thinking and remembering.
  • Medications. Even over-the-counter medications can affect your cognitive ability. It is important to review possible side effects of medications with your doctor.

There are many different ways your thinking and memory can be affected, so if you or a caregiver notices a change in the way you are handling information and day-to-day tasks, it is important to share the information with your doctor. Some examples of changes include:

  • Someone who used to have an impressive command of language now has trouble remembering the names for common objects such as the word “cup,” or other frequently used or simple words.
  • Asking what’s for dinner, and then asking again and again every five minutes as if it is a new question.
  • Losing the ability to read or recognize words or numbers on a page, inability to focus, inability to complete basic tasks or to follow simple instructions for example if someone needs coaching on how to put clothes in the hamper.
  • Trouble with motor skills, such as using silverware, buttoning clothes, or walking.
  • Changes in behavior and personality, such as sudden outbursts of anger or rudeness from a normally easygoing individual.

It is not uncommon for patients to feel frustrated, defensive and embarrassed about their reduced abilities. It is also not uncommon for caregivers to feel frustrated and helpless.  

 

Sometimes memory impairment is severe and sometimes it is not. Similarly, sometimes memory impairment is long-term and sometimes it is temporary. There is no one-size-fits-all solution, so it is essential to have a comprehensive assessment or evaluation. The assessment will help determine how your brain behavior has changed. Then it will be possible to determine which therapies might be most appropriate for you and your unique situation.

 

Assesment and Therapy

There many different names for memory therapies. You may see any or all of these terms in the course of your research and treatment:

  • Cognitive Rehabilitation Theory
  • Cognitive Retraining
  • Memory Retraining
  • Cognitive Rehabilitation
  • Teaching Memory Skills
  • Brain Injury Rehabilitation
  • Brain Therapy

All of these terms mean roughly the same thing: to teach or re-teach brain tumor patients thinking, reasoning or memory skills that may have been lost during the course of treatment. 

 

The therapies available to brain tumor patients are somewhat similar to the therapies used by those with brain injuries. However, recent research suggests that although intensive, aggressive therapy may be appropriate for brain injury patients, a lighter touch may yield better results when a brain tumor is involved. The first step in this process is to have an evaluation.

  1. Do your homework.  Ask a loved one or caregiver to help keep track of changes in your thinking, reasoning or memory abilities.  While it can always be difficult to remember all the questions you have for your doctor, it is even worse when possible memory impairment is involved. 
  2. See your doctor. After you’ve shared your list of concerns, the doctor can do a simple evaluation or refer you for a more thorough assessment. You may see a neuropsychologist or neurologist who is specifically trained in brain tumors or brain trauma and treatment.  

  3. Prepare for evaluation. You can’t study for an evaluation, although it’s not uncommon to try. Memorizing the date and the name of the president, trying to look “normal” as you walk or stand up – two standard challenges in a cognitive assessment – may actually work against you. You want the doctor to know about the cognitive challenges you are facing, so that the correct course of therapy is assigned to you. Just get a good night’s sleep and eat a well-balanced meal before your appointment. Wear comfortable clothing, and be sure to bring your list of difficulties with you. It is always helpful to have someone accompany you, another set of ears to hear and absorb what the doctor or clinician advises.

There are many different kinds of evaluations. Some can take up to eight hours and others are much shorter. The results will give the specialist an idea of what kind of damage your brain has experienced, and which course of therapy and rehabilitation will work best for you.

 

With the help of appropriate therapy, memory, thinking and physical skills may be retrieved.  While your skills may not be the same as before the tumor or treatment, the positive effects of therapy may help you feel more confident and may enhance your quality of life.

 

A neuropsychologist may be able to help with memory and cognitive changes. To learn, visit our neuropsychology page.