Never is the true essence of the human experience brought into higher relief than in the setting of cognitive impairment. The margin of error is slim in that even minor lapses – word finding, forgetfulness, slowed processing speed, naming errors – can impact one’s quality of life tremendously. “Chemobrain” is a once-dismissed, now widely acknowledged and often persistent side effect of chemotherapy. Associated brain changes have been seen on a morphological and functional level, in primarily the frontal and hippocampal regions – these are some pretty important areas! Whether the result of direct neurotoxic effect or indirect damage through oxidative stress (increased production of reactive oxygen species which damage mitochondria and delicate lipids), or potentially related to pro-inflammatory cytokines in the setting of malignancy, the etiology remains to be clarified. The brain, at 60% lipid content, primarily polyunsaturated fats, is a clear target for the pro-oxidant effects of both chemotherapy and radiation.
Once again, some researchers are looking back to nature to undo some of these toxic effects through the application of antioxidant supplements and anti-inflammatory lifestyle measures. In this way, foods grown in conditions that promote their native antioxidant properties (think organic) confer these benefits to an inflamed system.
In pre-clinical studies, pre-exposure treatment with gamma glutamyl cysteine ethyl ester (a glutathione precursor), zinc sulfate, or N-acetylcysteine appeared to protect against these neurotoxic effects. Relatedly, an 8-week yoga intervention was found to mitigate cognitive complaints and impairments 6 months after chemotherapy in breast cancer survivors. It stands to reason that the general tenets of Functional Medicine would apply to this allopathic quandary as well – if we accept the indication for chemotherapy and its attendant toxicity, how can we work to unburden the body of further demands on the system (environmental, dietary, psychosocial) and use diet, behavior, and spirit to restore balance. Then, we won’t have to ask, “survival, but at what cost?”