How many times have you had that awkward moment - you meet someone that you haven't seen for some time, and for some reason, you just can't remember their name. For cancer patients undergoing chemotherapy, this happens more than we'd like to admit. It used to sort of a patient's joke about having "chemobrain" as a way to explain a little forgetfulness, but studies done in the past few years have documented effects of chemotherapy on the frontal cortex of the brain. There isn't a lot of data on this - the few studies out there have been done with breast cancer patients - they tend to live longer and hence are a better study population than patients with other forms of cancer. It's not clear which part of the overall regimen is responsible for the interference with the frontal cortex - it could be any of a number of things that have managed to cross the blood/brain interface. 
It could be the cytotoxic chemo drugs that kill actively growing cells; it could be the steroids or other meds given to minimize the side effects; it could be from a combination of these and other drugs administered. For women, it may also be an interaction between hormone changes with menopause interacting with the drugs as well. For patients with extreme fatigue, it may be confounded with altered sleeping patterns. Whatever the precise reason(s), it can mean problems with learning new tasks, performing multiple tasks simultaneously and short term memory loss. The good news is that there is at least one study that indicates that this condition may be reversible to some exent when treatment is completed. I hope they're right.I'm sure that chemo has probably affected me to some extent. I find myself struggling sometimes at work and in social situations to come up with names of people that I don't interact with on a regular basis or sometimes with people I've recently been introduced to. I probably owe an apology or two out there when I've failed to make proper introductions, but I just drew a blank with your first name, or last name or both. If you give me a minute, you might be able to imagine my short-circuited brain trying to feverishly reconstruct our relationship in the convoluted manner that helps me figure it out:
- I worked with you or someone in your work group on a certain project that triggers a series of relationships that associate you with perhaps as many as three or four people before I figure it out again. I know you from church because your child was in a Sunday school class that my daughter helps out in or that my wife had you volunteer to be a Sunday school teacher, so I try to associate you through a relative.
- You used to ride on my vanpool, so I sneak a peak an old email or ridership report (I still do the bookkeeping on my vanpool, so I have records that go back for a long time).
- Old saved email works great for tracing old threads of
conversations that help remember your name. - I should send a Christmas card to the folks at Google - they've saved my butt a few times.
- I write down lot more things in my desk journal at work.
- I try to put reminders on my schedule to make sure I don't forget things.
- I make checklists.
- I try to keep my brain working constantly - I may not be physically as able I used to be, I can't afford to lose the brain too because I won't get by on my good looks (you've already heard my whine about the various attractive rashes from the Erbitux).
They all help, along with a healthy dose of fear that I'll drop the ball on something or someone important. I hope that people will understand - I don't want to use it as a blanket excuse for not pulling my share of work and responsibility, but sometimes it takes me just a little longer. Thanks for your patience.
