Prior to her treatment for breast cancer in 2015, Marty Oxford taught gifted elementary school students in first through fifth grades. Teaching was a passion for the Pine Mountain, Georgia, resident, but she had to put her three-decade career on hold while undergoing surgery and chemotherapy treatments.
She coped with the hair loss, the nausea, neuropathy and lymphedema. But what she didn’t understand was what was happening to her brain. During an appointment with her medical oncologist before starting radiation therapy, Oxford explained how returning to teaching, even part time, was proving to be a challenge. “I told him my brain wasn’t functioning the way it used to,” says Oxford, a patient at our hospital near Atlanta. “It was exhausting to work. It was difficult to plan what I was working on.”
Oxford’s doctor sent her for a consultation with Jennifer Cargile, a speech-language pathologist at our Atlanta-area hospital. “She said, ‘Let's talk about chemo brain,’” says Oxford. The American Cancer Society defines chemo brain as a decrease in mental sharpness and an inability to concentrate and remember details. A 2016 study, published in The Journal of Clinical Oncology, concluded that some breast cancer patients may experience chemo brain for months. Its symptoms include feelings of mental fogginess and forgetfulness.
“I asked what I needed to do to get past it,” says Oxford. “Jennifer taught me organization, the importance of rest and nutrition and pacing. I continued seeing her through my radiation treatments. As best I could, I used all the strategies she taught me. I was so happy. I felt like I had beaten this, and I was back to work, and everything was good.”
A short while later, Oxford realized she was still struggling with the haziness associated with chemo brain. “I would come home and basically not be good for anything else for the rest of the day,” she says. “I had used up all my mental and physical energy just to do my job.”
Oxford used her summer vacation in 2016 to rest, recoup and rebuild. But while preparing to get back to school that fall, she found she was still struggling with cognitive issues. “Spelling had always come naturally to me,” she says. “That was an area where I never had to think. I now commonly misspell words. When I am editing anything that I've written, I have to edit for spelling because I don't automatically have that in my mental toolbox.”
At Cargile’s suggestion, Oxford took several steps that helped reduce the signs of chemo brain, including:
- Stay rested - A lack of sleep may cause the body to become stressed, which may interfere with its ability to fight cancer.
- Maintain a healthy diet - A balanced diet consists of nutrient-rich foods and fiber while limiting fat and sugary foods.
- Mental activities - Designed to help increase memory functions, these exercises include ways to remember to-do lists and keep attention focused.
- Physical activity - Exercise may benefit cancer patients including reducing the symptoms of fatigue, helping with weight control and alleviating stress and anxiety.
Now that she’s back at school, Oxford is finding additional ways to battle the fog. In the classroom, as a back-up plan she keeps words and notes close by in case she loses focus or can’t immediately recall a word—getting the students to help her fill in the blanks. “I am fortunate that I have students who will just laugh it off or help me when I use the incorrect word,” she says. “My students were part of the process while going through cancer treatment, and so I've just explained this is part of how I am now, and sometimes it’s difficult. They respect that and are willing to help out when they can.”
Even with the extra help, Oxford says she’s made a difficult decision: She plans to retire from teaching in December. “I can’t teach the way that I used to,” she says. “Maybe there’s something for me to do that I can do more efficiently.” She and Cargile have discussed various professions that may be better suited to her new reality.
In the meantime, Oxford is participating in a monthly support group for patients experiencing chemo brain, and she says it’s helping. “The privilege of being in a room with other people who totally understand what you're talking about is wonderful,” she says. “It's a great opportunity to share advice and learn new ways to deal with chemo brain.”
This blog is an installment in a series called, “What I Wish I Knew,” which features cancer survivors who share what they learned from their cancer diagnosis and how it may have helped them in the beginning of their journey.
Learn more about coping with cognitive dysfunction.