Integrated Approach to Neurological Complications

An integrated approach is essential to addressing all the challenges unique to neurological cancers and conditions. In addition to your conventional treatments, behavioral strategies, lifestyle alterations, and nutritional, physical and emotional support, are all essential components of care.

Rehabilitation therapy, in particular, can help improve cognitive function, communication skills and physical performance. For example, physical therapy can help rebuild strength, improve coordination and balance, and restore mobility. Occupational therapy can help with performing everyday activities, like getting dressed, grooming, bathing and eating. Speech-language pathology can help improve speech, cognition, and swallowing problems that may limit your ability to eat and drink safely.

Overcoming Neurological Limitations

Naturally, it can be difficult to adjust to neurological impairments. Changes in cognitive and physical function can be upsetting, frustrating and scary. In addition to interventions from your cancer team, there are ways you can help yourself so you can continue to participate in important areas of your life.

NOTE: THIS INFORMATION IS NOT INTENDED NOR IMPLIED TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. YOU SHOULD ALWAYS REPORT ANY NEUROLOGICAL PROBLEMS TO YOUR PHYSICIAN IMMEDIATELY.

12 Tips for Managing Cancer-Related Neurological Dysfunction

• Give yourself time. It takes time for the brain to heal, and it takes time to learn new ways to do familiar things. Try to think through tasks and complete one before beginning another. If you become confused, take a break and return to it later. Go easy on yourself if your physical abilities aren’t the same as they used to be. Start out slowly and build up gradually.
• Create structure. By creating structure, you can remove obstacles to remembering. Establish a daily routine and keep the same schedule each day. Divide tasks into manageable parts and do chores in the same order. Create an organized environment free of clutter. Keep commonly misplaced items, such as keys, in the same place.
• Reduce distractions. We often do one thing while thinking about another. When you need to complete tasks that require concentration, try to minimize distractions. Work and read in a quiet, uncluttered environment. Try to recognize and address internal distractions, such as thoughts, hunger and fatigue as well. If you find yourself losing focus, move onto something else or take a short walk.
• Make reminders for yourself. Make a checklist of daily chores, errands and important things to remember. Use a pill box to keep track of medications. Write your appointments in a calendar and put it somewhere visible (e.g., on your refrigerator).Carry a daily planner or notebook with you. Place post-it notes around your house, or leave yourself voice mail messages as reminders.
• Try cognitive retraining exercises. To sharpen your memory and concentration, try learning a new skill, taking a class, or doing crossword puzzles or other games. When reading, use a pencil or highlighter to increase your active involvement. Use auditory cues by repeating information (e.g., a person’s name) out loud. Use memory techniques like acronyms, rhymes and word play.
• Prioritize activities. You may be trying to keep up with your former routine, which can create frustration. Instead, try shorter, easier versions of the activities you enjoy. Prioritize tasks so you have energy to do the most important ones first. Set goals for the day/week and record your progress. Remember to pace yourself and take time out to rest.
• Use assistive devices. Assistive devices (e.g., canes, walkers, braces, splints, orthopedic shoes, etc.) can promote independence and compensate for muscle weakness, poor balance and neuropathy. Use button hooks, ring and zipper pulls, in-step supports for shoes, and cuff and collar extenders. A long-handled reacher can help you retrieve items on high shelves and pick up objects that fall to the floor.
• Establish a safe home environment. Modify your home to prevent falls and other injuries. Keep rooms, hallways and stairways well lit, and use a night lights. Install handrails on stairways and cover your stairs with a non-slip surface or safety treads. Remove small rugs and other clutter that could cause falls. Install grab bars in the shower and lay down skid-free mats. Secure extension cords along the edge of the floor.
• Be aware of limitations. Neurological complications, like peripheral neuropathy, can cause a lack of pain sensation. Use potholders while cooking, rubber gloves when washing dishes, and shield your fingers while cutting foods. Also, be careful when driving. Make sure you can fully feel the steering wheel, gas and brake pedals, and you can quickly move your foot from the gas to the brake.
• Get healthy in other areas. Proper sleep, exercise, diet, and stress management are all important in rebuilding cognitive and physical skills. Exercise can build muscle strength and improve concentration. A well-balanced diet with proper hydration can help reduce fatigue and build mental stamina. Relaxation techniques like yoga and light stretching may improve mental clarity and reduce emotional distress.
• Be open with your cancer team. Keep your cancer team informed about any changes in your thinking, memory, behavior and physical performance, including when symptoms began, what time of day they occur, etc. With this information, your doctor may be able to eliminate factors that are contributing to neurological problems, such as certain medications, or recommend supportive resources.
• Seek emotional support. Dealing with neurological dysfunction can be a long, frustrating and emotional process. You may feel upset if recovery is slow or if symptoms don't improve. Be open with your family and friends about how you’re feeling. You may also decide to meet with a counselor or join a support group.

NOTE: THIS INFORMATION IS NOT INTENDED NOR IMPLIED TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTHCARE PROVIDER REGARDING ANY NEUROLOGICAL PROBLEMS YOU MAY BE EXPERIENCING.

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I hope this information has helped you in some way. I will check in with you again next month.