There are a number of studies looking at chemo-brain, it seems to be a real phenomenon but no one really has a handle on the cause. A study on breast cancer patients found that a very high percentage had actual brain shrinkage, in most cases this resolved in about three years. The women also had accompanying cognitive issues. It is not anemia nor is it due to pain medication, it is true "mild cognitive dysfunction" (or even worse) and can persist for some time, well after blood counts are restored and long after effects from pain medication persist. At a Hopkins Patients Education Day for head/neck cancer patients last April, many attending said they have had cognitive issues post-treatment. I know my husband has and he is in fact in a study looking at cognitive issues in people who have had various sorts of brain impacts (injury, dementia, cancer etc.)

As Gary says, the chemo drugs do not cross the blood-brain barrier (or are not supposed to) but a MO I spoke with says they are considering the possibility that some by-product of the drugs can reach the brain. In tissue culture cisplatin is more damaging to brain cells than to cancer cells, accordng to an abstract I read last summer.

In any case, a real mystery. Some people have had help from ADD drugs. Certainly "exercising" the brain helps and the neurologist Barry saw recommended Gary Small's books and also, doing tasks which challenge like Sudoku. Consider it part of the post-treatment therapy, along with swallowing exercises etc.

Gail