My family is very worried about my father's state of mind. Today is the last chemo treatment. He has throat cancer {inoperable} and has had chemo for eight months with thirty something radiation treatments over the summer. He is just the shell of the man he used to be. He reminds me of a very old man in a nursing home. Confused all the time, lots of blank stares. Is this normal? He hallucinates too. My mother fears the radiation and chemo has fried his brain. She says she is afraid he will never come back. Today starts the very last chemo and last radiation has been a month ago today. Will my dad come back? Is this temporary? Thanks for any input

Can you provide some more info about the drugs he is taking. Reading the bords here, hallucination (generally) seems to be tied to painkilllers, and changing them helped. Radiation (IMRT?), should not fry your brain, they avoid irradiating brain tissue. What chemo did he receive?
Radiation and chemo (especially for 8 month) really knocks you on your ass and it takes a long time to recover form this. This is not something that once the TX is done you pick up and go again...
From personal experience, after radiation (2 weeks) even a walk from garage to lab was a "death" march because I was that weak.
You also need to consider the emotional impact that this may have (depression etc). Many patients struggle with this in different forms.
I would definitely talk to his MO about this.

BEST

M

his chemos are taxatory[docetaxel] in combination with cisplatinum[tlatinol], and then he wears a pump for 5 days with fluorouracal[#5-fu]. These are the chemos he gets about a month apart. Started in April,2 before radiation and 2 after. Today starts the fourth.

He had 33 tx of radiation with 220 rads in each tx to his neck. He also had 7 treatments of carboplatin during the radiation.

For meds now, he takes hctz 25mg x1 a day
tenormin 50 mg x1 day
asprin 81mg x1 day
zytorin 10-40 mg x1 day
pilocartine 5mg x3 day

He has not had any vicodin for 2 weeks. I hope you can make since of my above post. It was like dictating a foreign language. This is so scary... The MO says this is normal to be out of sorts. But that just isnt reassuring when he doesnt seem to be in this reality anymore.

Blui

Looks very similar to the chemo regiment I had, however I only had three rounds so I can only imagine what 8 months would do. That amount of chemo would certainly tend to knock you on your ass.

Over the past few years a lesser-known side effect the cognitive dysfunction commonly called "chemo-brain" has been getting more attention from patients and doctors.

People who have chemo-brain sometimes find themselves unable to concentrate on their work, or unable to juggle multiple tasks. Some find they do not remember things as well as they used to.

Chemo-brain is frustrating because you find yourself unable to accomplish even simple tasks taht before treatment were easy. It seems to be a mystery to doctors as well, who are still trying to understand what causes it and who is likely to suffer.

Hope this information helps.

Kevin

That sounds like a very aggressive chemo regime and I would expect could contribute to cognitive difficulties. Also to be considered is your Dad's age and how he copes with stress in general. The stress of the diagnosis of cancer combined with the stress of all the treatments would be enough to send many off the rails physically and mentally. My husband 67 yrs. old, went through periods of hallucinating, nightmares etc. both during treatment and after, and still does dream a lot and talk out in his sleep. He is 8 months post treatment now and his depression is just beginning to lift.
Hopefully as your Dad is finished treatment he will gradually make his way back to his old self, but be patient as it is a long slow road at times.

While I forget things and get easily distracted, my math skills are sharper than ever. I think I got chemo-brain from the chemo, but I think the radiation honed my adding skills(work-related).

My treatment consisted of 14 weeks of chemotherapy, with radiation the last 7. A couple of weeks into the radiation, I began to feel very spaced out, almost in a twilight zone. And I wasn't taking any painkillers. Much of the time, I just wanted to be left alone.

I think the total treatment experience is very disorienting. I did gradually come out of it after treatment ended, and now 9 months later I feel much more like my old self. So I would expect your Dad to bounce back some, but it probably will be slow going.

I have heard (and used "chemo" brain a few times myself) but the fact is that there is a "blood brain barrier" that keeps chemo drugs out of the brain. More than likely it's pain medication combined with poor nutrition and dehydration.

The radiation also takes out a lot of blood cells when they are being radiated passing through the carotid artery. So he is probably suffering from some anemia as well.

The body replaces the red blood cells every 120 days or so.

Most of us had the symptoms you describe. It was about a year or maybe more until I was fairly mentally recovered from the treatment.

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