"Double-Boarder" Triple ?

po18guy said:

Chemo brain = PTSD?

There is evidence being gathered that the condition known as "chemo brain" might actually be a form of PTSD from the trauma of a cancer diagnosis. There is only one chemotherapy drug which is known to cross the blood-brain barrier (Methotrexate) and most cancer patients do not receive it.  So, if the chemotherapy drugs are not present in the brain, what is affecting it?

It seems reasonable that psychological trauma may indeed be the cause. A very interesting subject, as many chemo brain patients may feel that there is nothing they can do about their situation. Reports such as this tend to indicate that there may indeed be some action that would help them.

Po,

I would think that a PTSD-chemo brain link very possible. But I feel chemo brain is most likely a composite of extreme sickness, harsh chemicals, and fear all rolled up into a nighmare.   I had chemo brain pretty bad:  no alterness, poor concentration, fatigue, poor memory.  Irritability when people would get irritable at me for not communicating well.

During my month in ICU, I also had delirium for over a week, another condition related to PTSD or brain fog.  Clinical delirium is also known as ICU Psychosis, and occures due to extreme illness, massive drug application, and sensory depravation.  It also therefore occures in some torture victims.  I have observed men recently releasaed from military torture situations, and they they were clearly insane. Some recover, many do not. They are not highly valued by society or the medical community, and mostly get ignored and abandonded.   All of these conditions have to be related and share some causality.  It may be a bit morbid, but it is something I have studied and read about.  ICU Psychosis mostly is found in people who have died and recovered, or who were labelled in extremis, or "at the point of death," for long periods.

I was part of the nationwide study that approved Zoloft for PTSD; this was around 1996 or 1997. Zoloft had long before that been approved for major depression, of course.  Following my being crushed in the car accident and about a year of rehab, the intake doctor said I "more than qualified."   Flashbacks, startle reactions, recurring nightmares, fear in a car are all hallmark symptoms.  (SInce being ejected from the car, I have had three additional, major auto crashes. Most people can't pelieve I will even ride in aan automobile todAY.)  Zoloft was approved, and today is one of the most commonly perscribed PTSD drugs, but I found it of little use for PTSD or even depression.  For me, the SSRIs have never done much good.  Plus, I had major depression (formerly called "clinical depression") from my early teens, before any form of trauma or injury.

I view PTSD as more organic in causality:  I had organic brain damage from low oxygen and massive amounts of morphine thereafter.  I feel these elements are more substantial than purely psychological responses, although both are critical.  Many people in war or terrorism are not physically injured, but nonetheless get severe PTSD.

Certainly a serious cancer diagnosis, especially one in which treatement does not go well, can and should cause PTSD in at least some patients.

These factors are all inter-related. I do not see how one cause can be ferreted out from among a crowd and regarded as "the cause." The causes are many.  

This article says 33% of all patients in IUC over 3 days get ICU Psychosis.  I was there 25 days, most of the time on life support.  

https://www.medicinenet.com/script/main/art.asp?articlekey=7769 

max

Had my annual PSA blood draw to check for relapse of Prostate cancer (PCa) yesterday, thankfully negative.  Three years good.

Having PCa reinforced my awareness of how different cancers are; the verbage in PCa discussions shares almost none of the vocabulary with blood cancers.  My PCa struck about 4.5 years after the Lymphoma, and I began PCa study then, a whole new world, but I had been assisting an older friend with his PCa treatments for some time prior to thisb but he died of the disease about two years before I got it.  I had always taken him to the oncologists and did most of the speaking for him, since he was not very cognizant at that late stage.  This was very informative for me.  It is as if he taught me from the grave in a way....  Many said it was odd that after nursing him for a year as he died of PCa, I then shortly thereafter got it myself.  I value what I learned from him.

Following surgical removal of the prostate (one of the most common ways to seek first-line curative effect), if ANY PCA later shows, it is regarded as relapse.  There is then some chance of killing the micro-metastatic tumors, but Radiation Oncologists are mostly using educated guesses on where to radiate, because most PCa tumors are too small for CT or PET to detect, at least until they are grossly enlarged. Last I read, most CTs can't see a tumor under around 3-4 mm; my lung doctor told me this also when I was being tracked for a lung tumor a few years ago. That tumor was around 4 mm, and he said it just met the threshold for CT detectablilty (it later was clinically assessed as benign).  Most men who have positive biopsies of tumors still inside the gland show no reaction on PETs at all; biopsies randomly pull tissue samples from inside the gland guided by a quadrant matrix. Along these same lines, convention among urology oncologists says that for PSAs less than 10 (ten is a pretty high PSA), it is a waste of time to do any form of scanning, since CT, PET, and MRI very likely will show nothing.

Once PCa is metastatic at all, it is uncurable.  Hormonal treatments extend life for many men ten years or more at times, but very unlike Lymphoma, Stage 4 means "no cure, ever, with current medicine."

Another curosity is that chemo is NEVER curative of PCa.  It is used for pallative effect only, almost always Taxotere and Prednisone (the two most common chemos against BCa also).  Chemo against PCa is always last ditch, and usually won't prolong life for more than a year at most.  

ALL men over 50 should get an annual PSA test, which is cheap and painless.  Some authorities no longer recommend this, but they are bean counters.  My own family doctor told me to not get a biopsy based on my PSA, but I went to a urologist on my own, who said I needed one immediately, and I tested Stage II.  Get tested !  PCa also is virtually always symptomless until highly advanced, so no symptoms is no argument against testing either.

max