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For Some Breast Cancer Survivors, the Battle Continues

CHICAGO, Ill. (Oct. 21, 2013)—When Catherine Ross was diagnosed with breast cancer in 1994—and again in 2002—she knew what was ahead of her: procedures, chemotherapy, and strong prescription drugs. What she did not expect were the side effects of the treatments, including a cognitive condition that some call “chemo brain.”

“There are still things I can’t do. I find when I’m talking, I have to force myself to concentrate on what I’m saying. It’s hard to remember what I’ve said to someone, and I can feel that my thinking pattern is a little off,” says Ross, now 57, adding that her cancer treatment has affected her short-term memory, writing, and spelling. “One day at work, I was struggling to put my empty lunch containers back into my lunch bag when a co-worker suggested I put them inside of each other. I just laughed because it’s something I would have automatically done before my chemotherapy.”

With the help of two occupational therapists, Ross is working to manage the cognitive setbacks of her treatment and the painful lymphedema she has as a result of lymph node removal. Occupational therapy practitioners work with patients at various stages of the breast cancer diagnosis to address the physical, emotional, and cognitive implications associated with chemotherapy, radiation, and/or surgery which can result in the decreased ability to engage in daily activities and tasks.

A pilot program called “Take Action,” is a new occupational therapy program for breast cancer survivors in the survivorship phase of care that addresses the cognitive effects of chemotherapy and other late effects of cancer treatments on daily life. The research program was developed by Robin Newman, OTD, OTR/L, CLT, CDRS, clinical assistant professor of occupational therapy at the University of Illinois at Chicago and occupational therapist at NorthShore University HealthSystem, after encountering numerous clients with similar cognitive symptoms resulting from breast cancer treatment.

“For many people, a breast cancer diagnosis can come when they are parenting or working and may experience significant functional limitations associated with the aggressive treatments,” said Newman. “When treatment is over, the battle continues. Breast cancer survivors often experience unique occupational challenges in self-care, work, and leisure activities. We help them figure out how to adjust to the cognitive and physical changes they are experiencing.”

Newman said that Ross is not alone in her “chemo brain” symptoms. Group participants expressed fears of driving on the expressway, noticed they could not keep up in conversations with co-workers, one teacher had trouble thinking through a lesson plan, concentration, and communicating with family members that they are not back to normal even though treatment may have ended months ago.

Driving, cooking, exercising, making lists, adjusting priorities, and time management present challenges.

“For some breast cancer survivors, daily tasks such preparing a meal can be overwhelming. We worked on ways to break down the tasks into steps like going to the grocery store one day and saving the food prep and cooking for the next day, when possible. Planning tasks ahead of time and turning them into achievable goals makes them less threatening,” said Newman. “It’s all about adjusting the expectations you have of yourself. Many cancer survivors feel the need to be back to who they were and that doesn’t always happen. It’s about rediscovering who they are now and being OK with that.”

Founded in 1917, the American Occupational Therapy Association (AOTA) represents the professional interests and concerns of more than 140,000 occupational therapists, assistants, and students nationwide. The Association educates the public and advances the profession of occupational therapy by providing resources, setting standards including accreditations, and serving as an advocate to improve health care. Based in Bethesda, Md., AOTA's major programs and activities are directed toward promoting the professional development of its members and assuring consumer access to quality services so patients can maximize their individual potential. For more information, go to www.aota.org.

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To schedule an interview with Robin Newman or Catherine Ross, or to learn more about occupational therapy’s role in breast cancer recovery, call AOTA Media Relations Manager Katie Riley, 301-652-6611, ext. 2963 or e-mail, kriley@aota.org or visit www.aota.org.