Why reading aloud?

Cancer fog, which is formally known as cancer-related cognitive impairment (CRCI), can occur before, during and after any treatment type, and it affects the complex networks of the brain[1], but it has also been shown to take its toll on the frontal lobe [2], which is the area responsible for executive functions, including – 

  • memory and concentration
  • keeping up with conversations
  • motivation and planning
  • reading and navigating.

Visual processing also happens in the frontal lobe. However, listening uses the temporal lobes, which are far less affected by cancer and its treatments. This might lead you to think listening to audiobooks when affected by cancer fog could be the answer, and it might be for some people, but it can also be extremely problematic.

Audiobooks are great, but they may not work for people with cancer fog because of the known difficulties operating technology[3,4] and the struggle with that frontal lobe motivation (i.e. motivaion to put an audiobook on in the first place). Additionally, fatigue can play a huge role during cancer treatment, regardless of the treatment type.

Other reasons for tailored, in-person reading in real-time, based on the findings of my research, include –

  • people loved that the reading was just for them
  • the story delivery can be personalised – louder parts when needed, pauses, etc. adjusted dynamically in response to the listener
  • the ability to share a laugh, express a sadness, or exclaim together
  • the lack of suitable, uplifting short format stories contained within an individual audiobook volume
  • a lack of confidence in keeping people reading/listening given motivation is generally affected by cancer fog
  • the warmth of human contact has been shown as advantageous in repeated studies
  • the only existing study of listening to imaginative literature used audio books and they had a huge drop-put rate.[5]

Participants in the study of reading for wellbeing during cancer treatment spoke of being read to –

  • it felt like a treat
  • contact with a person was better than a recording – even audiobook fans said this
  • it gave a sense of connection with an actual person by sharing the story
  • they couldn’t pause a person to go and do chores, and so it was an enforced relaxation time
  • they tried extra hard to concentrate out of respect for the person reading
  • stories were the focus of reading sessions, so there was no anxiety or awkwardness around what to talk about or pressure to make small talk
  • some people simply don’t like audio books
  • some likened it to a live performance, like the difference between going to see an orchestra and simply putting on a CD
  • it reminded some of happy times with parents or teachers reading aloud to them
  • you can’t talk to an audio book about the story at the end, and almost everyone wanted to talk about the stories!

Additionally, most people in the study indicated genre preferences (even if we based those on films they liked to watch because they weren’t readers), but they didn’t want to choose their own reading material. This meant that having someone come to read to them involved a sense of anticipation, wondering what would be read that day.   

  

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We’ve been telling each other stories for eons.

References

[1] Zhu, H., Lin, R., Wang, J., Ruan, S., Hu, T., Lei, Y., Ke, X., & Luo, H. (2024). Cognitive function and its associated factors among patients with cancer pain: A multicentre cross-sectional study in China. BMJ Open, 14(1), Article e071417. https://doi.org/10.1136/bmjopen-2022-071417

[2] Ahles, T. A., & Root, J. C. (2018). Cognitive effects of cancer and cancer treatments. Annual Review of Clinical Psychology, 14(1), 425-451. https://doi.org/10.1146/annurev-clinpsy-050817-084903

[3] Nelson, B. (2017). Clearing the fog around “chemobrain”: New research affirms the evidence for cancer‐related cognitive impairment and points toward triggers and treatments. Cancer Cytopathology., 125(7), 517-518. https://doi.org/10.1002/cncy.21891

[4] Nova Scotia Health. (2022). Cancer related brain fog. https://www.nshealth.ca/sites/nshealth.ca/files/patientinformation/nshccp4029.pdf

[5] Hammer, N. M., Egestad, L. K., Nielsen, S. G., Bjerre, E., Johansen, C., Egerod, I., Pinto, B., & Midtgaard, J. (2017). Feasibility and acceptability of active book clubs in cancer survivors–an explorative investigation. Acta Oncologica, 56(3), 471-478. https://doi.org/10.1080/0284186X.2016.1277036