Memory and concentration problems ('chemo brain')
Some people have memory or thinking problems during or after their cancer treatment. This is sometimes called ‘chemo brain’ or ‘brain fog’. Most people’s symptoms improve after their treatment is over, though for other people these changes can last a long time.
What is ‘chemo brain’?
Memory or thinking problems that happen during or after cancer treatment is sometimes called ‘chemo brain’ or ‘brain fog’. The medical term is cancer-related cognitive impairment. It is often called ‘chemo brain’ because the symptoms were first linked to chemotherapy. But these changes can also affect people with cancer who have not had chemotherapy.
What causes it?
‘Chemo brain’ can be caused by cancer itself, by the treatment, or both. Different kinds of treatments can cause these problems. Other factors include:
- Genetics
- Age
- Your other health conditions
- Medications you are taking
- Psychological factors, like anxiety or depression
What are the symptoms?
People who have memory and thinking problems caused by cancer or treatment often say they feel less ‘sharp’ than usual. Other symptoms of ‘chemo brain’ can include:
- Finding it hard to concentrate or focus
- Feeling confused
- Feeling like your brain is foggy
- Trouble remembering things
- Struggling to find the right word or to finish a sentence
- Finding it hard to multi-task or do more than one thing at a time
- Struggling to learn new things
- Taking longer than usual to do everyday things
- Feeling mentally slower than usual
- Confusing dates and appointments
- Misplacing objects
These symptoms can be upsetting and frustrating and can make it harder for you to carry on with your day-to-day life.
Memory and thinking changes or ‘chemo brain’ can be linked to fatigue (extreme tiredness), which is very common symptom with cancer. Many people find that chemo brain is worse when they are more tired.
Will I have ‘chemo brain’?
It’s different for everyone and it’s hard to predict how your thinking and memory might be affected or how long this will last.
These changes can happen at different times when you have cancer: before, during, and after cancer treatment.
Some studies have found that memory and thinking problems happen in up to 1 in 3 people with cancer before treatment, up to 3 in 4 people during treatment, and more than 1 in 3 people after completing their treatment.
How long does ‘chemo brain’ last?
For many people, ‘chemo brain’ improves after treatment. For others, it can take some time – even a few years – after treatment is complete.
Most people recover a lot of their memory and thinking skills, like planning and organising, within 5 years after their treatment. Some skills can take longer to recover, like verbal recall (when you can’t remember a word and it is ‘at the tip of your tongue’).
Can I prevent ‘chemo brain’?
There is no guaranteed way to prevent chemo brain or cancer-related cognitive changes, but some strategies may help reduce the risk and improve the symptoms. These include brain training, meditation and mindfulness, and exercise.
We have some tips below for improving ‘chemo brain’.
There is no evidence that any vitamins or supplements can prevent ‘chemo brain’. Always check with your doctor before taking any vitamins, supplements or herbal medicines because some of these may not be safe for you or may interact with your cancer treatment.
What should I do if I have ‘chemo brain’?
Let your doctor know if you have any of these problems. They can suggest ways to cope or they may prescribe medication, such as steroids, that may improve your symptoms.
Even if a symptom is not troubling you too much, it’s still best to let your medical team know how you’re feeling, as it may be a symptom of something else. For example, brain fog or fatigue may be a sign that your red blood cell count is low or that your treatment is affecting your hormone levels. If this is the case, there may be a treatment to help you feel better.
Talking to your medical team or doctor
- Make a record of what changes are happening, the time of day, whether anything seems to make them better or worse, and how badly they are affecting you.
- Write down questions to ask your doctor in advance.
- Take someone with you to help: a friend or family member could help you remember what you wanted to say, and keep notes on what the doctor said.
Tips for improving and coping with ‘chemo brain’
Tips for improving ‘chemo brain’
You can help improve your memory and thinking problems using:
- Exercise: This can increase circulation and oxygen in the brain. Exercise can also help to reduce stress and help you to feel better in yourself. Some studies suggest exercise may improve cognitive function and reduce symptoms.
- A healthy, balanced diet. You might find it more difficult to concentrate if you’re hungry.
- Brain training: Doing memory and thinking exercises and puzzles or trying to learn a new skill (like a new language or musical instrument) may help to keep your brain sharper. Staying mentally active, taking notes, and reading daily can help.
- Complementary therapies like art therapy or meditation.
- Cognitive treatments: Your doctor may recommend treatments like cognitive behavioural therapy, psychotherapy, or cognitive rehabilitation.
- Relaxation and good sleep habits: Being stressed or over-tired can make memory and thinking problems worse. Get enough rest and try stress-relief techniques such as meditation or massage. Some local cancer support centres have sessions where you can learn stress-relieving techniques such as mindfulness and meditation.
Tips for coping with ‘chemo brain’
- Writing notes or putting reminders on your phone can help you to remember things, such as important dates, appointments, things you need to do and phone numbers and addresses.
- Journaling: Keeping a diary could help you to remember what has happened.
- Take breaks to make sure you’re rested. Fatigue can make chemo brain symptoms worse.
- Avoid multi-tasking and focus on one thing at a time
- Ask your family and friends for help.
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