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Cancer Treatment Tips

Chemo Brain: Memory and Concentration Problems

Cancer treatment can bring about various side effects including one referred to as chemo brain — a cognitive decline that may be experienced before, during, and/or after cancer treatment. Although this type of memory loss is called chemo brain, it can be caused by other cancer treatments, not just chemotherapy.

Often described as mental “cloudiness,” chemo brain can make it hard to focus, concentrate, learn a new skill, perform usual activities, and process or remember information. For most people it does improve over time after treatment is complete.

Many people don't tell their cancer care team about these problems until it affects their everyday life. In order to get the help and support you need, however, you should take time to let your cancer care team know if you notice any mental changes, no matter how small.

How Do You Know If You Have Chemo Brain?

Some examples of what patients with chemo brain may experience can include:

  • Memory lapses that involve forgetting even the simplest of things

  • Inability to concentrate

  • Trouble learning new things

  • Difficulty remembering details like names, dates, and sometimes larger events

  • Trouble multitasking (doing more than one thing at a time) compared to how you were able to function before treatment Being disorganized or taking longer to finish certain tasks due to slower thinking and processing

  • Difficulty remembering common words

The good news is that most patients notice the effects of chemo brain lessening after treatment. However, some may experience it for years, which can greatly affect a person’s life. When it starts, how long it lasts, and how much trouble it causes is different for every patient. Typically, these mental changes are subtle, often going unnoticed by other people, but can be frustrating, and even worrisome, for the patient.

What Causes Chemo Brain?

In short, there is no one specific cause of chemo brain. While it is most commonly associated with chemotherapy treatment, people who never had chemo have experienced the symptoms as well. For this reason, it has been suggested that it could be a combination of factors including:

  • Cancer treatment, such as chemotherapy, radiation therapy, hormone therapy, or targeted therapy

  • The cancer itself, for example, brain tumors

  • Hormone changes or hormone treatments

  • Age at the time of diagnosis

  • Surgery and the drugs used during surgery (anesthesia)

  • Infection

  • Other drugs used as part of treatment, such as steroids, anti-nausea, or pain medications

  • Other illnesses, such as high blood pressure and diabetes

  • Having other symptoms like tiredness, pain, or sleep problems

  • Emotional distress such as depression or anxiety

  • Being weak or frail

  • Being postmenopausal

  • Nutritional deficiencies

Most of these cause short-term problems, and get better as the underlying problem is treated or goes away. Others can lead to long-lasting brain problems unless the cause is treated.

Tips for Managing Chemo Brain

Typically, treatment for chemo brain involves learning how to manage the symptoms. With a little effort, you can sharpen your mental abilities and cope. Here are some tips to get you started:

  • Keep track of your schedule and create reminders on a planner, computer, or smartphone.

  • Get enough rest and sleep.

  • Knock out the most demanding tasks at the time of the day when you feel your energy levels are the highest.

  • Create a handy list that consists of important information such as phone numbers, addresses, meeting notes, and even movies or books you’re interested in.

  • Exercise your brain by taking a class, learning a new language, or engaging in word puzzles.

  • Stay physically active. Not only is it good for your body, it can improve your mood, make you feel more alert, and decrease tiredness (fatigue). Ask your oncologist what exercises would be best and if there are any you should avoid.

  • Add brain-boosting foods such as broccoli, beets, celery, and dark leafy greens to your diet.

  • Try not to multitask, but rather focus on one task at a time.

  • Set up and follow routines. Try to keep the same daily schedule.

  • Pick a certain place for commonly lost objects (like keys) and put them there each time.

  • Avoid alcohol and other agents that might change your mental state and sleeping patterns.

  • Keep track of your memory problems with a diary. Take note of when you notice problems and what’s going on at the time (medications that you’ve taken, time of day, situation, etc). Doing this can help make it easier for your doctor to find the root cause.

  • Ask for help when you need it and be sure to tell your friends and loved ones when you experience symptoms of chemo brain. Their support can be invaluable!

If you are experiencing long-term issues caused by chemo brain, your doctor might prescribe other methods to help you cope. This could include:

  • Cognitive rehabilitation and cognitive training, which can help improve cognitive skills and coping abilities.

  • Occupational therapy and vocational rehabilitation to help patients handle job-related skills and the activities of daily living.

  • Medications, such as antidepressants, stimulants, cognition-enhancing drugs, and drugs like morphine, which block how narcotics work.

When to Talk With Your Cancer Care Team

If you experience any symptoms of chemo brain, schedule an appointment so you can talk with your oncologist. Since he or she will want to know when the problems started and how they affect your daily life, it’s a good idea to make a note each time you experience issues.

Some questions you might want to ask your doctor could include:

  • Is my condition due to treatment or is it possibly caused by another medical problem?

  • Are there steps I can take to improve my memory or my ability to focus?

  • How long should I expect my symptoms to last? Is there treatment for my symptoms?

  • Would I benefit from participating in any type of therapy?

  • Should I see a specialist? If so, can you recommend one?

You might want to consider taking a friend or family member with you to help you keep track of what was said during the visit. They can also describe the mental changes they see in you from a different perspective if needed.

Can Chemo Brain Be Prevented?

Unfortunately, there is no known way to prevent the cognitive changes that cause chemo brain. However, this could change in the future once more research is done. For some people, treating their cancer will mean they might have trouble with thinking, memory, planning, and finding the right words. Chemo brain seems to happen more often in people who get high doses of chemo, and is more likely to happen if the brain is also treated with radiation therapy.