Managing Treatments

Chemo Brain: How Chemotherapy Affects Your Mind

Sometimes it feels like chemotherapy goes straight to your head, causing forgetfulness and brain fog. However, there are things you can do to improve your mental function when you have "chemo brain." Try writing down your side effects as you experience them, and then share patterns with your care team.

Some call it chemo brain. Others call it chemo fog. It’s not just in your head! Whatever you name it, sometimes your treatment is followed by memory loss and a general mental fogginess that’s difficult to manage. Cancer treatment is tough already; adding in cognitive problems doesn’t help. The best way to combat these issues is to learn what’s going on and find the best coping method for you.

What Is Chemo Brain?

The term includes a long list of issues including memory problems or difficulty focusing during or after chemotherapy. According to the American Society of Clinical Oncology, up to 75 percent of people undergoing cancer treatment have cognitive issues during treatment and 35 percent have those problems for months after treatment ends.

While not everyone reacts the same way, some common side effects from cancer treatment include a short attention span, problems multitasking, difficulty concentrating or learning new skills, visual recall problems, confusion and disorganization. There’s no test to diagnose chemo brain, but your doctors may look for other causes to rule out, like an infection.

What Causes Chemo Brain?

Unfortunately, there’s no easy answer to point to, according to the Mayo Clinic. Possibilities include your cancer treatment itself. Complications like sleep troubles, pain, infection, fatigue or anemia can play with your brain and your mental stability. Emotions and mental health (anxiety and depression) might play a role too, as does medication use. It depends on what your treatment involves, so don’t be afraid to talk your doctor about your issues.

How Do You Manage It?

Jot down your symptoms in a journal, so you can show patterns and tell your doctor how it’s affecting you. The symptoms sometimes go away with time, but learning to cope with the changes is a positive treatment step.

A therapist or neuropsychologist can work with you on ways to adapt. That might mean trying memory exercises to retrain your brain. It might include planning harder tasks for after you’ve eaten or when you know you won’t be tired, to give it your best effort. If you’re having difficulty remembering things, it helps to give yourself reminders of tasks or list things you need to do on your phone or on a whiteboard. Some people find that putting notes around the house works for them, as does getting ready for the next day’s activities in advance.

You may find that stress makes remembering things more difficult. In that case, decreasing stress through relaxation techniques, like reading a good book or practicing mindfulness, helps. Designate some time during your day to do something peaceful, like a puzzle, to help decompress. Avoiding stressful situations is also a good idea. If you need to change your schedule or cut certain things out of your life to do that, you have a legitimate excuse.

What Are the Long-Term Effects?

You may continue to experience the chemo fog permanently. It could affect your future ability to work, but other people file for disability because of it, so that’s an option. If your mental fog is long-term, your doctor might recommend medication to help. Some cancer survivors find that medication used for attention deficit hyperactivity disorder, Alzheimer’s disease or antidepressants help with these symptoms.

Taking care of your health is important, so get enough exercise, sleep and eat healthful foods. These are the keys to keeping your body and mind at their peak, before, during and after cancer treatment. Most importantly, reach out for help if you’re having difficulty. Your treatment team can recommend the best approach for you.

Deborah Abrams Kaplan
Deborah Abrams Kaplan