You have a cancer diagnosis — Check.
You’ve been prescribed a course of chemo — Check.
Nausea ensues — Check.
Your concentration is gone, along with your memory and word retrieval. You’ve become disorganized and intellectually sloppy —Check, check, check.(1)
Doctors were once skeptical that this problem even existed.(4) However, increasing scientific evidence supports what adult cancer patients have long reported — chemotherapy’s side effects extend beyond the physical.(1)
“Chemo Brain” is the colloquial term for mental cloudiness that can occur before, during and after chemotherapy treatment. Chemo brain is estimated to affect between 14 and 85 percent of cancer patients.(4)
Chemo brain is actually a misnomer, as chemotherapy might not be the sole cause of mental fog during cancer treatment.(4)
Researcher Dr. Karen Syrjala reports, “Interestingly, my research team found a higher percentage of patients than expected scored below average on tests for verbal fluency and memory even prior to their treatment.”(4) So not all cognitive decline can be pinned exclusively on chemotherapy.
Possible Causes of Chemo Brain
The American Cancer Society lists possible causes of what is clinically referred to as cancer treatment-related cognitive impairment or post-chemotherapy cognitive impairment:(2)
- The cancer itself.
- Other drugs used as part of treatment, such as steroids, anti-nausea, or pain medicines.
- Poor sleep.
- Hormone changes or treatments.
- Other illnesses, such as diabetes or high blood pressure.
- Nutritional deficiencies.
- Stress, anxiety and worry.
For most people, symptoms arrive and depart swiftly. Others experience long-term mental changes.
How Long Will it Last?
The cognitive impairment chemotherapy causes can impact a patient’s ability to work or study, lowering overall quality of life.
The good news? Most people recover, although slowly. But some areas of the brain may not return 100 percent. Despite that, the brain is adaptable, and most cancer survivors learn to adjust to the cognitive losses.(4)
About 30 percent of patients have long-term effects that hinder their ability to manage the tasks of daily living.(4)
What Can I Do for My Foggy Brain?
If your brain is suffering the assault of cancer and chemotherapy, there are some strategies you can use to cope:(2),(4)
- Get adequate sleep.
- Keep exercising to manage moods and reduce worry and frustration.
- Use verbal repetition to remember important things, e.g., Feed the dog, Feed the dog, Feed the dog.
- Use strategically placed sticky notes to remind you of your to-do list.
- Form consistent habits, like placing your car keys in the same spot and checking that the stove is off before sitting down to a meal.
- Don’t try to multi-task. Just don’t.(2)
- Ask for help. A friend or family member at your side can assist in whittling away chores and responsibilities, and can help keep you focused on the task at hand.
Finally, share this article with close family and friends so they understand what you're up against. If they understand, they’re more likely to be patient and offer support.
Reviewed September 27, 2016
by Michele Blacksberg RN
Edited by Jody Smith
1) Ahles, TA and Saykin, A. Cognitive effects of standard-dose chemotherapy in patients with cancer. NIH.gov. Retrieved September 26, 2016.
2) Chemo Brain. cancer.org. Retrieved September 26, 2016.
3) Syrjala, Karen L. et al. Prospective Neurocognitive Function Over 5 Years After Allogeneic Hematopoietic Cell Transplantation for Cancer Survivors Compared With Matched Controls at 5 Years. ascopubs.org. Retrieved September 26, 2016.
4) Syrjala, Karen L. Chemobrain. FredHutch.org. Retrieved September 26, 2016.