Chemotherapy Brain Fog (Chemo Brain)

What is chemotherapy brain fog (chemo brain)?

Chemotherapy brain fog, or chemo brain, is feeling as if you can’t think as quickly and as clearly as you did before you had cancer or received cancer treatment. Healthcare providers may refer to this condition as chemotherapy-induced cognitive impairment or cancer-treatment-related cognitive impairment. But healthcare providers have learned that people develop cognitive problems before, during or after receiving treatment.

Most of the time, chemo brain is a short-term issue, but some people may have the symptoms for months after they’ve finished treatment. Healthcare providers can’t cure chemotherapy brain fog, but they can recommend medications or therapy and activities that may help lift the fog of chemo brain.

How does chemo brain affect everyday life?

Chemotherapy brain fog affects cognition. Cognition is how we think, how we remember information and our ability to concentrate. Cognition issues related to cancer treatment may show up in small ways. Many times, people can manage everyday tasks, but feel those tasks require more concentration and take more time. Sometimes, chemo brain fog makes people feel self-conscious about their cognitive issues, so they become more isolated. Chemotherapy brain fog often affects people’s ability to function in the workplace.

Does chemo brain cause personality changes?

Some studies show people with chemo brain have depression. Sometimes, people get angry or frustrated because they can’t do things as well or as quickly as they once could.

How common is this condition?

Healthcare providers who study cancer treatment and cognition estimate that 25% to 30% of people who have chemo brain develop symptoms before they start cancer treatment. About 75% of people receiving cancer treatment tell their healthcare providers they having issues with memory, concentration and their ability to complete tasks.

What are chemo brain symptoms?

Issues with memory and executive function are common chemo brain symptoms. In this case, memory is being able to remember what people tell you and things you already know like addresses and names. Executive function is your ability to manage your time and make decisions. Symptoms may include:

• Having trouble thinking of the right word for a particular object or doing things that once came easily, like adding up numbers in your head.
• Having trouble following the flow of a conversation.
• Having a short attention span or trouble focusing on a specific task or idea.
• Having trouble multitasking, so you feel you need to do one thing at a time.
• Feeling sluggish, tired or not having energy.
• Feeling clumsy, as if something’s wrong with your motor skills.

What causes chemotherapy brain fog?

Despite its name, chemotherapy brain fog may happen for several different reasons

Medical treatment that may cause chemo brain

• Hormone therapy: People with breast cancer or prostate cancer may receive hormone therapy that may affect the parts of their brains that help with cognitive function.
• Radiation therapy: Fatigue from radiation therapy may affect cognitive function. Likewise, people who have brain cancer may have radiation therapy that could affect cognitive function.

Physical issues

• Losing sleep: You may feel anxious and stressed about your situation. Coping with cancer may make it hard for you to get enough sleep. It’s difficult to focus when you’re exhausted.
• Losing your appetite: Anxiety about treatment or treatment side effects may affect your appetite. Food gives you the energy you need to manage your daily life.
• Depression: Some people with cancer develop depression. Depression may make it challenging for you to concentrate.

How do healthcare providers diagnose chemo brain?

There’s no single test for chemotherapy brain fog. Healthcare providers may do blood tests to rule out conditions that may cause brain symptoms.

How do you deal with chemo brain?

Healthcare providers may recommend several therapies or activities that may reduce some chemotherapy brain fog symptoms, including:

• Cognitive rehabilitation: This treatment involves learning new ways to take in and retain new information.
• Movement therapy: Exercises like yoga and tai chi, which require you to slow down and focus on how you move and hold your body, may help with memory and focus.
• Attention restoration: Everyday activities where you need to focus, like taking care of pets or gardening, may improve your ability to focus.
• Meditation: In meditation, you focus on certain words, images or ideas. That focus may help you manage stress or feeling distracted.

I need treatment for cancer. Can I prevent chemo brain?

Your healthcare providers choose the treatments that they expect will kill or slow your cancer. They know some of those treatments may affect your memory and your ability to concentrate. They’ll work with you to reduce those side effects as much as they can while effectively treating your condition.

Are there risk factors that increase the chance I’ll have chemotherapy brain fog?

Healthcare providers have found a few risk factors, most of which you can’t control. For example, age and underlying medical conditions may increase your risk of developing chemotherapy brain fog before, during or after receiving cancer treatment.

How long does chemo brain last?

People may have chemo brain for varying amounts of time. Chemo brain may last for several months to several years.

How do I take care of myself?

First, treat yourself with patience and gentleness. There’s nothing easy about cancer and cancer treatment. You may need time to recover physically, mentally and emotionally from the challenges of having cancer and coming through cancer treatment, including chemotherapy. Here are some suggestions that may help you cope with chemo brain:

• Let people know you’re dealing with chemotherapy brain fog: Cancer may make you feel as if you’re always asking for help. You may think chemo brain is something you should manage on your own. But telling family and friends when you’re feeling “foggy” will help them understand why you’re having trouble remembering information.
• Keep track of triggers: Track the situations, like time of day, activities or your state of mind, when you feel unusually confused, have trouble concentrating or are forgetful. This exercise will help you spot triggers — the situations that may spark chemo brain symptoms.
• Create easy-to-follow daily routines: It may help to have a written schedule listing your plans, from taking any morning medications and eating breakfast on through your evening.
• Get enough rest and sleep:Fatigue increases chemo brain symptoms.
• Eat a healthy diet: Ask your healthcare provider about working with a nutritionist so you can be sure you’re getting enough “brain” food.
• Get regular exercise: Exercise can lift your spirits and helps you to regain strength and confidence. Certain kinds of exercise, like tai chi and yoga, that emphasize slow movement and focusing on form may be helpful.
• Give your brain a daily workout: Figuring out a puzzle or mastering a word game may help you focus and keep your brain busy. But pace yourself so you don’t get discouraged or frustrated.

When should I see my healthcare provider?

As a cancer survivor, you’ll probably have regular checkups with your healthcare provider so they can evaluate your overall health. That said, if you notice your chemotherapy brain fog symptoms suddenly get worse or you have new symptoms, contact your healthcare provider right away. That way, they can evaluate whether your new or worsening symptoms are signs of another medical issue.

What questions should I ask my healthcare provider?

You may not be able to avoid chemo brain, but you may feel better about your situation if you know why and how chemotherapy brain fog happens. The National Cancer Institute suggests the following questions:

• Will my treatment increase my risk of developing cognitive issues?
• When would I start having symptoms and how long could they last?
• Are there any steps I can take to reduce the impact on my cognitive abilities?
• What are the symptoms or issues my family needs to know about?
• When should I call you about these issues?
• Can you suggest resources I can use to help with chemo brain fog?
• Are there medical specialists I should contact for additional help?

A note from Cleveland Clinic

If you have cancer, having chemotherapy brain fog may not make the top of your worry list. Your priorities may be, 1) understanding your cancer diagnosis, 2) understanding and preparing for the proposed treatment and 3) completing treatment with the hope that you no longer have cancer. In other words, you’re managing many challenges. Even so, don’t downplay symptoms like having trouble making decisions, focusing on tasks and remembering information. Like actual fog, chemotherapy brain fog may start slowly. You may not notice changes right away. When you do, talk to your healthcare provider. Chemo brain can affect your quality of life. Your healthcare provider will evaluate your situation and suggest ways to ease chemo brain symptoms.