Did you know that chemo brain is a common term cancer survivors use? It describes thinking and memory problems that can occur during and after cancer treatment. Doctors and researchers may call chemo brain many things. For example, chemo fog, cancer treatment-related cognitive impairment, cancer-related cognitive change, or post-chemotherapy cognitive impairment. 

The word “cognitive” refers to the way your brain works to help you communicate, think, and learn. Likewise, it helps you solve problems and remember. Nowadays, people use the term all over the world. However, we can’t properly understand the causes of concentration and memory problems. It’s very likely that there are multiple causes. No matter the cause, chemo fog is a frustrating and debilitating side effect of cancer and its treatment.

Researchers are working to understand the memory changes that people with cancer experience. Most importantly, sometimes people with cancer worry about chemo brain. They also joke about or become frustrated by this mental cloudiness. Likewise, patients also experience mental changes before, during, and after cancer treatment.

What’s chemo brain?

Firstly, most define it as a decrease in mental “sharpness”. According to patients, they can’t remember certain things and have trouble finishing tasks. Most importantly, patients have trouble concentrating on something or learning new skills. The world today still doesn’t know its exact cause but it can happen at any time when a patient is undergoing cancer treatment.

These mental changes can make people unable to perform usual activities. For instance, school, work, or social activities. In fact, it can seem like it takes a lot of mental effort to do them. Many people don’t tell their cancer care team about their problems until it affects their everyday life. 

It’s important for patients to get help and support. Be sure to let your cancer care team know if you notice any mental changes, no matter how small. Here are some examples of what patients with chemo brain may experience:

• Firstly, forgetting things that they usually have no trouble remembering (memory lapses).
• Secondly, trouble concentrating. For instance, can’t focus on what they do, have a short attention span, and may even “space out”.
• Thirdly, trouble remembering details like names, dates, and bigger events.
• Trouble multi-tasking, like answering the phone while cooking, without losing track of one task. For example, they can’t do more than one thing at a time.
• Trouble learning new things.
• Taking longer to finish things (disorganized and slower thinking and processing).
• Lastly, trouble remembering common words (unable to find the right words to finish a sentence).

For most people, these mental changes only last a short time. Others can have long-term or delayed mental changes. In other words, how long the chemo brain lasts is a major factor. It affects people’s lives in different ways. When it starts, how long it lasts, and how much trouble it causes may vary. 

Believe it or not, it affects every cancer patient differently. The patients often notice subtle changes, but people around them might not even notice any changes at all. Still, the people who have problems can’t notice differences in their thinking.

Different causes

Chemo fog is usually related to chemotherapy, but treatments connect can also cause it. For example, hormone therapy, radiation, and surgery. These treatments can cause short-term, long-term, or delayed mental changes or cognitive problems.

Chemo fog symptoms may start and continue after treatment is over. Some people with cancer have very real brain problems even though they didn’t have chemo. Certain aspects can increase the risk of developing chemo brain or worsening brain function problems. These include:

• Cancer itself. For example, brain tumors.
• Old age.
• Being weak or frail.
• Infection.
• Other drugs used as part of treatment, such as steroids, anti-nausea, or pain medicines.
• Other conditions or illnesses, such as diabetes or high blood pressure.
• Having other symptoms like tiredness, pain, or sleep problems.
• Emotional distress, such as depression or anxiety.
• Surgery and the drugs used during surgery (anesthesia).
• Hormone changes or hormone treatments.
• Being postmenopausal.
• Nutritional deficiencies.
• Lastly, using alcohol or other substances that can change your mental state.

Believe it or not, most of these cause short-term problems. The problems do improve as the patient treats the underlying problem or disappears. However, other problems lead to long-lasting brain problems unless the cause is treated.

Treatments

Fortunately, there are many treatments for chemo brain:

• Cognitive rehabilitation. This might be part of a cancer rehabilitation (rehab) program. It includes many activities to improve brain function. For instance, learning how the brain works and ways to take in new information. Likewise, ways to perform new tasks, doing some activities repeatedly, and becoming harder with time. It also helps patients use tools to help stay organized such as planners or diaries.
• Exercise. Fortunately, exercise can improve your thinking and ability to focus. Many activities can help improve your attention and concentration levels. For example, playing sports, going to the gym, gardening, caring for pets, or walking, 
• Meditation and wellness. The last treatment is meditation and wellness. As a matter of fact, this activity can dramatically improve brain function by increasing your focus and awareness. Why not give it a try?

Talk to your cancer care team about these treatment suggestions. Perhaps you can also discuss other options they may recommend to help you cope with cognitive problems.

Day-to-day coping tips

There are some things that you can do to help. Not only will you sharpen your mental abilities, but also manage your chemo brain. Some examples are:

• Use a detailed daily planner, notebooks, reminder notes, or your smartphone. Keeping everything in one place makes it easier to find the reminders you may need. You might want to keep track of appointments and schedules. Likewise, “to do” lists, important dates, websites, phone numbers, addresses, and meeting notes. Consider movies you want to see or books you like to read.
• Do the most demanding tasks at the time of the day. For instance, when you feel your energy levels are the highest.
• Try to exercise your brain properly. Take a class, do word puzzles, or learn a new language.
• Consider getting enough rest and sleep.
• It’s important to keep moving. Regular physical activity isn’t only good for your body but it also improves your mood. Most importantly, it makes you feel more alert and decreases tiredness (fatigue).
• Try eating a lot of vegetables. According to studies, eating more vegetables links to keeping brain power as people age.
• Set up and follow routines. Therefore, try to keep the same daily schedule.
• Pick a certain place for commonly lost objects but always keep them there. For instance, keys and sunglasses. 
• Try not to multitask. In other words, focus on one thing at a time.
• Consider avoiding alcohol and other agents. Those that might change your mental state and sleeping patterns.
• Ask for help when you need it. For example, friends and loved ones can help with daily tasks. They’ll cut down on distractions and help you save mental energy.
• Track your memory problems. Keep a diary of when you notice problems and what’s going on at the time. Likewise, the medicines you took time of day and your situation. This will help you figure out what affects your memory. Keeping track of when you most notice the problems can also help you prepare. You’ll know to avoid planning important conversations or appointments during those times. This will also be useful when you talk with your doctor about these problems.
• Try not to focus on how much these symptoms bother you. Accepting the problem will help you deal with it. As many patients noted, laughing about things you can’t control can help you cope. Therefore, remember, you probably notice your problems much more than others do.

Support system

Another thing you can do to better manage chemo fog is finding a support system. In other words, tell family, friends, and your cancer care team about it. Finding and getting support is important. Therefore, let them know exactly what you go through. You may feel relieved once you tell people about your problems. For example, those you sometimes have with your memory or thinking.

Chemo brain is a side effect you can learn to manage, even though this change might not be easy to see as others, such as hair loss or skin changes. Your family and friends surely noticed some things and may even have some helpful suggestions. For instance, your partner might notice that when you rush, you have more trouble finding things.

Lastly, tell your friends and family members what they can do to help. Their undying support and understanding can help you relax. Likewise, they make it much easier for you to focus and process information.

Talk with your doctor or cancer care team

Do brain problems cause trouble at work or school? Do they interfere with your usual activities? Talk with your doctor to try to pinpoint what causes your brain fog. Most importantly, what you can do about it. This is especially important for people with chemo brain that lasts longer than the treatment period. Likewise, it keeps causing trouble in their daily lives.

It helps a lot if you have a diary of the situations you have trouble with. Likewise, it also helps inform your doctor about the things that make the problem worse or better. For instance, are they worse in the morning or evening? Do you have more trouble when you’re hungry or tired? Does it help to nap, walk, or have a snack? Surely, your doctor will want to know when the problems started and how they affect your daily life.

• Firstly, write down questions about the problems you have. Take them to your appointment along with your memory tracking log to talk over with your doctor. Ask what may cause the problems. Likewise, find out if there’s anything the doctor can offer to help you.
• Bring a list of all the medicines you take. For example, herbs, vitamins, supplements, and those you take on an “as needed” basis.
• Lastly, take close friends or family members with you. They’ll surely help you keep track of what’s said during the visit. Therefore, they can also perfectly describe the changes they see. Only if the doctor wants a different viewpoint of how your brain problems are affecting you.

However, if your memory and thinking problems keep causing trouble in your daily life, ask for help. Your doctor will tell you if you need to see a specialist. For instance, a neuropsychologist, speech-language pathologist, occupation therapist, or vocational therapist. 

These skilled professionals in the medical field can test you. Likewise, they’ll also recommend ways to help you better handle the cognitive problems or changes that you experience. In fact, we now know this treatment as cognitive rehabilitation.

The bottom line

In short, you may need to visit a hospital or cancer care center to find skilled experts on testing brain function, including chemo brain. Ask if you can get a referral to one of these specialists. Only a specialist can help you learn the scope of your problem and work with you on ways to manage it. 

Before you start, consider finding out exactly what your insurance will cover. How exactly can we prevent chemo brain? So far, there’s no known way to prevent the cognitive changes that it causes. Experts are still studying its causes.

Chemo brain can affect thinking, memory, planning, and finding the right words. The incidence of this condition is higher in people who get high doses of chemo and is more likely to happen if the brain is also treated with radiation therapy. That’s the bottom line.

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