What is Chemo Brain?

Chemo brain is a common phenomenon for blood cancer patients. For decades, patients have described experiencing problems with memory, attention and processing information. This phenomenon is often called ‘chemo brain’ or ‘chemo fog’. It can be defined as a decrease in mental sharpness – being unable to remember certain things and having trouble finishing tasks or learning new skills.

Although it is commonly used, the term ‘chemo brain’ can be misleading. Research shows that changes in memory and concentration can also happen in people with cancer who have never had chemotherapy. Doctors now think that these problems could be due to a variety of reasons, including the different cancer treatments and the cancer itself.

Other terms for chemo brain include:

• Mild cognitive impairment.
• Cognitive dysfunction.
• Cancer associated cognitive changes.
• Cancer related cognitive impairment.

Signs and symptoms

The symptoms of chemo brain are usually mild, and people are still able to do everyday things. But they may notice they aren’t able to do some things quite as well as before they had cancer.

Symptoms can include:

• Difficulty concentrating (short concentration span).
• Memory loss (trouble recalling names, dates and sometimes other events).
• Difficulty doing more than one thing at a time (multi-tasking).
• Taking longer than usual to finish tasks (disorganised, slower thinking and processing).
• Trouble finding the right words or being able to finish sentences.
• Difficulty in learning new skills.
• Difficulty in focusing on a task.

What causes chemo brain?

The causes of chemo brain are not clear. Research suggests that it may be caused by a combination of factors:

• The cancer itself.
• Cancer treatments, including chemotherapy, radiotherapy, surgery and hormonal therapy.
• Very intensive treatment such as high dose chemotherapy followed by a bone marrow transplant.
• Stress, anxiety and depression.
• Sleep problems.
• Nutritional deficiencies.

Coping with chemo brain

There are many things that you can do to help you sharpen your mental abilities. The symptoms of chemo brain are usually temporary and often get better with time, but for some people, symptoms can continue for years after treatment. There are a number of things you can do to help yourself. Your doctor or specialist nurse can also give you more information and support.

Keeping a diary of your symptoms can be a really

useful tool. It can help you to see if certain things make your symptoms worse. For example, you may notice that your symptoms are worse at a certain time of day, or when you are tired or hungry. Using a diary can help you to plan activities for when you are at your best.

Some other tips to cope with chemo brain are:

• Keep a treatment diary.
• Keep a calendar on your wall or use the calendar on your phone.
• Make lists, for example, shopping lists or ‘to-do’ lists, so that you feel confident you will not forget anything.
• Exercise your brain – memory exercises may help to train your brain and improve your memory and concentration. You can help keep your mind active by doing crosswords, word games or number puzzles.
• Get enough rest and sleep.
• Avoid trying to do too many things at the same time – don’t try to multi-task.
• It might be helpful to write yourself notes and stick them up where you can see them.
• Try to do the most difficult tasks earlier in the day.
• Before your appointment, write a list of questions and things you want to talk about.
• Keep a written record of your previous hospital appointments and planned appointments.
• Try to follow a healthy diet.
• If possible, set up and follow regular routines – try to keep the same daily schedule.
• Ask for help when you need it – friends and family can help with daily tasks to cut down on distractions and help you save mental energy.
• Keep active – being physically active can help you feel more mentally alert.
• Reduce stress – stressful situations can affect everyone’s memory. Relaxation can help to reduce stress and may help to improve your memory and concentration.

Chemo brain may be a less obvious side effect of blood cancer and its treatment. Therefore, it is important to talk to family and friends about it as they will be able to support you better when they understand more about how you feel. It is also important to talk to your doctor or nurse if you think you have cognitive impairment and you are finding it difficult. They might be able to refer you to a specialist to help you.