Brain fog during chemo is common, frustrating, and very real.
Chemotherapy comes with many side effects that are often visible and hard to deny, such as hair loss and nausea. However, one side effect that is often unfairly brushed aside is “chemo brain,” or cognitive changes during chemotherapy and other treatments for cancer.
Chemo brain is real—and incredibly common in people undergoing chemotherapy. Most people who experience chemo brain describe it as causing things like memory lapses, slower processing, difficulty multitasking and concentrating, and forgetting common words.
Chemo brain can also lead to emotional symptoms. The mental cloudiness can be very frustrating, and it can add stress to an already stressful period of someone’s life.
What Causes Chemo Brain?
There’s no single answer for this question, and in fact, some people experience “chemo” brain fog without even undergoing chemotherapy. Thus, doctors believe chemo brain is actually the result of a complex mix of factors, such as:
The cancer itself, such as a tumor in the brain
Anti-nausea meds and other related drugs to relieve side effects
Anesthetics used during surgeries
Low blood counts
Lack of sleep and general fatigue
Nutritional deficiencies, which are common due to lack of appetite and nausea
The age of the patient
Depression, which is common among people undergoing cancer treatment
How Long Chemo Brain Lasts
The majority of chemo brain symptoms come and go quickly. When chemotherapy or other cancer treatments stop, most people see their chemo brain (and other chemo side effects) fade away.
However, some people do experience long-term cognitive changes. Some risk factors, such as depression, are linked to a higher chance of long-term cognitive side effects, according to the American Cancer Society.
Coping with Chemo Brain
Chemo brain isn’t simply frustrating: It can actually get in the way of treatment. It could cause patients to forget doctor’s instructions about medications, or to forget to ask certain questions during appointments, for example.
While chemo brain isn’t your fault, prioritizing a healthy lifestyle during treatment can help mitigate some of the symptoms of chemo brain. That includes eating a balanced diet with lots of veggies, getting enough sleep, exercising, and managing stress.
Additionally, it can help to stay organized during treatment. Keep a symptom diary to show your doctor during appointments, as well as a detailed planner to keep track of appointments and other important events. Write down your questions before heading to appointments, and bring a loved one to help you remember instructions and other details. Take notes during appointments, and keep a list of all your medications.
Perhaps most importantly, tell your treatment team and your loved ones that you are experiencing brain fog from your cancer treatment. This can help increase support so you feel less guilt or pressure regarding your cognitive symptoms.
“In patients that are worried about it, I let them know that it’s not something that’s guaranteed to happen, and it may not happen at all,” says Ashish Saxena, MD, oncologist at Weill Cornell Medicine and NewYork-Presbyterian. “Like a lot of other side effects, [chemo brain] will get better [after] time away from chemotherapy.”
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So chemo brain is sort of a general
term that a lot of times patients use to
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describe the effects that sometimes they
may get with chemotherapy where their
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thinking doesn't seem quite as clear.
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Their memory doesn't seem as sharp.
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It's important to talk to your doctor
about it, and in severe cases,
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you could be referred to
a specialist who can help manage it.
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So common things patients may feel and
tell their doctor about when they're
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discussing what they are calling
chemo brain is problems with memory.
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Problems with slowing of their thinking,
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problems with sort of complex tasks
that they used to do really well.
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Chemo fog is still being studied.
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So a lot of times we don't know
exactly what the mechanism is for it.
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But some of the factors that might
contribute may be the cancer itself,
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if it's a tumor that's in the brain.
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Also how the patient was before they
got their treatment or their cancer,
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if they already were having some
of these issues, they were older.
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Anxiety, things like that, can affect
things like thinking and memory.
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In patients that are worried about it,
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I let them know that it's not
something that's guaranteed to happen.
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It may not happen at
all a lot of the time.
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like a lot of the other side effects,
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will get better as time away
from the chemotherapy happens.
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But then if it's not, that we do have
things that we can do to help them and
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that they should let us know about it.
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Chemo brain. Atlanta, GA: American Cancer Society, 2016. (Accessed on June 27, 2019 at https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/changes-in-mood-or-thinking/chemo-brain.html.)