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Coping with the Cognitive Side Effects
of Cancer

by Jeffrey S. Wefel, PhD, ABPP, and Mariana E. Bradshaw, PhD, ABPP

Knowledge image

Among the possible side effects of cancer, many survivors report changes in their thinking skills during and after treatment. The severity of these changes varies by person and can include memory problems; difficulty with concentrating, multitasking, and word finding; and slowed thinking. This cancer-related cognitive impairment is often referred to as chemo brain.

Causes
Chemo brain can result from cancer treatment (such as chemotherapy, surgery, radiation, or hormonal therapy), or it may be a side effect of the cancer itself. Additional factors like low blood counts, certain medications, and mood disturbances (such as anxiety or depres­sion) can also contribute to chemo brain.

For most people, cognitive issues generally fade soon after cancer treat­ment ends. However, for some, it may take a year or more to feel normal again, and even then, some survivors may never regain full cognitive function. Fortunately, with the right tools, you can reduce the impact chemo brain has on your daily functioning in order to improve your quality of life.

Behavioral Strategies
You can maximize your cognitive function by making some simple lifestyle changes and by using organizational tools and memory aids:

  • Rather than trying to multitask, you should prioritize your to-do list, mini­mize distractions, and focus on one task at a time.
  • Designate a station where you can store your keys, your cell phone, and other important items to avoid the frustration of having to search for mis­placed possessions.
  • Keep track of important information and upcoming appointments using your smartphone, a day planner, or a calendar.
  • Use your phone, alarm clock, or kitchen timer to set audible reminders for important tasks and appointments.
Author of Article photo

Dr. Jeffrey Wefel

In addition to these compensatory strategies, it’s equally important for you to manage the factors that might be worsening your chemo brain:

  • Follow a healthy diet.
  • Get plenty of rest, and practice good sleep hygiene.
  • Regularly exercise your brain and your body. Physical activity can help combat fatigue and improve mood, while memory and thinking exercises can help improve cognitive functioning.
  • Practice relaxation strategies to help reduce stress.
  • If you’re experiencing symptoms of depression or anxiety, let your doctor know so you can discuss your options for treatment.

Author of Article photo Dr. Mariana Bradshaw

Cognitive Training
Numerous prom­ising cognitive training approaches are available to help enhance cancer survivors’ brain function. For example, hospital-based education and cognitive remediation programs have been success­ful in ensuring academic development and improving attention span for children undergoing cancer treatment. Likewise, home-based, computerized cognitive training programs can help improve memory and executive functioning in both children and adults. Talk with your doctor about your cognitive training options.

Advances in cancer management have resulted in an increasing number of cancer survivors, some of whom must cope with cancer-related cognitive side effects. Fortunately, the impact of these side effects on daily functioning and quality of life can be minimized with appropriate interventions, more of which may be on the way, as efforts are underway to discover medications that may be helpful in enhancing brain function in cancer survivors.

If you’re currently experiencing chemo brain, you may want to ask for a referral for a neuropsychological assess­ment. This assessment can identify your cognitive strengths and weaknesses and help guide a more personalized plan to manage your chemo brain symptoms.

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Dr. Wefel and Dr. Bradshaw are board-certified neuropsychologists at the University of Texas MD Anderson Cancer Center in Houston, TX. Their practice focuses on the neuropsychological effects of cancer and cancer therapy in adult cancer survivors.

To find a board-certified neuropsychologist in your area, visit theaacn.org.

This article was published in Coping® with Cancer magazine, July/August 2015.