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Chemo Brain

What It Is and What You Can Do about It

by Fremonta Meyer, MD

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Over the past several years, the medical community has become increasingly aware of a phenom­enon that cancer survivors have long experienced – chemo brain. Yes, recent research shows that cancer-related “brain fog” is real, and it can have a significant impact on quality of life.

What Is Chemo Brain?
Chemo brain refers to the cognitive impairment that can occur after cancer treatment. Up to 67 percent of people who receive can­cer treatment that’s not directed toward the brain experience cognitive changes in some form. Symptoms vary from person to person but generally include short-term memory problems, word-finding difficulties, short attention span, difficulty concentrating, and inability to multitask.

For most people, these symptoms are mild to moderate and will resolve grad­ually on their own over time. Many survivors notice a definite improvement in symptoms within six to nine months of finishing chemotherapy. However, some people experience cognitive changes that can last years after treat­ment ends. Keep in mind, though, that chemo brain is not a progressive dement­ing condition. In fact, some research has even found that chemotherapy may be associated with a lower risk of developing Alzheimer’s and other types of dementia.

What Can I Do to Improve My Symptoms?
If cognitive problems are affecting your performance at school or at work, requesting some simple accommodations (like extra time for taking exams or a private workspace) may help. Your doctor can suggest pos­sible accommodations, and can even write a letter to your employer or school administrator if needed.

Chemo brain symptoms generally include short-term memory problems, word-finding difficulties, short attention span, difficulty concentrating, and inability to multitask.

Author of Article photo

Dr. Fremonta Meyer

To help with memory problems, create a system to help you get organized and stay on top of things. Keep your to-do lists and calendars in one central notebook. Set alarms on your phone to remind you of upcoming doctor’s appointments, when to take medica­tions, a family member’s wedding, or anything else you want to remember. Read to-do lists, names, directions, and appointments aloud to help you remem­ber them. The combined visual and auditory input makes the information more likely to stick.

Avoid multitasking while you recover your cognitive skills. If you’re over­whelmed with daily responsibilities, write down a task list in order of im­portance. Once you prioritize, focus only on the first task that needs to be done – don’t think about anything else.

Regular aerobic exercise is also im­portant, as it has been shown to increase blood flow in the frontal lobes of the brain. In addition, mindfulness practices like yoga and meditation can help you culti­vate the ability to pay attention, which in turn leads to better memory retention.

Several research studies have shown that neurofeedback ( and computer-based brain fitness exercises, like Lumosity ( and Posit Science (, can reduce chemo brain symptoms. If you try brain fitness exercises, be sure to practice them regularly, four or five times a week for half an hour or more, for opti­mal results.

How Can a Medical Provider Help?
A neuro-psychologist can perform for­mal cognitive testing to give you a better understanding of your individual cognitive strengths and weaknesses. This testing also can provide evidence to support your need for accommoda­tions in school or at work. In addition, cognitive rehabilitation therapy may help you develop coping strategies tai­lored to your specific needs. This type of therapy is often covered under your health insurance’s occupational therapy benefit. Some people benefit from taking psychostimulants, such as methylphenidate (Ritalin), dextroamphetamine (Adderall), and modafinil/armodafinil (Provigil/Nuvigil). These medications tend to be most helpful for managing fatigue and improving attention and concentration.

Could Other Factors Be Involved?
If you’re six to nine months out of active treatment and you continue to experi­ence cognitive changes that affect your quality of life or ability to function, you should see your doctor for a medical evaluation. Many factors other than chemotherapy can affect cognitive func­tion in cancer survivors. Fatigue, low blood counts, aging, pain, difficulty sleeping, stress, anxiety, depression, pre­scription medications, hormonal changes, and medical conditions like diabetes, thyroid disease, and sleep apnea can all affect cognitive function. Your doctor can help you identify and treat these issues.

If your medical evaluation doesn’t point to any contributing factors, that’s OK. Doctors are still trying to pinpoint the exact cause of chemo brain. Be pa­tient with yourself and try the techniques mentioned here to help manage your cognitive symptoms. They should im­prove over time. When you’re feeling frustrated, remember that chemo brain is a sign of strength – in order to have chemo brain, you have to be a cancer survivor!

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Dr. Fremonta Meyer is a psychiatrist at Dana-Farber Cancer Institute in Boston, MA, and assis­tant professor of psychiatry at Harvard Medical School. She has an interest in women’s cancers and cognitive function in cancer survivors.

This article was published in Coping® with Cancer magazine, November/December 2014.