Chemo Brain Introduction: When cancer treatment disrupts your thinking and memory skills
Mayo Clinic Staff
For years people undergoing cancer treatment described their minds as being in a fog — unable to concentrate and remember details important to their everyday lives. Doctors and researchers knew something was wrong, but they couldn't put their fingers on what it was.
A growing body of research shows that what those people were experiencing is called cognitive impairment — the loss of the ability to remember certain things, learn new skills and complete certain tasks. The cause of cognitive impairment during cancer treatment still isn't clear, nor is it clear how often it happens or what may trigger it. Doctors aren't sure what they can do about it.
But that doesn't mean there isn't any hope. Recognize
cognitive impairment and its association with cancer
treatment, and talk to your doctor about your symptoms or
concerns. Taking small steps can help you cope with
changes in your memory during treatment.
You may have heard the terms chemobrain and chemofog. These terms refer to cognitive changes during and after cancer diagnosis and treatment. Women with breast cancer who underwent adjuvant chemotherapy were the first group to bring these symptoms to light, as more started mentioning their symptoms to their doctors. It isn't clear whether chemotherapy, or other factors such as stress and hormonal fluctuations, cause the changes in memory and thinking. What is clear is that some people with cancer do notice increased difficulties with certain mental tasks after cancer treatment.
In general, researchers have found that chemotherapy can affect your cognitive abilities in the following manners:
About 20 percent to 30 percent of people undergoing cancer treatment will experience cognitive impairment, though some studies report that at least half the participants had memory problems. Signs and symptoms of these memory changes last for at least a year or two after your treatment. The changes can continue for several years or they can go away sooner.
Changes in memory during and after treatment may be
very subtle. You might notice changes during your everyday
tasks and as you start working again after treatment. The
memory changes are often so subtle, in fact, that
researchers find that people who report having memory
difficulties tend to score in the normal ranges on tests
of their cognitive ability. That makes it more difficult
to understand, diagnose and treat the memory changes.
Doctors don't know what causes the cognitive changes associated with chemotherapy. It was previously thought that chemotherapy drugs didn't enter your brain, but were rejected by the blood-brain barrier, which separates things that should be in your brain from those that shouldn't. But some researchers now suspect some chemotherapy drugs may be able to slip past the blood-brain barrier. This could potentially affect your brain and your memory.
It isn't clear which chemotherapy drugs are more likely to cause memory changes or if higher doses pose a bigger risk than do smaller ones. And it isn't possible to predict who's more likely to have cognitive impairment after chemotherapy.
A number of factors can cause temporary memory problems in people undergoing chemotherapy — making it difficult to decipher the so-called chemobrain from the normal stresses of treatment. Temporary memory problems can, for the most part, be treated. Causes include:
Talk to your doctor about your memory problems. If your
symptoms are caused by medications or stress, your doctor
can treat those symptoms and help get your mind back on
If you have impaired memory, your doctor may first try to rule out any other causes of memory problems, such as stress and depression. Currently no medications exist to treat cognitive impairment associated with cancer and its treatment. Researchers are investigating whether medications for such disorders as depression, attention-deficit hyperactivity disorder (ADHD) and dementia could prove effective.
You can help yourself cope with the changes in your memory by taking a few simple steps. You might want to:
Find the coping method that's best for you and stick to
it. Talk to your doctor about your concerns. He or she
might have some other suggestions.
Chemotherapy isn't the only cancer treatment that may cause memory and thinking problems. Other treatments that might affect your brain include:
As research continues doctors will be able to better
understand which cancer treatments cause cognitive
impairment and what they can do to limit their side
If you're currently undergoing cancer treatment or you've already been through treatment, take note of any problems you have remembering certain things or concentrating during certain tasks. Talk to your doctor about your signs and symptoms.
If you've yet to start your treatment, talk to your doctor about the risks of treatment, including cognitive impairment. Understanding your risks can help you make more informed decisions about your treatment.
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