People receiving chemotherapy sometimes find it hard to think clearly, describing the feeling as their brain is in a "fog." The popular name for this is chemobrain, which may mean different things to different people, but for the most part, describes a change in one's ability to think clearly, concentrate, or focus on one task. Many cancer survivors report similar symptoms even many months or years after completing treatment. The causes of chemobrain are not clearly understood, and the severity and duration vary from person to person.

Symptoms of chemobrain

It is important to discuss any symptoms that affect your ability to think clearly, concentrate or focus, do mathematical calculations, or even read a map. Some of the symptoms usually described include:

• Difficulty completing tasks and multi-tasking
  
  
• Difficulty finding the "right word"
  
  
• Difficulty balancing a checkbook
  
  
• Difficulty with spatial orientation
  
  
• Difficulty comprehending what people are saying (you may find yourself asking them to repeat the same information over and over again)
  
  
• Feeling like you are in a fog or disoriented
  
  
• Fatigue
  
  
• Inability to focus or concentrate
  
  
• Forgetfulness
  
  
• Mood swings
  
  
• Insomnia

The severity of the symptoms can be affected by age, stress level, and an underlying history of depression and anxiety. There are no definitive screening tests available to determine who is at risk for chemobrain, and the reason why it occurs in some patients and not others is still being investigated.

It is important to distinguish between cognitive problems resulting from chemobrain and the emotional reactions to stress and illness. Certain medical conditions can also impair one's ability to focus, think and speak clearly, and may be confused with chemobrain, such as:

• Anemia
  
  
• Depression
  
  
• Fatigue
  
  
• Lack of fluids or minerals, or other metabolic problems

Strategies to help with the effects of chemobrain

The following is a list of strategies to try that may help enhance quality of life and help keep you mentally sharp:

• Keep a log or checklist containing daily reminders. Put it in a convenient location, so you can look at it frequently throughout your day. If necessary, keep a duplicate or similar copy at work.
  
  
• Take on one task at a time, and avoid distractions.
  
  
• Carry around a small pad and keep it handy, so you can easily write down reminders for yourself.
  
  
• Use large-print calendars and mark upcoming events and appointments.
  
  
• Place post-it notes around the house and workplace to leave yourself reminders.
  
  
• Get plenty of rest.
  
  
• Try yoga to relax and regain some mental clarity.
  
  
• Have someone accompany you to your doctors' visits. Don't be afraid to ask questions, even if you feel like you are repeating yourself. Keep a journal of your visits and write down important facts that you discuss with your doctor. If it is too overwhelming, have the person who goes with you take some notes and review them with you after the visit is completed.
  
  
• Talk with your employer if you are having problems at work. Discuss what workplace modifications can take place in regard to deadlines, demands, and workload.
  
  
• Prepare for tomorrow today. The night before, take out the things you will need for the next day.
  
  
• Color code or label certain cabinets or drawers where you store things around your home you use frequently.
  
  
• Put things back in the same place after you use them, such as your car keys, so they will be easier to find.
  
  
• Create a more structured environment, free of clutter.
  
  
• Use word play, such as rhyming, to remember certain things more easily.
  
  
• Keep important phone numbers easily displayed next to your phone and carry around a small address book in case you forget someone's number if you are out.

And, don't be afraid to ask your family and friends for help. If you need additional assistance to cope with the symptoms of chemobrain, talk with your doctor or other health-care team members about counseling and other resources available to you. Read Cancer.Net Feature: How to Find a Counselor for more information.

Additional resources

CancerCare: Coping with Chemobrain: A four-part series addressing chemobrain

Cognitive Problems After Chemotherapy (PDF)

Doctor, Can We Talk About Chemobrain? (PDF)

Ways to Improve Concentration (PDF)

Keeping Your Memory Sharp (PDF)

Mayo Clinic: Chemobrain: When Cancer Treatment Disrupts Your Thinking and Memory Skills

Breast Cancer Network of Strength: Cancer Fatigue and Chemobrain Chat Transcript

breastcancer.org: Thinking and Memory Challenges Chat Transcript (August 2006)

More Information

Emotional and Physical Matters