Finding your way out of the fog

Finding your way out of the fog

PiNK 2019 Winter p.14-p.15

Ali Raven examines a frustrating effect of breast cancer treatment – cognitive impairment, commonly known as ‘chemo brain’.


Having treatment for breast cancer can make you feel that you aren’t on top of things. If you find you lose where you are on the page of a book, forget names and places or have trouble plucking the right words from you memory – you may have a side effect of treatment known as ‘chemo fog’ or ‘chemo brain’.

Following cancer treatment, some people find it difficult to concentrate or may feel more forgetful. While this is often called chemo brain or fog, some people with cancer will have changes to their memory and concentration even if they didn’t have chemotherapy. This is why healthcare professionals are more likely to call it cognitive impairment or cognitive dysfunction. This means that someone has difficultly remembering something or making decisions.

What causes chemo brain?

It isn’t known exactly what causes these changes to memory and concentration. Some experts think that cancer treatment may possibly have an effect on the normal ageing process. But cancer itself, the impact of a diagnosis and treatment, side effects such as fatigue (extreme tiredness which doesn’t go away with rest or sleep) and menopausal symptoms (caused by chemotherapy or hormone therapy) are also thought to play a part.

Anyone who has had cancer treatment may be affected by chemo brain, but it’s thought some people may be more likely to experience it than others. This includes people who are depressed (which can be common in people with cancer) and those who are older or less able to get up and about.

What does it feel like?

The symptoms of chemo brain vary from person to person and may be quite subtle. Some people find it hard to describe their symptoms as they may feel they are vague and hard to pin down. You may have changes in your memory, concentration and ability to think clearly and put thoughts into action. You may be less organised than usual and less able to focus, or have trouble finding the right words, finishing sentences or losing your place while reading.

5 things you can do

If you feel you may be experiencing chemo brain, there are a few things you can do to try to help manage your symptoms and improve your wellbeing.

Keep a diary

A diary can help you identify the times when you are at your best or when you have more difficulty concentrating or remembering things. Being aware of this can help you plan your day. You can write a list or put reminders in your phone of things you need to do.

Learn to relax

Feeling stressed and anxious can affect your memory and concentration, and trying to reduce these using relaxation techniques may help. Try listening to music you find calming. Or you can practise deep breathing. Listening to a relaxation CD or using an app may also help you relax.

Some people may find mindfulness useful. Mindfulness is about focusing on the present moment to try to reduce stress and improve your quality of life.

Keep your brain busy

Some people find puzzles like Sudoku or crosswords help keep their brain active and challenged. There are also ‘brain training’ apps or computer games that can give your brain a workout and make you feel more on top of things.

Keep active and eat well

You may find that doing some physical activity helps to clear your head and focus better. This could be a walk, a cycle or swim – whatever you enjoy doing.

Try to eat a balanced diet and get plenty of rest and sleep. Being hungry or tired can make chemo brain worse.

Talk to your specialist team

Tell your specialist team about your symptoms, they may be able to refer you for help or give you information about local services, for example a counsellor or support group.

Chemo brain usually gets better over time after treatment has finished. Although not serious it can be a frustrating additional side effect when you’re trying to recover from breast cancer.

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