Will "Chemobrain" Last Forever?

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In addition to fatigue, a common concern in cancer survivors is “chemobrain,” or a specific type of cancer-related brain fog. If you've ever grabbed your keys, jumped in the car, and then wondered where you were going, you're not alone. Up to 75 percent of all cancer survivors report slowed processing or decreased memory during or after cancer treatment.

The mechanism of chemobrain is not well understood and many factors are thought to be at play—including genetics, hormonal status, age, and type of treatment. In one study of breast cancer survivors, for example, measurable declines in short-term memory and ability to complete complex instructions were noted before receiving chemotherapy.¹ This suggests that some aspects of the cancer journey—perhaps the anxiety related to a cancer diagnosis—can contribute to decreased brain function in the absence of what has long been considered the main culprit, chemotherapy.

The good news is that in most survivors this brain fog is a short-term, reversible side effect of cancer. In the meantime, however, it can be very frustrating. Luckily, there are ways to help your brain recover and prevent yourself (and those around you) from becoming frustrated.

The most frequent problem areas noted in cancer survivors are impaired short-term memory, problems finding words, decreased attention span, and increased difficulty multitasking. Going back to the car example, for instance, this is where you're sitting in your car wondering where you're going, or perhaps forgetting the important questions you wanted to ask your doctor at your next appointment.

Animal models show that chemotherapy blocks the production of new cells in areas of the brain responsible for learning and memory. For this reason, strategies that activate other parts of the brain can help you remember and learn. This might mean linking information to a visual image, for example, or creating a rhyme or song that places information in a different area of the brain.

Keeping lists or writing down reminders can also be extremely helpful. Some of my patients found that carrying a journal or day planner with them at all times was a useful strategy. Think of it sort of like an external hard drive.

Exercising your mind in unusual ways can also help your brain. Word puzzles, sudoku books, or other cognitive games can excite areas of the brain and help create new neural connections. Small studies suggest these interventions can be more effective in improving thinking than medications in some patients.

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Physical activity can also help. A recent analysis of 12 studies looking at breast cancer survivors found moderate amounts of exercise improved self-reported cognitive function, fatigue, and ability to execute tasks.² Some patients actually reported better thinking than before treatment!

Another trial found that weekly yoga improved cognitive function as well.³ The exact mechanism for these effects is unknown, but these findings are consistent with other studies in older patients with memory loss: moving your body helps your brain.

Finally, don't be afraid to reach out to your doctor for help. This is particularly important if you have other symptoms like depression or headaches. Your doctor may recommend meeting with a speech therapist or neurologist. You may also need further testing like a brain scan or blood testing.

Cancer-associated cognitive decline or “chemobrain" is common in cancer survivors. It is usually short-term and reversible with time. Coping strategies—including moderate exercise (yoga), carrying a journal to write down essential information, and completing mind exercises like word puzzles—can decrease frustration while your brain heals.