Memory and concentration

You may be finding that your memory and ability to concentrate has been affected since having treatment for cancer. People often call this experience 'chemo fog' or 'chemo brain'.

Here is information to help you to find out more about 'chemo brain' and how to manage it.

What is chemo brain?

Some people notice that they are more forgetful or have trouble concentrating or making decisions after treatment for cancer. 

Symptoms may include:

• difficulty multitasking or concentrating on single tasks
• poor short term memory
• short attention span
• feeling tired
• feeling confused
• difficulty finding the right word when talking or writing
• difficulty completing everyday tasks
• finding it hard to learn new skills
• feeling more disorganised than usual.

Although commonly called chemo brain,  this can occur after different types of treatment for cancer. Recent research has shown that it may result more from the stress of diagnosis and treatment  than the  treatment itself.  

'Cognition' is the term for  the act of thinking processing and reasoning thinking. The medical terminology for chemo brain refers to mild cognitive dysfunction or impairment 

Alongside stress, fluctuating hormone levels and some medication taken during treatment can directly affect your thinking and make you feel sluggish. Other causes can be being dehydrated, sleep deprived, poor nutrition, depression, or fatigue (tiredness). 

For most people this mental fogginess wears off soon after treatment. Some people find it lingers for months afterward. In a few cases the fogginess can be permanent. 

How can I manage confusion / memory loss

There is no specific treatment for chemo brain. However, there are other side effects from treatment that can add to its symptoms, and they can be treated. Side effects adding to 'chemo brain' symptoms include anaemia, hormone changes, insomnia (difficulty sleeping), depression and stress.

• Talk to your healthcare team about any difficulties you are having with your memory and concentration. 
• Write down the effects on your daily life to help you to remember and explain the symptoms to your doctor/specialist nurse at the appointment.
• Exercise can reduce stress, fatigue and  depression;  recent research has also shown exercise to help improve memory in women treated for breast cancer. 
• Hydration: even mild dehydration has been shown to affect memory and concentration. Drinking plenty of water can help, unless your doctor has advised you to limit your fluid intake.
• Track and understand: try to identify patterns of when you feel ‘foggy’. Is it when you are tired, hungry, rushed or when there is lots of noise or activity around you?  You can make changes or plan around these times if you need to focus on something. 
• Memory aids: use notes, lists and phone alarms for reminders. Keep important things like keys in the same place each day. Ask friends to follow up conversations with a text to remind you of things you have said you will do.
• Brain training: doing crossword/sudoku puzzles or brain training exercises may help increase connections in the brain.
• Sleep: Getting enough sleep will help you to feel stronger emotionally and physically.
• Nutrition: Eating healthily can improve mood and fatigue and keep blood sugar levels stable, all of which can help improve memory and concentration. Let your healthcare team know if you are planning to take any vitamins or supplements as some can interfere with your treatment. 
• Reduce stress where you can and do some things you enjoy. Relaxation techniques such as meditation and mindfulness can also be helpful. 
• Complementary therapies such as herbal medicine and  acupuncture have been shown to be helpful in reducing stress and boosting memory and concentration.
• Be honest: let friends and family know that you are having more difficulty thinking/remembering things than usual. Say that it is likely to be temporary but that you would appreciate their help in the meantime.
• Keep things manageable: pace yourself, try not to multitask, focus on the task in hand and and simplify things where you can.
• Be kind to yourself: try not to dwell on the ‘fogginess’. Remind yourself this is temporary and that you are doing the best you can.

When to seek further help

For most people experiencing problems with memory and concentration will be temporary and you will be able to manage using the strategies above. 

If you’re finding that the fogginess is causing you anxiety, affecting  your ability to carry out essential tasks or continued for longer than expected, then do let your healthcare team know. Speaking with your GP, hospital doctor, specialist nurse can help.

Call into your local Maggie's centre. You can discuss your symptoms and find out more about support available for you.

What now?

Find your local Maggie’s centre. Drop in to learn more about the support during and after treatment that can help you.

Have a look at our blogs and links on this page to find out more about coping with problems with memory and concentration during and after treatment for cancer.

Talk with others about what you are experiencing. It can help to hear that what you’re feeling is not unusual, and help you to feel less alone.