Memory and Focus Concerns with Cancer

What are signs of memory or thinking problems with cancer?

The issues you may be experiencing with thinking, focusing, or remembering things when you have cancer are called "cognitive problems." While these issues may cause concern or worry, you are not alone–more than 70% of people with cancer face these issues. About one-third of people still have them after they have completed cancer treatment.

Signs of cognitive difficulties may include:

• Difficulty concentrating, focusing, or paying attention
• Struggling to do more than one task at a time
• Trouble remembering things, like names, dates, or phone numbers
• Experiencing "mental fog" that may make you feel disoriented
• Feeling confused and struggling to learn new information
• Having a tough time making decisions
• Struggling to find the right word for something or completing organizational tasks like paying bills

What causes chemo brain?

Some cancer treatments can cause changes in how your brain works. Even though this is commonly called “chemo brain,” anyone with cancer can experience memory, focus, and thinking problems. These problems can be caused by treatments including:

• Chemotherapy
• Radiation therapy
• Hormone therapy
• Immunotherapy
• Targeted therapy
• Brain surgery
• Other medicines used as part of treatment, such as steroids, anti-nausea, or pain medicines

The symptoms, severity, and timing of cognitive challenges are unique to each person. You could experience mental fog during or after cancer treatment. For some people, there may only be small changes to thinking, like trouble remembering things. For others, there could be greater challenges like trouble focusing, paying attention, or concentrating. In some people, there may even be cognitive issues before any cancer treatment at all. This could be due to other health issues or the stress of a cancer diagnosis. The level of cognitive problems depends on the type and location of the cancer, the type of cancer treatment, age, and other health-related factors like stress, depression, or anxiety.

How can I manage attention, thinking, and memory challenges?

If you are experiencing these issues, it is important that you talk about it with your doctor. Your healthcare team can assess if there are any other health-related issues like dehydration, anemia, poor nutrition, anxiety, depression, fatigue, and insomnia that they can treat to help manage your attention, thinking, or memory problems.

When talking to your healthcare team about any of these issues, try to give details about what you are feeling, when you notice these changes the most (times of day). Let them know what makes it better or worse, and how these changes are affecting your life. Be sure to include any other health symptoms you are feeling that could be related like fatigue, trouble sleeping, pain, or stress.

There are some key steps you can take that may help with changes in cognition.

• Rest: Ensure you are sleeping and getting plenty of rest when you need it
• Exercise and movement: Staying as active as possible can help keep your brain alert
  • Try light physical practices like gardening, walking, yoga, tai chi, or qigong
• Mental practice: Keeping your mind active can help with focus and attention
  • Try puzzles, word games, painting, playing an instrument or learning an easy, new hobby to keep your brain active

Here are some tips to help you cope with cognitive issues:

• Routine: Try to create a daily schedule you can stick to and rely on
• Checklists: Make a list of your daily reminders and check it often to keep yourself on track. Make sure you put the list where you can see it. Keep reminders on your phone or in a notebook you carry with you
• Preparation: Get yourself ready for the next day the night before so you can organize yourself and aren’t rushed in the morning
• Consistency: Place important items like your wallet or car keys in the same place every time so you can find them easily
• Task completion: Try to do one thing at a time and finish that task without interruptions if you can
• Organization: Try to keep your space tidy and organized so it is easier to find things. You can also label folders, drawers, or cabinets so you can easily find what you are looking for

Most importantly, talk to your healthcare team, friends, and family about any thinking or memory problems so you can get the support you need. During this time, you may need help from your caregivers to help you organize and remember things. If you are working during this time, talk with your employer and see if they can provide help or support like changing your workload or extending deadlines. You are not alone in your experience, chemo brain is common for people facing cancer and your healthcare team and loved ones are there to support you.

You may be experiencing other common side effects of cancer and cancer treatment like fatigue. Learn about what you can do if you are feeling tired.