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Managing Chemo Brain With Breast Cancer

Medically reviewed by Todd Gersten, M.D.
Written by Emily Wagner, M.S.
Updated on October 3, 2022

  • People living with breast cancer sometimes develop “chemo brain,” which makes thinking clearly difficult.
  • Most people notice mental changes during cancer treatment, but these are usually temporary.
  • Light exercise, plenty of sleep, and other lifestyle changes can help manage chemo brain symptoms.

Chemotherapy (chemo) treatment for breast cancer can lead to a condition known as chemo brain, which affects cognitive functions such as thinking and memory. It can even have lasting effects after treatment has stopped. Chemo brain is also called chemo fog, cancer-related cognitive dysfunction, or cancer-related cognitive impairment.

Many MyBCTeam members have shared their experiences, frustrations, and coping strategies for dealing with chemo brain. One member said, “I’m two years out and still have ‘cog fog’! I wonder if I’ll ever think normally again!”

Another wrote, “Whether it’s chemo brain, menopause brain, or both — it has been four years, and I feel so stupid and slow. I hate it.”

What Is Chemo Brain?

Health experts often describe chemo brain as a decrease in mental sharpness, or as mental cloudiness. This fogginess commonly occurs with chemotherapy treatment, but it can also happen with other types of cancer care, like radiation therapy, surgery, and hormone therapy.

Chemo brain is fairly common. One study found that 67 percent of people reported cognitive changes during chemotherapy treatment. The symptoms of chemo brain start during treatment and can last between nine months and 12 months after it is complete. Roughly 10 percent to 20 percent of people experience long-term cognition problems, according to Dana-Farber Cancer Institute.

A very small percentage of people may have noticeable symptoms for years after treatment; if you experience these cognitive symptoms, let your health care provider know. Your oncology team may be able to help.

Symptoms of Chemo Brain

The symptoms of chemo brain will often make it difficult for you to complete daily activities, such as going to work, school, or social events. The condition also can have a negative effect on your quality of life.

Symptoms of chemo brain include:

  • Memory loss (mostly short-term memory)
  • Trouble multitasking
  • Confusion
  • Difficulty concentrating
  • Inability to find the right word when speaking or writing
  • Short attention span
  • Slowness completing routine tasks
  • Difficulty learning new skills
  • Sleep problems
  • Trouble remembering conversations (verbal memory)
  • Trouble remembering lists or images (visual memory)

Risk Factors for Chemo Brain

Certain risk factors can contribute to your chances of developing chemo brain. These include:

  • Other medical conditions, such as high blood pressure or diabetes
  • Emotional conditions, such as anxiety or depression
  • Infections
  • Hormonal treatments for breast cancer
  • Side effects of other medications being taken during treatment, such as pain medicine, steroids, and anti-nausea medicine
  • Other cancer-related symptoms, such as sleep problems, fatigue, or pain
  • Older or postmenopausal age
  • Nutritional deficiencies

How Can You Prevent Chemo Brain?

Currently, there are no known ways to prevent getting chemo brain. Doctors and researchers are still learning exactly how chemotherapy drugs affect the brain. Chemo brain seems to be more common in people who receive higher doses of chemotherapy, and it may be worsened with radiation treatment to the brain (if breast cancer spreads to the brain).

Living With Chemo Brain

Many MyBCTeam members rely on alarms, sticky notes, and journaling to remember things. “After detoxing from chemo and doing memory puzzles, my brain is back!” reported one member. Other members have found that daily planners and list-making apps help them keep track of their daily lives.

MyBCTeam members also recommend supplements and physical activities such as yoga. Light aerobic exercises, such as walking, running, dancing, or biking, can help alleviate symptoms of brain fog and fatigue. Be sure to consult your doctor before starting any new exercises or supplements.

Day-to-Day Living With Chemo Brain

Chemo brain can affect your ability to function on a daily basis. Building a routine to follow every day can keep your brain on a schedule and may help prevent some cognitive issues. Other suggestions for managing chemo brain include:

  • Doing your hardest tasks when you have the most energy during the day
  • Getting enough sleep
  • Avoiding multitasking by focusing on one thing at a time
  • Keeping a diary of your memory problems and what you were doing when they occurred
  • Picking a specific place for items you may lose, and putting these items there every time you use them
  • Eating a healthy diet, including plenty of vegetables
  • Avoiding alcohol or other substances that can affect your mental state and sleeping patterns

If the cognitive problems caused by chemo brain are affecting your day-to-day activities, talk to your oncologist. They can make a referral to a neuropsychologist, who can test your cognitive function and recommend strategies for dealing with your cognitive symptoms (known as cognitive rehabilitation). You could also see an occupational therapist, a vocational therapist, or a speech language pathologist.

Support groups can also be an important part of breast cancer survivorship and adjusting to brain fog for some. Some hospitals offer wellness programs to help breast cancer survivors cope with chemo brain. One member wrote, “For the longest time, I thought it was just anxiety that comes with the condition. Now I know better, thanks to my beloved MyBCTeam friends.”

Talk With Others Who Understand

MyBCTeam is the social network for people with breast cancer and their loved ones. On MyBCTeam, more than 58,000 members come together to ask questions, give advice, and share their stories with others who understand life with breast cancer.

Have you experienced chemo brain during your breast cancer treatment? Share your experience in the comments below, or start a conversation by posting on your Activities page.

Updated on October 3, 2022
All updates must be accompanied by text or a picture.

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Todd Gersten, M.D. is a hematologist-oncologist at the Florida Cancer Specialists & Research Institute in Wellington, Florida. Review provided by VeriMed Healthcare Network. Learn more about him here.
Emily Wagner, M.S. holds a Master of Science in biomedical sciences with a focus in pharmacology. She is passionate about immunology, cancer biology, and molecular biology. Learn more about her here.

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