Chemo Brain Fog: Treating Cognitive Changes After Chemotherapy

Chemo brain (also called chemo fog and cancer-related cognitive impairment) is a term used to describe the impairment of memory and thinking that often occurs during and after cancer treatments, especially chemotherapy.

It affects the cognitive function of the brain, including memory, attention span, focus, and rational-thinking skills.

Chemo brain is one of the most common long-lasting side effects associated with chemotherapy.

Research studies have reported that chemotherapy-induced cognitive deficit occurs in nearly 10 to 40% of cancer patients and cancer survivors.

Chemo fog can be highly debilitating and frustrating for patients. 

Being aware of the early signs of chemotherapy brain and taking steps to minimize these side effects can improve the quality of life of patients to a great extent.

Keep reading to learn more about what chemo brain means, its symptoms, and how to minimize it.

Symptoms of Chemo Brain

Some common signs of chemotherapy brain fog include:

  • Confusion
  • Mental fogginess
  • Difficulty concentrating
  • Being unusually disorganized
  • Difficulty learning new skills
  • Reduced attention span
  • Difficulty finding the right words while speaking
  • Frequent incidents of short-term memory loss
  • Problems with multitasking
  • Taking longer than usual to complete simple daily activities
  • Decline in visual memory

Cancer survivors and patients undergoing cancer treatments should watch out for the signs of chemo fog and see a doctor if they experience problems with memory or thinking. 

They can keep a journal of the symptoms they experience so that the physician can better understand how the memory problems are affecting their everyday life.

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What are the Causes and Risk Factors of Chemo Fog?

Certain factors have been found to contribute to memory problems and increase the risk of brain fog from chemo in cancer survivors. 

These factors may be related to the specific form of cancer, the treatment method of cancer, complications of cancer treatments, and the presence of risk factors.

Some causes of chemo brain related to the specific diagnosis or form of cancer include:

  • Cancer mass that begins in the brain or spreads to the brain can cause changes in memory and thinking.
  • The diagnosis of cancer can cause stress and anxiety, due to which patients may experience problems with thinking and memory.  
  • Some forms of cancer produce chemicals that worsen cognitive impairment and memory deficits.

Cancer treatments associated with a higher incidence of chemo brain include:

  • Chemotherapy, especially when used in high doses
  • Bone marrow transplant
  • Hormone therapy
  • Radiation therapy
  • Immunotherapy
  • Targeted drug therapy
  • Surgery

The complications of cancer treatment that can worsen the symptoms of chemo brain include:

  • Hormonal imbalances
  • Fatigue
  • Anemia
  • Infections
  • Sleep problems

Other than these, there are a few risk factors that can make cancer patients more vulnerable to developing chemo brain. 

Some of these include:

  • Diagnosis and treatment of cancer at a younger age.
  • Inherited susceptibility to developing chemo fog.
  • Side effects of medications used for managing cancer-related symptoms, such as pain-relieving drugs.
  • Pre-existing medical conditions, such as depression, anxiety, thyroid problems, diabetes, and nutritional deficiencies.

Potential Complications of Chemotherapy Brain

The intensity and duration of the symptoms of chemotherapy brain fog vary among different patients. 

In most cases, cancer-related brain fog is temporary. Also, most patients are able to continue with their routine activities during the cancer treatment.

  • Some cancer patients and survivors find that their routine tasks take extra time and concentration. 
  • Some cancer survivors are unable to return to work due to the severe decline in their memory and concentration.

Consult your doctor if you notice these changes. 

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Treatment For Chemo Brain Fog

The treatment of chemo brain is aimed at coping with symptoms. 

Your healthcare team can collaborate with you to explore strategies that could alleviate the impact of chemo brain.

Here are some treatment options that can help address chemo brain.

Medications for chemo brain

There are no medications approved for the treatment of chemo brain. However, your doctor might prescribe medicines, such as Methylphenidate, Modafinil, Memantine, or Donepezil, which are approved for managing related conditions if they are expected to improve your symptoms.

Controlling risk factors

Controlling risk factors or conditions that contribute to your memory problems is the key element of chemo brain treatment.

Cancer, as well as cancer treatments, can cause other conditions, such as depression, anemia, sleep problems, and hormonal imbalances, which can worsen your memory problems. 

Controlling these factors can make it easier for you to cope with the symptoms associated with the impairment in memory and concentration.

Relieving the symptoms

A neuropsychologist who specializes in the diagnosis and treatment of conditions that affect cognitive functions, such as memory and thinking, will create a plan to help you cope with the symptoms of chemo brain.

This form of treatment plan is sometimes referred to as cognitive remediation or cognitive rehabilitation.

Some common elements of cognitive remediation that can help you adapt and cope with memory problems include:

  • Performing repetitive exercises to train your brain.
  • Tracking your symptoms to identify the factors that can worsen or improve your symptoms.
  • Practicing stress-relief techniques such as meditation and progressive muscle relaxation.
  • Using coping strategies such as learning new ways to perform everyday tasks.

Can You Prevent Chemotherapy Brain Fog?

Yes, some individuals find adopting certain practices beneficial in supporting cognitive function during and after cancer treatments. For example, you can try to:

  • Clear your mind of distractions.
  • Identify and manage controllable factors about your working environment, such as using noise-canceling headphones or earplugs, if noise is contributing to your distraction.
  • Create a plan so that you know what exactly you will need to do in order to complete the tasks.
  • Divide your tasks into smaller portions.
  • Take frequent breaks while working on complex tasks.
  • Stay organized using planners or calendars.
  • Have an organized workspace so that you have more time to accomplish the tasks.
  • Exercise your brain by solving number games or crossword puzzles.
  • Eat your meal at a fixed time to ensure a steady supply of energy to the brain.
  • Make sure you get at least 8 hours of sleep every night.
  • Take up a new hobby or master new skills to challenge your brain.  

Frequently Asked Questions

How long does chemo brain usually last?

The symptoms of chemo brain usually persist for a few months, although some patients continue to experience memory impairment for as long as 5 to 10 years after the cessation of cancer treatments. 

How serious is chemo brain?

Most patients who experience chemo brain are able to resume their routine life within a few months.
However, in some cases, chemo brain can significantly affect the quality of life of patients by interfering with their ability to perform routine tasks. 

Can chemo brain lead to dementia?

Yes, chemo brain might cause dementia. Recent research has suggested that chemotherapy drugs are more toxic to the brain cells than to the cancer cells they are meant to destroy.

Chemotherapeutic drugs can affect the cognitive domains of memory, processing speed, attention, and executive function in the brain, and thus, increase the risk of dementia and other cognitive dysfunctions.


Chemo brain can make it difficult for cancer patients and survivors to perform their routine activities independently or do their jobs. 

Being aware of the warning signs and taking steps to improve brain functions can help them avoid the severe symptoms of chemo brain fog.

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  1. Mitchell T, Turton P. ‘Chemobrain’: concentration and memory effects in people receiving chemotherapy – a descriptive phenomenological study. Eur J Cancer Care (Engl). 2011 Jul;20(4):539-48. doi: 10.1111/j.1365-2354.2011.01244.x. Epub 2011 Mar 28. PMID: 21443746.
  2. Matsuda T, Takayama T, Tashiro M, Nakamura Y, Ohashi Y, Shimozuma K. Mild cognitive impairment after adjuvant chemotherapy in breast cancer patients–evaluation of appropriate research design and methodology to measure symptoms. Breast Cancer. 2005;12(4):279-87. doi: 10.2325/jbcs.12.279. PMID: 16286908.
  3. Selamat MH, Loh SY, Mackenzie L, Vardy J. Chemobrain experienced by breast cancer survivors: a meta-ethnography study investigating research and care implications. PLoS One. 2014 Sep 26;9(9):e108002. doi: 10.1371/journal.pone.0108002. Erratum in: PLoS One. 2015;10(2):e0117740. PMID: 25259847; PMCID: PMC4178068.
  4. Henderson FM, Cross AJ, Baraniak AR. ‘A new normal with chemobrain’: Experiences of the impact of chemotherapy-related cognitive deficits in long-term breast cancer survivors. Health Psychol Open. 2019 Mar 5;6(1):2055102919832234. doi: 10.1177/2055102919832234. PMID: 30873289; PMCID: PMC6405778.
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