Cognitive changes (chemo brain)

Any problems with concentration or memory are usually temporary and mild. But they can be frustrating and interfere with your normal activities. They may delay some people from going back to work, school or to social events.

Common symptoms include:

• extreme tiredness (fatigue)
• feeling like you can’t think clearly
• finding it hard to remember things
• being unusually disorganised
• finding it difficult to do more than one thing at a time
• getting distracted more easily
• feeling low in mood.

If you have these symptoms, you should talk to your doctor. It can be helpful to keep a record of your symptoms to show the doctor.

The causes are unclear. Research suggests that it may be caused by a combination of factors. Some risk factors may include:

• certain cancer types such as brain tumours
• cancer treatments including chemotherapy, hormonal therapy, radiotherapy, immunotherapy and steroids
• treatment to the brain, such as intrathecal chemotherapy or radiotherapy to the brain
• high-dose treatment with chemotherapy or radiotherapy
• side effects of cancer treatment, such as infection, low number of red blood cells (anaemia), extreme tiredness (fatigue), sleep problems, poor nutrition and menopause
• emotional reactions to cancer and treatment, such as anxiety and depression
• non-cancer drugs such as painkillers or anti-sickness (anti-emetic) medicines.

The benefits of your cancer treatment will usually outweigh the risk of developing CRCC. Your doctor or nurse will talk with you about your treatment if you are worried.

Problems with concentration or memory are often mild and get better with time. But for some people, symptoms can continue for years after treatment.

There are a number of things you can do to help yourself.

Many people find that talking to family and friends can help. Changes in memory or concentration are often less obvious than other side effects of treatment. You may need to explain how you are feeling and how it is affecting you.

Your family and friends may not be aware these problems can be a side effect of treatment. If they have noticed any symptoms, they may be relieved to know that these usually get better with time.

It is a good idea to write down how these changes are affecting you before you see your doctor. If your memory is bad, it may help to take someone with you. You could also ask the doctor for permission to record the conversation. Your doctor may:

• check for symptoms or side effects that could be contributing to your symptoms
• check if any of your medicines could be making symptoms worse
• refer you for specialist help, such as a counsellor or support group.

Our cancer support specialists can offer you support. They can also give you details of support organisations and counselling services in your area.