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Some cancer patients have changes in cognitive function during cancer treatment. Patients and families may notice changes in thinking, attention, or memory. Cancer patients often call this “chemo brain” or “brain fog.” Cognitive side effects during cancer are not fully understood, and there may be different causes including chemotherapy, radiation therapy, surgery, or hydrocephalus. Some cognitive changes are temporary, while others may be long lasting.
Some treatments for pediatric cancer, including chemotherapy and radiation therapy, increase risk for long-term problems in cognitive function. These problems are known as cognitive late effects.Read more about cognitive late effects in life after cancer.
Signs and symptoms of cognitive changes during cancer often depend on the age of the patient. Patients may feel like their thoughts are slow or that their mind is foggy. Symptoms of cognitive problems or chemo brain may include:
Cognitive side effects of chemotherapy and radiation therapy likely have multiple causes. Cancer treatments can impact the brain directly through effects on cell growth, inflammation, and blood supply.
Other factors may also affect thinking, attention, and memory in patients with cancer. These include:
It is important for families to keep in mind that the development of cognitive problems may not be related to the cancer experience. Symptoms may instead reflect familial risk or developmental problems unrelated to treatment (e.g., dyslexia or ADHD). A neuropsychological assessment can help detect specific problems, identify possible causes, and allow for interventions that best meet patient needs.
Cancer treatments may cause some cognitive changes that may or may not be long lasting. However, there are things families can do to help manage cognitive side effects and promote cognitive health.
For many patients, cognitive function will improve over time. However, there are some practical ways to cope with chemo brain and cognitive problems day to day. Patients and families can work together to develop strategies that best fit their needs. Make sure strategies are age-appropriate and give patients a say in planning.
Use memory aids and tools. Memory problems are very common with chemo brain and cognitive side effects. Calendars, notes, to-do lists, and reminders can help patients organize their day and accomplish tasks.
Keep to a routine. Many families find that consistency is key to help with memory and focus. A stable routine can also help reduce stress and anxiety because children know what to expect.
Focus on one thing at a time. Multi-tasking can be difficult for patients struggling with chemo brain or cognitive side effects. Limit distractions during activities. Help patients break down tasks into simple steps, and do one step at a time.
Practice mental skills. Chemo brain or cognitive side effects can affect each person differently. Some patients might have more trouble with memory while another might struggle with focus. Find fun ways to work on skills and exercise the mind through games, puzzles, and activities. Make sure to choose age- and ability-appropriate activities.
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Reviewed: April 2019