Chemo brain: Wait, what was I talking about?

I didn’t think this was a thing until I had chemo and experienced it myself. I would forget mid bloody sentence what I was saying, I’d forget what I went into a room for (which I know happens on occasion to the best of us but happened every freaking time) and put things in random places. One of my friends found herself putting keys in the fridge. It sounds funny and it kinda is, but it also sucks and can be infuriating.

Chemo fog, brain dysfunction, chemo brain, cognitive impairment or whatever you want to call it, is a decrease in your mental “sharpness”. It’s where you struggle with concentration and your memory seems to fail you. Sound familiar?

The studies vary massively with numbers of people affected by it ranging from 10% (10 in 100) to 90% (90 in 100)! The majority of people I've spoken to have suffered with it, so I feel the true number of people affected is on the higher side.

Problems you may experience include;

Difficulty concentrating.
Difficulty finding the right words.
Difficulty multitasking.
Difficulty learning new skills.
Short attention span.
Normal tasks taking longer to complete.
Short term memory issues.

Thankfully for the majority of people it is short term, and occurs during treatment and for a short while after (a few months). However in some people it can start after treatment. How long it lasts for is variable - and we’re not really sure why.

It’s not well understood why it happens. It’s thought to be due to a number of reasons.

The number one cause seems to be chemotherapy.

But also;

Brain tumours themselves can cause these symptoms.
Side effects of medication/radiotherapy/immunotherapy.
Anaemia (low haemoglobin).
Menopause or hormonal changes.
Fatigue/lack of sleep.
Emotional distress, anxiety, depression, stress etc.
Pain - especially if poorly controlled.

A few studies have shown that increased depression and anxiety can worsen chemo brain (see links below) and one showed that the older you are and the more cycles of chemo you have, the more likely you are to suffer with chemo brain - see study here.

What can you do to reduce the impact of chemo brain?

Keep a diary and/or a “to-do" list.
You can do a paper diary - but then what if you misplace it? I kept everything on my phone and it worked well. I also shared my diary with my partner so he can put things into it and he can see what I’m supposed to be doing when and where so can remind me.
If it wasn’t in my diary - e.g. appointments, seeing friends for coffee, going for a walk, I wouldn’t do it because I’d forget.
Likewise if it wasn’t on my to-do list - it ain’t getting done!
Do one thing at a time - try not to multitask.
If you’re a multitasker like me, this is hard to do at first but I could not multitask for sh*t during my treatment.
Avoid distractions
When doing things try and limit background noise such as the TV or radio.
Get regular exercise
This can help with your mood, with tiredness and improve alertness.
Avoiding alcohol
This can impair your thinking, concentration and memory at the best of times…
Eating more vegetables
Apparently this improves brain function. See articles here, here and here.
Exercising your brain
Doing puzzles (sudoku, crosswords, word search etc), reading, trying to learn new skills (my sister bought my a knit your own hat kit and a friend bought my a biscuit decorating kit!), learning a new language (I’m forever trying to improve my French, I used Duolingo’s app) etc.
Getting enough sleep
I know this is hard (see blog post on sleep here).

It’s hard especially if you’re used to multi tasking, remembering things without the need to write stuff down and being able to finish a sentence without drifting off. I really struggled with it, but the above tips definitely helped.

Talk to your friends and family, make them aware of how cr*p your memory and concentration is so they can help you and be more understanding. Even if it’s not that affected - it’s a good excuse to ‘forget’ when people ask you to do things!

My memory and concentration is improving, I don’t forget what I’m saying mid sentence anymore, well, sometimes, wait? What was I saying?

Oh yeah, my concentration has improved, but I’m still popping everything in my diary, on my to do list and not multi tasking, as that ship has sailed my friend. One day, I hope it comes back, but if I can’t do 2 tasks at once, it’s no big deal, maybe it’s best to do one task at a time and do it properly anyway.

If you’re struggling with these symptoms I’d always advise speaking to your cancer team.