What about my memory and thinking?

Recent research has shown that chemo can impact the thinking functions of the brain (known as cognitive functioning) for up to 10 years after treatment. Some of the brain's activities that are affected are concentration, memory, comprehension (understanding), and reasoning. The changes that are found in patients are often very subtle, but the people who have these problems are very aware of the changes in their ability to think.

Patients who have had chemo and have problems with thinking, memory, or concentration often call it chemo brain or chemo-fog. Some people report having these symptoms even before they start treatment. Others report it even though they have not had chemo. Still others notice the problem when they are getting hormone treatments. So the term "chemo brain" may not be completely accurate, but it is the name that most people call it right now. It does seem to happen more with high doses of chemo, and some drugs have been found to affect the brain. But at this time, there is no sure way to prevent it.

Researchers are currently studying the problem. They are looking for more information to help prevent and treat chemo brain. But just being aware that problems with thinking can happen may help patients and their family members feel less isolated and alone.

If you have problems with thinking that interfere with your daily life, there are memory retraining exercises and programs, as well as other treatments that may help you retain or improve your memory and problem-solving abilities. You can also learn strategies that may help you cope with the loss of cognitive function. Ask your doctor if he or she can recommend a health professional who can help. You can get more information in our document called Chemo Brain.

What emotional effects can I expect?

Chemo can bring major changes to your life. It can affect your overall health, threaten your sense of well-being, disrupt your daily routines, and put a strain on your relationships. It is normal and understandable for you and your family to feel sad, anxious, angry, or depressed.

There are ways to cope with these emotional side effects, just as there are ways to cope with the physical side effects.

You can draw support from many sources. Here are some of the most important:

Doctors and nurses

If you have questions or worries about your cancer treatment, talk with members of your health care team. If they are unable to give you the help you need, they can refer you to other health professionals who can help you.

Counseling and mental health professionals

Counselors can help you express, understand, and cope with the emotions cancer treatment can cause. Depending on what you want and need, you might want to talk with a psychiatrist, psychologist, social worker, sex therapist, or member of the clergy.

Friends and family

Talking with friends or family members may help you feel a lot better. Often, they can comfort and reassure you in ways that no one else can. But you may find that you have to make the first move. Many people do not understand cancer and may withdraw from you because they're afraid of your illness. Others may worry that they will upset you by saying the wrong thing.

You can help relieve these fears by talking openly with others about your illness, your treatment, your needs, and your feelings. You can correct mistaken ideas and let people know that there's no one "right" thing to say. Once people know they can talk with you honestly, they may be more willing and able to open up.

Support groups

Support groups are made up of people who are going through the same kinds of experiences you are. Many people with cancer find they can share thoughts and feelings with group members more easily than with anyone else. Support groups can also be an important source of practical information about living with cancer.

You can also find support in one-to-one programs that match you with a person like you in age, gender, type of cancer, and so forth. You might talk with this person on the phone or arrange visits.

Where to find information about support programs:

• Your hospital's social work department
• Your local American Cancer Society office or by calling us at 1-800-227-2345

Coping tips for everyday life

Here are some tips to help you during chemo:

• Try to keep your treatment goals in mind. This can help you keep a positive attitude on days when the going gets rough.

• Eating well is very important. Your body needs food to rebuild tissues and regain strength.

• Learn as much as you want to know about your disease and its treatment. This can lessen your fear of the unknown and increase your feeling of control.

• Keep a journal or diary while you're being treated. A record of your activities and thoughts can help you understand the feelings you have as you go through treatment. It can also help you highlight questions you need to ask your doctor or nurse. You also can use your journal to record the side effects. This will help you when you talk about them with your doctor and nurse. You can write down the steps you take to cope with side effects and how well those steps work, too. That way, you'll know which methods worked best for you in case you have the same side effects again.

• Take it easy. You may not have as much energy as usual, so try to get as much rest as you can. Let the small stuff slide and only do the things that are most important to you.

• Try new hobbies, and learn new skills.

• Exercise if you can and if your doctor says it's OK. Using your body can make you feel better about yourself, help you get rid of tension or anger, and build your appetite.

How can I relieve stress and relax?

Simple techniques can help you cope with stress and help you relax. Try some of these methods to find the ones that work best for you. You may want to check with your doctor before using any of these, especially if you have lung problems.

Muscle tension and release

• Lie down in a quiet room.

• Take a slow, deep breath.

• As you breathe in, tense a muscle or group of muscles. For example, clench your teeth or stiffen your arms or legs.

• Keep your muscles tense for a second or 2 while holding your breath.

• Then breathe out, release the tension, and let your body relax completely.

• Repeat the process with another muscle or muscle group.

Another way to do this is called progressive relaxation. You work your way up your body starting with the toes of one foot. Contract then relax all the muscles of one leg. Do the same with the other leg. Work your way up your body, contracting then relaxing each of the muscle groups in your body, including those in your neck and face. Remember to hold your breath while briefly contracting your muscles and to breathe out when releasing the tension.

Rhythmic breathing

• Get into a comfortable position and relax all your muscles.

• Close your eyes or focus on a distant object if you prefer to keep them open.

• Breathe in and out slowly and comfortably through your nose. If you like, keep the rhythm steady by saying to yourself, "In, 1, 2. Out, 1, 2."

• Feel yourself relax and go limp each time you breathe out.

• You can continue this for just a few seconds or for up to 10 minutes.

Biofeedback

With biofeedback training, you can control body functions such as heart rate, blood pressure, and muscle tension. A machine will sense and alert you when your body shows signs of tension. The machine will also give you feedback when you relax your body. With time and practice, you will be able to control your relaxation responses without having to depend on feedback from the machine. Your doctor or nurse can refer you to someone trained in teaching biofeedback.

Mental imagery

• Close your eyes, breathe slowly, and feel yourself relax.

• Imagine a ball of healing energy – perhaps a white light – forming somewhere in your body.

• When you see the ball of energy, slowly breathe in and blow the ball to any part of the body where you feel pain, tension, or discomfort, such as nausea. When you breathe out, picture the air moving the ball away from your body, taking with it any painful or uncomfortable feelings. (Be sure to breathe naturally; don't blow.)

• Continue to picture the ball moving toward you and away from you each time you breathe in and out. You may see the ball getting bigger and bigger as it takes away more and more tension and discomfort.

Visualization

Visualization is much like imagery. With visualization, you create an inner picture that represents your fight against cancer. You might visualize rockets blasting away the cancer cells in your body or knights in armor battling the cells.

Hypnosis

Hypnosis puts you in a trance-like state that can help reduce discomfort and anxiety. You can be hypnotized by a qualified person, or you can learn how to hypnotize yourself. If you are interested in learning more, ask your doctor or nurse to refer you to someone trained in the technique.

Distraction

Distract yourself from your worries or discomforts by watching TV, listening to the radio, reading, going to the movies, or working with your hands by doing needlework or puzzles, building models, or painting. You may be surprised how comfortably the time passes.

Go back to Understanding Chemotherapy: A Guide for Patients and Families.

Last Medical Review: 11/02/2009
Last Revised: 11/02/2009