Brain gain: How to manage ‘chemo brain’

Among the many side effects of breast cancer treatment, the fogginess or mental changes that many people experience can be a frustrating one. ‘Chemo brain’ is a common side effect – affecting as many as 70% of cancer patients – which can be felt as a decline in mental ‘sharpness’. Signs of chemo brain include:

• Lapses in memory (trouble remembering details like names and dates)
• Difficulty concentrating (trouble focusing on things or having a short attention span)
• Trouble with multi-tasking
• Struggling to find the right word during a conversation
• Taking longer to finish things (struggling to organise things).

Chemo brain – as the name suggests – is most often experienced during chemotherapy, but it can also occur during hormone or radiation therapy. For most people, these brain changes will only last a little while, but for others, it can last for several years.

Because the exact cause of chemo brain isn’t known, there’s no one treatment for it, but there have been some clinical trials investigating the issue. The MAGLEV trial, for instance, looked at whether magnesium supplementation could help improve cognitive function in women on endocrine (hormone) therapy. While more research is going on in this space, the following tips can help you manage brain fog:

Get organised

There’s plenty to keep track of during and after treatment – appointments, tests and treatment schedules – as well as the usual day-to-day routines. Stay on top of things by keeping track of appointments, to-do lists or notes in one space, like a planner or your phone calendar. Or hang up a big family calendar and get everyone to fill it out.

It may also help to track your memory problems, and what sort of things make them worse. Figuring out what your triggers are (like medicines taken, what time it is or what you’re doing) can help you manage ‘chemo brain’. For instance, you may choose to work on important tasks when you have the most energy, and avoid scheduling meetings when you know your mind is feeling foggier. Keeping track of ‘chemo brain’ can also be a useful record when you’re talking to your doctor.

Exercise your body – and your mind

Exercise can help with many side effects of treatment, such as fatigue, and ‘chemo brain’ is no exception. A 2017 study found that women who did more moderate-to-vigorous exercise had less fatigue and improved symptoms of ‘chemo brain’, such as being faster at executive function tasks (like organising and staying focused) and better accuracy on working memory tasks. Brain-training programmes can also help. One study found that a brain rehabilitation programme, Brain HQ, saw breast cancer patients report significant improvements in memory, concentration and problem-solving after a 15-week trial. Plus, the effects were still present six months after the trial. You’ll need a subscription to access the full range of exercises, but you can still try a few exercises for free.

Get enough good-quality sleep

The process through which the brain ‘cleans out’ waste happens mostly at night, so poor-quality sleep has a big impact on our cognitive function. Putting in place good ‘sleep hygiene’ can help set you up for a good night’s sleep. That may be going to bed and waking up at the same time each day, keeping your bedroom for only sleeping, and setting up a proper bedtime routine with no screen-time before bed. Mindfulness and relaxation exercises can also help you drift off quickly.

Ask for help

Unlike some side effects of treatment, ‘chemo brain’ isn’t always visible. If you’re struggling, reach out to your support network and let them know what you’re going through and what they can help with. Our nurses are also happy to help – you can call them for free on 0800 226 8773 or email breastnurse@bcf.org.nz.