Past Issues
Editor's Feature
Brain Fog
I can’t multi-task anymore!
The term ‘chemobrain’ was coined by breast cancer survivors to describe disruptive changes to thinking and memory. During treatment, some patients notice difficulties with concentration, memory, multi-tasking and planning. Studies show that as many as 75% of cancer patients experience cognitive changes following diagnosis or treatment.
To explore chemobrain further, I talked to Heather Palmer, who has a PhD in neuropsychology and is an expert in the relationship between the brain and behaviour.
Q: What is chemobrain?
A: If you say ‘chemobrain’ to any cancer patient, they will know instantly what you are talking about—changes or difficulties with memory. In conversation, they can’t find the word they want. Writing a note or an email, they miss an entire sentence or spell a word completely wrong. They know the word doesn’t look right, but when they hear it in their head, it sounds like it is spelled right. People generally describe their symptoms as relating to memory, but they often mean more than just poor memory.
Q: Like dealing with the normal tasks we manage every day—planning supper, buying groceries, running errands and so on?
A: Exactly. For people with brain fog, multi-tasking can become too difficult and everything starts to fall apart—dinner gets burned, laundry gets left in the washing machine, someone doesn’t get picked up—you get the picture. This has a huge impact on successful day-to-day functioning. If you can’t multi-task successfully, you don’t get as much done and you forget things. You start to lose self-confidence. This makes you feel bad about yourself and that makes the problem worse.
Q: What causes chemobrain?
A: There are many possible causes; chemotherapy is only one possibility. That is why ‘brain fog’ is a more appropriate term. Not all survivors experience brain fog in the same way and they certainly don’t all experience it for the same reasons, so the cause isn’t necessarily the same. Most people experience memory lapses from time to time. For cancer survivors who do experience brain fog, memory problems happen more often and are more severe.
Q: Do doctors recognize brain fog?
A: Given the amount of stress and the impact it has on people’s day-to-day lives, I don’t think brain fog has received the attention it deserves. But awareness is improving. More and more research is being done and medical professionals are getting a better scientific understanding of the cognitive problems that affect many survivors during and after cancer treatment.
Q: Is there treatment for brain fog?
A: There are things people can do to improve their cognitive health. Our program, Maximum Capacity, uses the concept of neuroplasticity (the brain’s ability to reorganize itself by forming new neural connections). The approach is two-fold. Inside the brain, we try to develop new connections between brain regions and strengthen existing connections. Outside the brain, we teach patients more effective external strategies to take some of the load off the brain. This results in a better balance between internal and external usage. People function just as well, if not better, than before.
Q: Can you give us an example of an external strategy you teach?
A: Note-taking and using day planners are excellent strategies. But one of my favourite strategies is external self-talk. Self-talk uses clear, external verbalizations, such as “I’m going upstairs to get my glasses.” By saying it out loud, you process the information at a speed more consistent with your brain’s capacity. This also imposes organization. We can think many things at once inside our head. When we say them out loud, we deal with one thought at a time. External self-talk forces you to process the thought twice: you’ve thought it and heard it. By simply saying things out loud, you can organize your thoughts better, slow down and process more deeply. This way you will be more likely to remember.
Q: Where can people go for more help?
A: Talk to your doctor or nurse about cognitive rehabilitation programs in your area. We offer programs through the Maximum Capacity offices, as well as at most Wellspring Cancer Support Centres.
Related Discussions
So many cancer survivors think they are the only one with memory problems. You’ll find that this isn’t true. Read what others are saying on the forum and the blog. Join the conversation and share your story.
Discussion Forums
> Open Forum (English)
> memory loss
“I cannot remember words at times... I was explaining about a pattern for a scarf and couldn't find the word pattern. Is this normal?”
Created by: bunny
read more
Discussion Forums
> Open Forum (English)
> Arimidex side effects?
“Then talk about my memory!! At first I thought it was because of the chemo…”
Created by: Bubbles
read more
Editor's Blog
> Brain fog: not a figment of your imagination
Join Dr. Heather Palmer and me on this special blog about brain fog.
read more
Featured Resources
Yes, brain fog is real. While the exact cause is unknown, there are things you can do to improve your memory. Here are some resources from the SharingStrength library that can help you understand brain fog and find out how you can sharpen your mental abilities and manage cognitive problems.
- Chemobrain
Information from the American Cancer Society about chemobrain and how to manage it. - Chemobrain: When Cancer Treatment Disrupts Your Thinking and Memory
Information from the Mayo Clinic about memory changes and how to manage them. - Cognitive Changes and Chemotherapy
Excerpt from the Canadian Cancer Encyclopedia, describing cognitive changes, also known as chemobrain. - Cognitive Rehabilitation
Excerpt from the Canadian Cancer Encyclopedia about cognitive changes due to cancer and what you can do about it. - Coping with the Effects of Chemobrain
Audio file and text transcript of a radio show by the Yale Cancer Center about coping with chemobrain. - Memory and Concentration Changes
Information from ChemoReady.ca about memory changes and how to manage them.
Featured Organization
Maximum Capacity: Strategies for Cognitive Enhancement offers programs to help people experiencing cancer-related brain fog (sometimes called chemobrain) to clear the fog and get their thinking back on track.
All programs were developed by company founder and director Heather Palmer (PhD, neuropsychology) and are led by professionally trained individuals, face-to-face, in a friendly, welcoming environment. Participants are taught published, evidence-based scientific techniques and strategies to help improve or regain their thinking in three key areas: memory, task management and psychological well-being. The overall objective is to help people learn which combination of techniques works best for them in their daily lives. They learn through self-awareness and the experiences of other group members.
Heather Palmer gives talks to many cancer groups across the country. Maximum Capacity offers group seminars at its offices in Toronto as well as free of charge at many Wellspring Cancer Support Centres.
Maximum Capacity also works with seniors, people with traumatic brain injuries and anyone who is looking to improve their mental edge. Maximum Capacity believes that the brain has the capacity to make new pathways between brain regions and that, through proper training, people can regain cognitive skills they thought were lost for good.
