You’re not imagining things. Chemo brain — also known as “brain fog” — is real. Chemo brain interferes with your memory and makes it harder to think straight.

At the OHSU Knight Cancer Institute, we take a comprehensive approach to cancer. We treat the whole person, not the disease. That means we have a full range of experts and services to help you cope with this condition.

What is chemo brain?

Chemo brain is a common side effect of cancer and cancer treatment. It is often described as a fog or cloud that interferes with thinking.

It’s known as chemo brain because it was first reported by patients who get chemotherapy. But it can also happen to cancer patients who get radiation therapy and hormone therapy. It can even happen to patients before they get any treatment. The technical name is cancer-related cognitive impairment or CRCI.

Chemo brain usually gets better soon after treatment. But some symptoms can last for a long time. This can be hard on you and your caregivers.

Fortunately, several therapies can help you cope. Tell your care team if you’re concerned about chemo brain. They can help you figure out a plan and refer you to experts and services.

What are the symptoms of chemo brain?

 There is no official definition, but cancer patients sometimes report trouble with:

• Concentrating
• Remembering names or words
• Planning
• Making decisions
• Keeping track of things

What causes it?

Scientists are still working to understand the causes of chemo brain. Some patients have symptoms before treatment. Researchers think they may be caused by types of cancer that trigger changes in the central nervous system.

Some chemotherapy drugs can cause temporary inflammation in the brain, which has been linked to thinking problems. Radiation therapy and hormone therapy can also cause inflammation.

Many cancer patients face stress, which is also linked to thinking problems. Finally, cancer can make it harder to get a good night’s sleep, which can also cloud thinking.

How long does it last?

For many patients, symptoms of chemo brain resolve soon after they finish treatment. Some patients have them for longer. In some cases, issues persist for years.

How can you deal with it?

You can do several things to combat chemo brain and get back to your life. We offer expert support and assistance along the way.

• Get cognitive therapy
• Exercise regularly
• Sleep better
• Reduce stress (through mindfulness, yoga and acupuncture)
• Eat a healthy diet
• Learn coping strategies
• Ask your care team for help dealing with chemo brain. They can connect you to services and support.

Cognitive therapy

Like your muscles, your brain gets stronger with exercise. Our speech-language therapists offer cognitive therapy for chemo brain.

You and your therapist pinpoint issues and create a treatment plan. Then you work on exercises to boost your memory and strengthen your thinking skills. Therapy lasts from a few weeks to a few months, depending on your needs.

Ask your care team if cognitive therapy might be right for you.

Exercise regularly

Research at the Knight and other hospitals shows that exercise is a powerful form of therapy for cancer patients. This is particularly true when it comes to memory and thinking. Experts suggest at least 30 minutes of aerobic activity a day. Our physical therapists can work with you on exercises that suit your needs.

Ask your care team before starting an exercise program.

Sleep better

Cancer and cancer treatment can interfere with sleep, which is critical to brain health. Experts in sleep medicine have great tips for getting a good night’s sleep. We also offer treatment for sleep disorders.

Reduce stress

Cancer packs a lot of stress into your life, which can affect your thinking. We offer several classes in yoga and mindfulness, which lower stress and anxiety while improving sleep and quality of life. We also offer acupuncture for cancer patients.

Eat a healthy diet

You can’t think straight when you’re running on fumes. Cancer can disrupt your appetite and make it harder to eat smart, let alone think smart. At the same time, nutrition plays a vital role in your recovery. See information and resources on nutrition from our cancer dietitians.

Coping strategies

It can take a while for your brain to bounce back. In the meantime, here are some tips from our cancer social workers for coping with chemo brain:

• Set routines. This helps you remember all the things you need to do.
• Make lists. This helps you stay on track and break big tasks into smaller ones.
• Set reminders on your phone. Let your phone remember details so you don’t have to.
• Take regular breaks. This helps focus your attention.
• Do your thinking when you have energy. No one thinks their best when they’re tired.
• Have fun. Relaxing and having fun are essential to the healing process.