What's Chemo Brain, Anyway?

Chemo brain—aka brain fog, chemo fog or “where-did-I-put-my-keys-again syndrome”—is a real challenge for up to 75 percent of cancer patients during treatment. Even after the final chemo drip, about 35 percent still experience symptoms like memory problems, concentration issues or that maddening word-finding problem.

Darcy Hughes, a speech-language pathologist at Franciscan Health, explains the symptoms well: “[They] can show up early or later in treatment, and they might resolve quickly—or stick around for years.”

Why Does It Happen?

The exact causes are as murky as brain fog itself, but researchers have a few clues:

  • Cancer treatments like chemo, radiation and immunotherapy
  • Medications with neurotoxic effects
  • Physical and psychological tolls from cancer, including stress and fatigue

Even more confusing, these symptoms can overlap with other conditions, such as dementia, especially in older patients. Tools like the Montreal Cognitive Assessment can help physicians pinpoint the source.

What Does Chemo Brain Feel Like?

Picture this: You’re trying to follow a recipe, but halfway through, you can’t remember if you added the sugar. Or maybe you’re mid-conversation, and a simple word like “microwave” becomes an elusive ghost.

Common symptoms include:

  • Memory problems
  • Difficulty concentrating
  • Mental fatigue
  • Trouble with problem-solving
  • The dreaded “tip-of-the-tongue” phenomenon

How Do You Manage It?

First, let’s get one thing straight: managing chemo brain isn’t about “powering through” or “trying harder.” It’s about giving your brain the tools it needs to function better—and maybe cutting yourself some slack along the way.

Here are six practical tips to lighten the fog:

1. Establish a Routine
Think of your routine as a roadmap for your brain. Knowing what’s next can ease mental strain. Create a daily schedule with reminders for meals, meds and appointments. (Pro tip: Post it on the fridge!) Stick to consistent wake-up and bedtime hours. Work with family members to keep the schedule realistic and supportive.

2. Use Memory Aids
Forgetfulness doesn’t stand a chance against sticky notes, checklists and phone alarms. Darcy Hughes says checking off completed tasks can even give a little confidence boost. For example, if you keep forgetting to water the plants, a brightly colored note on your coffee maker might do the trick.

3. Engage in Mental Workouts
Time to flex those brain muscles! Jigsaw puzzles, Sudoku and crosswords can keep your mind sharp. But don’t overdo it—pick times of the day when you feel your best. Bridget Kress, a Franciscan Health occupational therapist, reminds her patients to “take breaks if you’re feeling overwhelmed.”

4. Try Relaxation Techniques
Stress makes brain fog worse, so learning to relax is key. Deep breathing exercises or listening to soothing music can work wonders. Just imagine: 10 slow breaths before tackling your to-do list might make that mental mountain feel like a molehill.

5. Prioritize Sleep
Quality sleep can feel like a magic reset button. Start by creating a calm bedtime environment:

  • Dim the lights
  • Limit caffeine in the evening
  • Put away screens an hour before bed

Find what works for you, whether it’s a warm bath or a favorite prayer.

The Emotional Toll

Let’s not ignore the elephant in the room: chemo brain can be emotionally draining. Frustration, anxiety and even depression can creep in. That’s why open communication with loved ones is so important. Celebrate small wins, like remembering an appointment or finishing a puzzle, and don’t hesitate to lean on your support system.

There's Hope—and Help

Many survivors report that chemo brain improves over time, especially with the right strategies and professional help. Occupational and speech therapists can be game-changers, offering personalized techniques to boost cognitive function. Programs like Franciscan Health’s Moving Beyond provide resources, support groups and tailored care to help survivors thrive.

Managing chemo brain isn’t just about clearing the fog—it’s about finding your way through it with grace, grit and a touch of humor. Remember: You’re not just a survivor. You’re a thriver. Advocate for yourself, celebrate the progress you make and keep moving forward—one sticky note at a time.

Learn more about the Moving Beyond program here!