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This information is about mild cognitive impairment (MCI). This means changes in memory or concentration that can sometimes happen during and/or after cancer treatment. It’s also known as cognitive dysfunction, or sometimes as ‘chemo-brain’ or ‘chemo-fog’.
The phrase ‘chemo-brain’ was first used after women who had been treated for breast cancer reported changes in memory and concentration. They linked these problems to their chemotherapy treatment and called it ‘chemo-brain’. In our information we use the term MCI.
Cognitive means thinking or the way we process information. Impairment or dysfunction means that something isn’t working properly.
Mild cognitive impairment is a term used to describe changes in memory, concentration, and the ability to think clearly and put thought into action. Some people notice these kinds of changes happening during and after cancer treatment. Originally, these problems were first noticed in people having chemotherapy treatment, which led to the name ‘chemo-brain’. However, the term chemo-brain is probably misleading as research has shown that changes in memory and concentration can also happen in people who have had cancer but who have never had chemotherapy|.
At the moment it’s not clear which treatments may cause these problems, or whether they may be caused by the cancer itself or by emotions such as anxiety| and depression|. So the term that’s now usually used to describe these problems is mild cognitive impairment (MCI) or cognitive dysfunction.
MCI can be very frustrating and may have quite an impact on your life. Its effects are usually temporary. But it can interfere with your normal activities and may delay some people from going back to work, school or to social events.
The symptoms of MCI are usually mild and subtle, and vary from person to person. Most people are able to do everyday normal things, but may find that some things are more difficult than usual. Common symptoms may include:
If you think you may have symptoms of MCI you should discuss them with your doctor. It can be helpful to keep a record of your symptoms to show the doctor so that they can see how often and how much they are affecting you.
It’s not clear how many people develop problems with their concentration or memory during or after cancer treatment. Different research studies suggest that the number is somewhere between about 1 in 6 people (16%) and more than two-thirds (69%) of people treated for cancer. MCI can affect both men and women.
The causes of mild cognitive impairment are unclear. Research suggests that it may be caused by a combination of factors. Some of the following may be possible causes and/or risk factors:
It’s difficult to prevent or treat MCI as it’s not clear what causes it. A number of drugs have been tried to help people with MCI but as yet none has definitely proved successful and research is ongoing to find an effective treatment.
MCI doesn’t affect everyone and its effects are usually mild. It’s worth remembering that the benefits of your cancer treatment will usually far outweigh any risks of developing MCI. Your doctor or nurse will be happy to discuss your treatment with you if you are worried about MCI.
MCI doesn’t affect everyone and its effects are often mild. The symptoms are usually temporary and improve with time. There are a number of things you can do to help yourself. Your doctors or specialist nurse can give you more information and support.
Keeping a record of your symptoms may help you to identify when you’re more distracted or whether certain things make your memory worse. For example, you may notice that symptoms seem worse first thing in the morning, or when you’re tired or hungry. Noticing triggers or patterns like this can help you to plan your day so that you do more difficult tasks when you feel at your best.
You may find it helps to do some things a bit differently, to help you to concentrate and remember more. For example:
Memory and repetitive exercises may help to train your brain and improve your memory and concentration. You can help keep your mind active by doing crosswords, word games or number puzzles like Sudoku.
It can also help to do some physical exercise as this can help you feel more alert and reduce fatigue.
Stressful situations can affect everyone’s memory. Relaxation can help to reduce stress and may help to improve your memory and concentration.
Try doing some activities that will help you relax, such as listening to music or going for a walk. You could try using relaxation CDs or DVDs, or do some relaxation exercises. We can send you further information about relaxation.
Many people find that talking to family and friends about what they are going through can help. Mild cognitive impairment is often less obvious than other side effects of treatment so you may need to explain how you’re feeling and how it’s affecting you.
Your family and friends may not be aware of MCI as a side effect of treatment. If they’ve noticed any symptoms, they may be relieved to know that they are fairly common and should improve with time.
Your family and friends will be able to support you better when they understand more about how you feel, and may be able to suggest ways they can help.
Some other tips that might help are:
Tell your doctor or nurse if you think you may have some of the symptoms of mild cognitive impairment. They should be able to help relieve any side effects of treatment (such as anaemia), that could be contributing to your MCI. They can also refer you to other people for specialist help, such as a dietitian, a counsellor for relaxation support, or a support group.
Before you see your doctor it’s a good idea to write down how MCI is affecting you and to make a list of questions to ask. It may help to take someone with you or to record the conversation so that you don’t forget anything.
To help understand more about MCI, research is focusing on finding out:
To help guide the research, an international group was set up in 2006 by health professionals and patients. The International Cognition and Cancer Taskforce (ICCTF) aims to coordinate research, produce guidelines and give information to people affected by cancer. You can get more information about the ICCTF on theirwebsite|.
You may be asked to take part in a research trial| and your doctor or nurse will explain fully what this involves. You don’t have to take part in the trial if you don’t want to and you don’t have to give a reason why.
This fact sheet has been compiled using information from a number of reliable sources, including:
Content last reviewed: 1 December 2010
Next planned review: 2012
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
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© Macmillan Cancer Support 2013
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