Concentration and memory problems after treatment for breast cancer

Cognitive problems Back to top

Cognitive means how we think and process our thoughts. We’re not sure what causes these cognitive effects although research is being carried out. The symptoms are often linked with chemotherapy| so the terms ‘chemobrain’, or ‘chemofog’ are used to describe them. But chemotherapy isn’t the single cause of concentration and memory problems and other factors may be involved.

Chemobrain is usually mild and often gets better within a year of finishing treatment|. Occasionally it can go on for longer or have more of an impact on people’s daily lives.

The symptoms may be more noticeable at the end of your treatment when you’re trying to get back to day to day life. Women can find this frustrating and worrying. But it’s common to feel tired at this time and this can make your problems worse.

Here are some examples of the difficulties people describe:

• difficulty in concentrating and focusing (feeling foggy)
• feeling mentally slower than before and finding it hard to take things in
• forgetting details of conversations/events you’d usually have no problem remembering
• mixing up dates and appointments and not being able to find things easily 
• difficulty doing more than one thing at a time (multitasking)
• struggling to find everyday words or phrases.

If you’re having these problems it’s a good idea to talk to your doctor about them. They will check if your symptoms are connected to any other causes. This can include the cancer itself, or the side effects of other treatments or medicines that you may be taking. Your doctors may decide to do some tests, such as blood tests or a scan, to investigate it further. There may also be other factors contributing to your symptoms and having these treated could help.

Menopause and possibly hormonal treatment

Early menopause| or going into menopause suddenly because of treatment, may result in similar symptoms or make them worse. 

Hormonal therapies|, such as tamoxifen|  and aromatase inhibitors (anastrozole|, letrozole| and exemestane|) may also have an effect on memory and concentration. 

Fatigue (extreme tiredness)

This is a common side effect of treatment and can cause similar problems with concentration and memory. Managing or treating fatigue| may help improve these problems.  

Anxiety, stress and depression

These can all cause difficulty with memory and concentration. These symptoms aren’t unusual in women who’ve had treatment for breast cancer. They can also affect your sleep and make you feel very tired. Treating these symptoms may help to improve memory and concentration.

Pain and other symptoms

If you’re in pain| or have other symptoms such as feeling sick|, it can be difficult to focus on anything else. Having your symptoms treated may help improve problems with concentration. If you think the drugs you are taking to control your symptoms are affecting your concentration let your doctor know.

Treatment Back to top

Some stimulant drugs such as dexmethylphenidate (prescribed for children with attention deficit disorder) and drugs used to treat sleep problems have been tried. But we don’t know enough about them yet.

A type of talking therapy called Cognitive Behavioural Therapy (CBT) which focuses on memory and attention may be helpful. Your GP can tell you more about this and can refer you for help.

What you can do to help yourself Back to top

There are different things you can do to improve your symptoms and help you to cope:

• Use things to help your memory such as planners, calendars, post it notes, to-do lists, etc.
• Keep notes of anything important, such as conversations with your doctor or nurse.
• Try to do one thing at a time.
• Have a daily routine and try to stick with it. Whenever possible cut out things that distract you (background noise, etc) when you’re trying to concentrate on a task. 
• Keep things in the same place. You’ll know where they are even if you don’t remember putting them there.
• Put items near the front door beforehand, if you need to take something with you when you leave the house.
• Use a pill box dispenser if you need to take medicines.
• Try brain exercises like crosswords, word puzzles or sudoku to help improve your concentration.
• Try to do simple arithmetic in your head for things like calculating your change.
• Keep a diary or note of times when it’s more noticeable or worse. You can then plan to do things that require concentration when you’re most likely to be at your best. You’ll also be able to recognise if there are patterns or triggers which make things worse for you.
• Look after yourself. Get plenty of rest but try to balance this with regular exercise. Exercise can help with fatigue and sleep problems, so may in turn improve your concentration and memory.
• Eat a healthy diet with plenty of fruit and vegetables. A healthy diet can help you to feel better and cope with your symptoms.
• Tell your family and friends about the difficulties you’re having. They can support you and help you find ways of making life easier.   
• Find some quiet activities that may help you to wind down and feel less anxious. Some examples are yoga, exercise, meditation, reading and complementary therapies.