JAMA ONCOLOGY PATIENT PAGE Cognitive Changes During Chemotherapy

Some cancer patients and survivors feel a mental cloudiness or “brain fog” that occurs during and after chemotherapy, sometimes referred to as chemobrain.

What Are the Symptoms of Chemobrain? Chemotherapy-induced cognitive dysfunction or impairment is the Cognitive Changes That Patients May Experience During and After Chemotherapy state of mind described by cancer patients and survivors as a vague and often distressing change in their thinking, alertness, and men- tal function from their prior baseline level. This has been described before, during, or after cancer therapy. For most patients it lasts for weeks to months, but for others it can be of longer duration and last several years. Some specific examples of symptoms include the following, all of which can be very distressing and may cause problems both at work and at home: Difficulty with new learning Taking longer • Taking a longer time to complete tasks to complete tasks • Trouble recalling names or objects • Trouble focusing • Difficulty finding words • Forgetting to finish small things, like turning off lights or locking the door

What Causes Chemobrain? Thereisnotasinglecauseforchemobrain.Someoftheknowncauses include the following: • Cancer itself Trouble multitasking Difficulty finding • Chemotherapy, radiation therapy, hormonal therapy the right word • Transplant treatment and side effects • Low blood cell counts • Steroids, anti-nausea therapy, pain medications (especially opioids) • Anxiety/stress/depression and worry from cancer and cancer- FOR MORE INFORMATION related therapy • American Cancer Society Website http://www.cancer.org/treatment/treatmentsandsideeffects Is Chemobrain Preventable or Treatable? /physicalsideeffects/chemotherapyeffects/chemo-brain While there is no single medication to either treat or prevent che- • American Psychosocial Oncology Society (APOS) mobrain, there are many things patients can do to manage the http://www.apos-society.org condition: • Keep a daily planner and a “to do” list and frequently update it. To find this and other JAMA Oncology Patient Pages, go to the Patient Page link on the JAMA Oncology website at Smartphones or tablets have daily planner apps to help patients. http://www.jamaoncology.com. • Do one thing at a time. Focus on only one task. • Sharing this condition with family and friends can help. Also keep your doctor informed about this issue. • Buy a pill box and maintain a pill diary for all medications. such as attention-deficit/hyperactivity disorder or narcolepsy or There is no approved therapy for this condition. Sometimes doc- medications for dementia. There is research ongoing on how these tors may prescribe stimulant medications used to treat conditions drugs and many other new drugs can help with this condition.

Author: Vivek Subbiah, MD The JAMA Oncology Patient Page is a public service of JAMA Oncology.The Published Online: November 12, 2015. doi:10.1001/jamaoncol.2015.4142. information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information Conflict of Interest Disclosures: None reported. concerning your personal medical condition, JAMA Oncology suggests that you Section Editor: Howard (Jack) West, MD. consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call (312) 464-0776.

jamaoncology.com (Reprinted) JAMA Oncology December 2015 Volume 1, Number 9 1353

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