What is “chemo brain?”

Chemo brain is a term that often describes the cognitive challenges that you may experience after receiving cancer treatment. These cognitive challenges may include difficulties with short-term memory, an inability to concentrate or trouble focusing, challenges with executive function, trouble with learning new things, and difficulties when working with numbers. If you are experiencing any of these challenges you should talk with your health care team.

Scientific research on the causes, prevention, and treatment of chemo brain are limited. However, some recent studies have shown that people can experience cognitive challenges, not only when receiving chemotherapy treatment, but also when receiving radiation or endocrine therapy.

Various studies have shown that up to 60% of patients experience cognitive problems post-treatment. There are also 20-25% of people who have cognitive impairments prior to treatment. Some of the predictors of whether or not someone will experience chemo brain include: age; genetics; and cognitive reserve before you start treatment (e.g., IQ, education, occupation, hobbies, etc.).

What other factors can affect cognitive function?

  • Stress, depression, anxiety, etc.
  • Sleep disorders (insomnia, sleep apnea)
  • Pain and pain medications
  • Poor nutrition and hydration
  • Lack of exercise
  • Other physical illnesses

Practical Strategies to Improve Cognitive Function

  • Get enough sleep
  • Hydrate (drink water)
  • Get proper nutrition
  • Exercise
  • Talk to your doctor about medications (e.g., depression, anxiety, pain, etc.)
  • Prioritize! Create a desk/office/home organizing system for things that are:
    • Important and urgent (do these first)
    • Important and not urgent (schedule these for another time)
    • Less important and urgent (delegate these if you can)
    • Not important and not urgent (consider removing these from your to do list)

Chemo Brain and Work

Studies show only 2% of people multi-task effectively. Consider some of these practical strategies to improve cognitive function at work:

  • Do one thing at a time
  • Reduce interruptions and distractions at work
  • Reduce clutter in your workspace
  • Take notes and make lists – use software programs or applications
  • Use calendar or reminder features on a phone, computer, or tablet

Ask for Reasonable Accommodations

Reasonable accommodations are available to eligible employees under the Americans with Disabilities Act (ADA) and state fair employment laws. Accommodations are any change in the workplace or in a policy that allow an individual with a disability to enjoy equal employment opportunities. Employees should think creatively about possible reasonable accommodations that might help them deal with the effects of chemo brain at work.

For example: Genevieve has been working through her chemotherapy treatment, but has been experiencing chemo brain, including loss of focus and short-term memory challenges. She is concerned it is affecting her ability to work. Genevieve works for an internet company and her desk is in a cubicle on a floor of the building with an open floor plan with offices circling the cubicles. There are 2 desks per cubicle and even though there low partitions between the cubicles, Genevieve finds it difficult to concentrate at work. What reasonable accommodations may help Genevieve continue to do her job effectively?

  • Work Space
    • Moving to an office with closed door
    • Moving to a desk in the corner of the floor plan with less surrounding noise
    • Only use one desk in the cubicle, instead of two
    • Create higher partitions (e.g., wall or bookcase barrier)
  • Technology
    • Wear noise-canceling headphones
  • Policy
    • Allow headphones if not normally allowed
    • Allow access to an office regardless of seniority
  • Schedule
    • Telecommute (work from home)
    • Shift work hours to 7am-3pm, when office is quieter and has fewer distractions
Reasonable Accommodation Resources

Last reviewed for updates: 01/2022

Disclaimer: This handout is intended to provide general information on the topics presented. It is provided with the understanding that Triage Cancer is not engaged in rendering any legal, medical, or professional services by its publication or distribution. Although this content was reviewed by a professional, it should not be used as a substitute for professional services. © Triage Cancer 2022

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