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Chemo brain (also known as Chemo Fog) is one of the most commonly reported post treatment symptoms for people who have undergone chemotherapy. 

While chemo brain can be generally described as feeling as if you are in a fog, it can show up in different ways. For instance, chemo brain can show up as the lack of ability to remember certain things, trouble finishing tasks, and/or difficulty learning new skills. 

There is a lot of individual variability. Sometimes the effects of chemo brain are very mild and short lived. Sometimes they affect daily living or interfere with the ability to work for up to 10 years after treatment. Chemo brain can also interfere with relationships with families and friends, especially young children.

Generally people can still function with chemo brain. It just takes more effort.

There are no proven medical treatments to prevent or get rid of chemo brain. Instead, treatment focuses on coping with symptoms. Some coping techniques include:

  • Scheduling your day to do the most important things when you are at your best.
  • Setting a pattern for important chores so you do them the same way each time. 
  • Memory retraining exercises and programs.
  • Controlling other causes of memory lapse, such as being overly tired or disorganized.
  • Modifying your work schedule. 
  • Minimizing the effects on your medical care by telling your doctor what you are experiencing, preparing for meetings with medical personnel and using aides to remember to take medications.

It is advisable to let family (including children) and friends know if you experience chemo brain. Their support and understanding can help you relax and make it easier to focus and process information.

If chemo brain causes you to need changes in your work situation to help do your job, consider asking for an accommodation. (You may even be entitled to one under laws such as the Americans With Disabilities Act). If you need to stop work, take appropriate steps, including doing what is necessary to keep your health insurance. (To learn how to prepare to stop work, click here.)

If you need help coping with chemo brain, consider seeking professional help with a psychologist or psychiatrist. Testing can help specialists find the extent of your symptoms and then suggest the best mental exercises for your problems. They can also recommend techniques for coping with your particular situation. 

For additional information, see:


  • There could be other causes for symptoms that appear to be chemo brain. If you believe you have chemo brain, ask your doctor to evaluate you to find out whether there may be another underlying treatable cause such as depression or hypothyroidism, and poor sleep. Once other causes are ruled out, the best doctor to provide a diagnosis of chemo brain is a neuropsychologist who knows how to test for brain function. 
  • Try not to focus so much on how chemo brain symptoms bother you. Accepting the situation will help you deal with it. As many patients have noted, being able to laugh about things you cannot control can help you cope.
  • You probably notice your memory situation much more than other people do. 

Work And Chemo Brain

If you are experiencing Chemo Brain symptoms:

  • Get a note from your doctor stating that you have chemo brain to use in case you need to.
  • If your work is impacted by chemo brain, ask for an accommodation. 
    • Examples of reasonable accommodations include
      • Limiting your job to the required basics 
      • Allowing more time to get the job done 
      • Extending deadlines
      • If noise is distracting, look for a way to move your work location or to decrease the noise or perhaps wear noise reduction ear pads.
    • If you have not disclosed your health condition, you will have to in order to get an accommodation. (For information about disclosing your health condition to your employer, click here.For information about disclosing to co-workers, click here.)
  • It helps to understand your legal protections under laws such as the Americans With Disailities Act (ADA) before starting such a negotiation. 

How To Cope With The Effects of Chemo Brain

Following are some ideas that have proved successful in minimizing the effects of chemo brain:

Health Care

  • Tell your doctor about the symptoms you are experiencing. If new symptoms or degree of symptom appear, let your doctor know by email or leaving a message at his office.
  • Prepare for each meeting with your doctor. For instance, 
    • Keep a symptoms diary that will give your doctor an idea of what symptoms you are experiencing, including time of day and situations in which your symptoms occur. (Survivorship A to Z provides a symptoms diary that you can use. The press of a button turns it into an easy to read graph.)  Keeping track can also help you plan your schedule around when you're feeling at your best. 
    • Keep track of your memory problems including the events that are going on at the time, medications you recenty took and the situation you are in. These notes can help you figure out what affects your memory.
    • Write down your questions and concerns. If you use our Prioritizer tool, you can not only keep track of questions and concerns, you can order them to your priority before the appointment by pushing a button. 
  • Record each session with your doctor. Recorders are built into smart phones. Stand-alone recorders are not expensive.
  • Use aides to help you to remember to take your medications.
  • Ask a family member, friend or other caregiver to help you sort through medical matters.

At work

  • In case your employer doesn't believe you have chemo brain, or doesn't know what it is:
    • Print information from this document which describes chemo brain.
    • Get a note from your doctor  or a neuropsychologist stating that you have chemo brain to use in case you need to. (To find a neuropsychologist, see the section in this document about finding a professional to help.)
  • Write everything down including facts you want to remember and actions you have to take.
    • Create a written plan which lists the steps you need to take to get the job done.
    • Ask co-workers to write you e mails or notes with information you need to remember or tasks you need to do rather than just tell you orally. You don't have to tell them about what's happening.
    • Place Post-It notes around your space as a daily visual to help keep you focused.
  • Think of multi-tasking as an enemy. Avoid multi-tasking. Break jobs down so you can do one thing at a time.
  • Keep your work area clear. Get rid of clutter. Clutter is distracting and can make concentration difficult.
  • When you have something important to say that requires a chain of thought (for example, to your boss or a sales call), rehearse what you want to say. Rehearsing keeps you in control when you cannot concentrate. Rehearsing makes it easier to know the thought to come back to. It helps keep you from spinning out of control.
  • Ask a co-worker to check your work - or use the computer to do it. 
  • Keep the boundaries of your abilities in mind. Everyone has boundaries. Knowing yours can be particularly helpful.

If your work is impacted by chemo brain, you can ask  for an accommodation to help you do your work. In fact, you may be entitled to a reasonable accommodation under laws such as the Americans With Disabilities Act (ADA) and similar state laws. (Our information includes how to negotiate for an accommodation. Examples of reasonable accommodations include:

  • Limiting your job to the required basics.
  • Reduce your client load.
  • Limit your hours.
  • Allow more time to get the job done. 
  • An employer supplied note-taker for meetings, or a recorder so you can record the meeting and review what was agreed upon later. 
  • Organize your work space or the way you do your work to make concentration easier. For example, a PDA pulls together your contacts, todo list and calendar.
  • If noise is distracting, look for a way to move your work location or to decrease the noise, or perhaps wear noise reduction ear pads.

Daily Tasks

  • Stay active.
  • Write down your tasks in a detailed daily planner. It doesn't have to be fancy. A simple notebook will do.
    • Keeping everything in one place makes it easier to find the reminders you may need.  
    • Serious planner users keep track of their appointments and schedules, "to do" lists, important dates, phone numbers and addresses, meeting notes and even movies they would like to see or books they would like to read.
  • Be realistic about how much you can do in a day.
    • Try to minimize the number of tasks you need to do each day.
    • Write your tasks down, for instance in a daily planner. Include how long each task will take and where you need to go. Keeping everything in one place makes it easier to find the reminders you may need.
    • List tasks in order of priority. You can use Survivorship A to Z's Prioritizer to change the order of your list to fit changing priorities.
    • PDAs (personal digitial assistants) can be useful in keeping you on track. Alerts that make a sound can help keep you organized and on schedule.
    • Serious planner users keep track of their appointments and schedules, "to do" lists, important birthdays and anniversaries, phone numbers and addresses, meeting notes, and even movies they'd like to see or books they'd like to read.
  • Do the most important tasks first.
  • Write things down as soon as you think of them.
  • Place Post-It notes around your home as a daily visual to help keep you focused.
  • Delegate as many tasks as you can. Friends and family are part of your team and want to help. Let them know what they can do. Give them a schedule if necessary.
  • Set a daily routine to the extent you can.
  • Conserve your energy. It can help you keep focus. 
    • Take frequent breaks.
  • Use appliances with automatic shut-off mechanisms.
  • Use telephones that store phone numbers.
  • Put important items like car keys in the same place every day.
  • Make notes or an outline as you read or study.
  • Set up reminders. Put small signs around the house to remind you of things to do, such as taking out the trash or locking the door.
  • Group long numbers into chunks. For example, the phone number 812-5846 can be repeated as "eight-twelve, fifty-eight, forty-six."
  • When doing a task with a number of steps, such as cooking or working on a computer, whisper each step to yourself.
  • Before you attend family events or work functions:
    • Review what you plan to say or bring up
    • Go over names and dates
  • Repeat what you want to remember. Saying it a couple of times can help your mind hold on to the information.
  • Carry a small digital recorder and record what you want to remember. Digital recorders are not expensive.
  • If there is something you want to remember to do when you get home, call your home phone and leave yourself a voice message.
  • When there are things you want to take with you when you leave home, leave them by the front door - or leave a Post-It on the door reminding you.

Day To Day

  • Make being organized a priority.
    • Make a "memory station" in your home. Put your keys and other items you need in the memory station. You won't have to worry about where things are.
  • Exercise your brain.
    • Do crossword, Soduku, and other puzzles
    • Play games which require thinking such as chess. Include card games which require thinking such as Bridge
    • Find things to memorize.
    • If symptoms are mild, consider learning a new language or taking a class.
    • Read a lot.
  • Exercise your body. 
    • Even mild exercise on a daily basis can help with attention and make you feel more alert. 
    • Exercise can also help decrease fatigue, depression and stress, all of which can contribute to memory problems. 
    • Caution: Do not overdo exercise to the point of fatigue. Fatigue may make the chemo brain worse.
  • Eat your vegetables. Studies have shown that eating more vegetables can help maintain brain power. (They are also part of a cancer prevention diet and lifestyle.)
  • Keep distractions to a minimum when you have to concentrate.
  • Do not try to multi-task. Focus on one thing at a time.
  • Manage stress. 
    • Managing stress better may improve your memory and attention. To learn how, click here.
    • Learning how to relax can help you remain calm even in stressful moments. For example, consider relaxation training to focus attention.
  • Get enough rest and sleep.
  • Accept the problem, including that it is not your fault.
  • Look for humor in the situation. As many patients have noted, being able to laugh about things you can't control can help you cope.
  • Keep in mind that you notice your problems much more than others do.
  • Interact with people to the extent you can. 
    • Studies show that simply interacting with people can sharpen your thinking skills.
    • Tell the people closest to you what is going on. They will likely notice something is amiss in any event.
    • Getting support and understanding can make you feel relieved, help you relax, and make it easier for you to focus and process information.
  • If you have children, it is advisable to also tell them about your cancer and your chemo brain.

Family and Friends

  • Tell family and friends about your chemo brain. Telling relieves the stress of trying to hide the effects.
  • Tell them what they can do to help.
  • Ask for understanding. Chemo brain is real.
  • Ask for help with activities or chores that are difficult for you.


If it is difficult to remember where you parked your car:

  • Park in the same spot every day.
  • Write the location of the spot on your parking ticket.
  • Purchase an electronic finder. For example, look for the type of device where you press a button and a noise is made at the source. Some cars (such as Subaru) have this feature built into their electronic key.
  • Use direct deposit for your paycheck so your check is deposited directly into your bank account.
  • Make alerts in your calendar, in your computer or PDA to remind you about financial deadlines, including when moneys are due for which you do not normally receive a bill.

Names and Numbers

  • Use rhymes, word associations and other memory tricks to remember names and numbers.
  • Try using more than one sense to help remember. For instance, link a person's name with an odor, taste or texture.
  • If you can't remember someone's name, phrase your sentence so you don't have to use the name.

PLEASE SHARE YOUR TIPS. E mail: Survivorship A to Z. Please let us know if it is okay to use your name if your tip is posted.

What Causes Chemo Brain?

No one knows what causes chemo brain.

Research has shown that some cancer drugs can, indeed, cause changes in the brain. Imaging tests have shown that after chemotherapy, some patients have smaller brain size in the parts of the brain that deal with memory, planning, putting thoughts into action, monitoring thought processes and behavior, and inhibition.

Some people report having these symptoms even before they start treatment. Others report symptoms of chemo brain even though they have not had chemotherapy. Still others notice the problem when they are getting hormonal treatments. So the term "chemo brain" may not be completely accurate, but it is the name that most people call it right now.

How often it happens, what may trigger it, or what can be done to prevent it, is also unknown.

Chemo brain could be caused by any one or a combination of the following factors:

  • The cancer itself
  • Chemotherapy drugs
  • Other drugs used as part of treatment (such as anti-nausea or pain medicines)
  • Patient age
  • Stress
  • Low blood counts
  • Anxiety
  • Depression
  • Fatigue
  • Sleep disturbances
  • Hormonal changes

Because the cause is not known, there are no tests for chemo brain. There are, however, tests which can rule out other causes of the mental fog known as Chemo brain.

Symptoms of Chemo Brain

Chemo brain shows up in the following possible ways:

  • Memory loss. Working memory is impaired. Retrieving previously learned information may be difficult.
  • Difficulty remembering common words or details.
  • A general blunting of mental sharpness.
  • The amount of new information that can be learned at one time may be reduced.
  • Difficulty concentrating or paying attention.
  • Difficulty doing more than one task at a time. For example, talking on the telephone while cooking.
  • Being easily distracted.
  • Losing a train of thought.
  • It can take longer to finish tasks (which can result in trouble meeting deadlines).
  • Feeling overwhelmed when more than one thing is happening at the same time, for instance, more than one conversation.
  • A general feeling that you are not functioning as you once did. As Sarah put it: "I'm still able to function. It's just the fine degree of memory or the speed at which I'd be able to recall information."

Reasoning and problem solving tend not to be affected.

The effects of chemo brain are generally mild to the point that other people may not notice. The effects can be more severe.

Chemo brain may lead to a feeling of diminished independence and increased dependence, feeling scared, or feeling emotionally drained. 

Chemo brain can last for a short period of time or continue for months after termination of treatment. Chemo brain has been known to extend for longer period of time, up to 10 years.

How To Find Help Coping With Chemo Brain

Start with your oncologist or primary care doctor for a diagnostic workup of potential medical problems that may be contributing.

If you have difficulty copies with chemo brain, contact a neuropsychologist. A neuropsychologist is a professional who specializes in helping people with memory problems. He or she will test brain function and possibly recommend ways to help better deal with the problems. If a neuropsychologist is not available, consider a neurologist (a medical director who specializes in the nervous system) or a psychologist.

Once you have identified potential doctors, see: How To Choose A Specialist.

NOTE: Check your insurance coverage to find out whether the appointment(s) will be covered. Even if covered, what will your costs be? (If money is a problem, see the articles in "To Learn More.")