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Advanced Breast Cancer and Chemo Brain

Chemo brain is a term used to describe cognitive changes associated with cancer treatments. Many people being treated for advanced breast cancer (ABC) experience chemo brain. Chemo brain can affect your language, how you learn, think, and reason.1

We further explored how chemo brain impacts those living with breast cancer in our 2020 Advanced Breast Cancer In America Survey. Results show that 63 percent of respondents say they noticed cognitive changes as part of their diagnosis. They had trouble concentrating, remembering things, and also felt confused at times. To provide more insight on how chemo brain affects those living with the condition, we asked our ABC community members to describe some of their experiences.

Noticeable changes from chemo brain

“I used to pride myself on having a memory like a steel trap.” – ABC community member

“The two that bother me the most are not being able to recall words and general memory issues.” – ABC community member

People with chemo brain often call it "mental cloudiness" or “brain fog." Chemo brain may make it harder to do the things you normally do. It may take longer to complete tasks as well. Typical symptoms of chemo brain include1:

  • Searching for words
  • Trouble finishing tasks or multitasking
  • Trouble learning new things or concentrating
  • Forgetfulness

Some with chemo brain notice only small differences in mental function. Others have more trouble and their symptoms interfere with their daily life.1

Causes of chemo brain

Medicines or treatments

“I am taking a combination of medications, both cancer and non-cancer related, that are the perfect storm for maximum chemo brain impact.” – ABC community member

“I thought cancer might have reached my brain, but then my oncologist explained it was more likely related to my medication.” – ABC community member

Chemo brain is most commonly linked to chemotherapy. This is especially true of high-dose chemotherapy or combination treatment with radiation. Results from our survey that 38 percent of respondents are currently receiving chemotherapy, and chemotherapy was the first treatment used by 35 percent of those who used 1 or more treatments and/or surgery.1

Chemo brain can occur at any time during or after treatment. Unfortunately, doctors do not yet know how to prevent it.1


“In response to my diagnosis, we made the changes to our lives that we felt were necessary.” – ABC community member

Certain lifestyle changes may lessen chemo brain. Exercising, eating well, and getting enough sleep may dull any cognitive changes you notice. Doctors also know that some lifestyle factors raise your risk of chemo brain.

Risk factors that increase the likelihood of chemo brain include:1

  • Trouble sleeping
  • Other health conditions
  • Mental health issues

Unfortunately, these risk factors are common in people undergoing treatment for ABC. Responses from those who completed the survey show:

  • 61 percent have sleep problems
  • 28 percent are also diagnosed with high blood pressure
  • 11 percent are also diagnosed with diabetes
  • 29 percent are also diagnosed with depression
  • 22 percent are also diagnosed with anxiety

Being older and drinking alcohol raises your risk as well. Hormone changes, such as being post-menopausal, have also been linked to chemo brain.1

The emotional toll of cognitive changes

“The unseen scars are not readily visible yet are often much more difficult to deal with.” – ABC community member

“This radical change has caused me to re-examine who I am, fundamentally, as a person.” – ABC community member.

Chemo brain may affect your sense of self. You may feel like you are not who you used to be which can impact your mental health. Asking for help may lessen the burden. In fact, 62 percent of respondents say they need emotional support. They often turn to faith, family, and friends for this support.

Attitude is everything

“I have to adjust my expectations of myself to be kind to myself.” – ABC community member

“But there is still magic and life goes on and I am still here, a person still figuring out how to do this life.” – ABC community member

Chemo brain may cause you to forget a word, lose your train of thought, or keep you from concentrating on tasks, but you are still you. Practicing self-care, meditating, asking for help, and keeping a positive attitude may help you cope with these changes.1

The 2020 Advanced Breast Cancer In America survey was conducted online from September 2019 through February 2020. The survey was completed by 546 people with advanced breast cancer.

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