Amy is a courageous 35-year-old woman and former Iowan who was diagnosed with Stage 4 Hodgkin’s lymphoma earlier this year. After removal of a large mediastinal tumor in her chest and 12 chemo treatments later, Amy is now cancer free and feeling blessed.

Throughout her cancer journey, Amy generously shared and memorialized her footsteps – the ups and downs. The amount of faith, grace, and humility she fought cancer with has been inspiring.

It’s Real

Along the way, Amy experienced “chemo brain,” a non-medical term used by cancer survivors to describe the mental cloudiness and thinking problems they notice before, during and after cancer treatment. Coping with the condition caused her periods of fear and anxiety.

She recalled: “I’ve always had this fear that when at chemo I’m going to use the restroom and forget to lock the door. That never happened. But, then I’m in the bathroom at work the following week and look up and the door isn’t latched. Oh, no!” Her doctor explained that the chemo treatments and other medications she was taking were playing a part in her short-term memory loss and anxiety issues.

Amy also shared the story about what happened on the day she had her 11th chemo treatment. “I was leaving chemo. I went to the parking garage to the location where I thought I had parked my car – and it was gone. I frantically looked around, even went up a level in case I forgot what level I had parked on. By now I’m in tears and feeling panicked. Then, I hit the lock button and heard my car honk at the bottom of the first level I was on. I had walked right by it.” She added, “Chemo brain, it’s a real thing people.”

Recognizing chemo brain

These sometimes vague, yet distressing, mental changes cancer patients experience are real. When chemo brain starts, how long it lasts, and how much difficulty it causes differs from person to person. Studies have suggested that up 70 percent of patients notice cognitive ‘clouding’ during active chemotherapy. Of those patients, the majority will get better within six to nine months, but a subset may have longer-term effects.

Signs and Symptoms

  • Being unusually disorganized
  • Confusion
  • Difficulty concentrating
  • Difficulty finding the right word
  • Difficulty learning new skills
  • Difficulty multitasking
  • Fatigue
  • Feeling of mental fogginess
  • Short attention span
  • Short-term memory problems
  • Taking longer than usual to complete routine tasks
  • Trouble with verbal memory, such as remembering a conversation
  • Trouble with visual memory, such as recalling an image or list of words


Research has shown there are many possible causes for mental fog or problems with brain function for cancer patients. Those problems can be caused or worsened by any combination of these factors.

  • The cancer itself
  • Chemotherapy
  • Other drugs used as part of treatment, such as steroids, anti-nausea, or pain medicines
  • Surgery and the drugs used during surgery (anesthesia)
  • Inflammation that occurs with surgery, radiation or chemotherapy
  • Low blood counts
  • Sleep problems
  • Infection
  • Tiredness (fatigue)
  • Hormone changes or hormone treatments
  • Other illnesses, such as diabetes or high blood pressure
  • Nutritional deficiencies (e.g., vitamin D)
  • Genetic factors might increase vulnerability
  • Patient age, an older brain is more vulnerable
  • Depression
  • Stress, anxiety, worry, or other emotional pressure

Family, Friends, and Your Cancer Care Team

A very important part of managing chemo brain involves taking about it.

Tell your family and friends; let them know what you’re going through. Tell them what they can do to help. Their support and understanding may help you to focus and better process information and perform daily tasks.

Always tell your cancer care team about any changes in your thinking. Your doctor will want to know when the problems started, how they affect your daily life, and what things make the problem worse or better.

You and your doctor can discuss:

  • medical issues that may be causing your symptoms.
  • coping strategies to minimize the effects of chemo brain (i.e., exercise, memory aids, treating fatigue and sleep problems, managing depression and anxiety, or other accommodation).
  • any treatment options.
  • any appropriate referrals (e.g., occupational therapist, neuropsychologist, language pathologist).

We’re here for you.

One thing is true, for everyone affected by chemo brain; you are not alone, and you can find help. Coping with chemo brain can be a team effort.

Drs. Amy Hughes and Roy Molina and their care teams at the Knoxville Hospital & Clinics (KHC) are here for you. Learn more about KHC’s Cancer Program.

Article References: : The American Cancer Society, Mayo Clinic, National Cancer Institute, Stanford University School of Medicine study (published in the Dec. 6, 2018, edition of Cell)


The information on this blog is provided for general information purposes and is not a substitute for professional medical advice, care, treatment or evaluation; nor should it be used in diagnosing a health condition. You are encouraged to consult your health care provider if you or a family member has or suspect you have a medical problem.