Thinking and memory loss with cancer

Thinking and memory changes are common for people who have been diagnosed with cancer. While it’s natural for the ageing process to affect how the brain works (cognitive function or cognition), people with cancer often report they feel a more sudden or noticeable decline in cognition.

These changes to cognition may occur before, during or after cancer treatment. Some changes are small but for some people, changes may be more obvious. These changes can include:

• Difficulty concentrating
• Memory changes such as forgetting names, dates and words
• A feeling of mental “fogginess”
• Difficulty processing information such as following directions or learning new skills
• Finding it hard to do more than one thing at a time
• Difficulty finding words during a conversation or keeping up with conversations
• Being unusually disorganised
• Feeling very tired or exhausted
• A loss in motivation

The exact causes of cancer-related cognitive impairment are not known; however, studies have shown that memory loss with cancer may be triggered by:

• Cancer treatments
• Side effects from treatment such as difficulty sleeping, fatigue, pain and hormone changes
• Inflammation caused by the cancer
• Medicines used for surgery or to manage side effects
• Emotions such as feelings of depression and anxiety
• In some cases, the physical presence of a tumour in the brain

Changes to thinking and memory loss with cancer do not affect everyone with a cancer diagnosis but are relatively common. One study found that changes in cognition can affect one in three people before treatment, up to three in four people during treatment and one in three after treatment.

Changes in thinking and memory are usually temporary and improve with time. Generally, cancer-related cognitive impairment is subtle, and other people may not notice. Speak to your doctor when you notice changes, if the decline is rapid, or if you are worried.

Cancer-related cognitive impairment may leave you not feeling like yourself which can affect your relationships with friends, family and colleagues, and have a big impact on managing at home, working or studying, or during social activities. This may make you feel upset, scared or frustrated and you might feel you have to put in extra mental effort and energy.

There are things you can do to cope with changes in cognition and improve your ability to manage daily life. Some suggestions are:

• Adjust your daily routine – keep a to-do list, use your smartphone/mobile features such as reminders or alarms, try not to multitask, avoid distractions, put objects like keys in a specific place, pace yourself
• Involve other people – if you feel comfortable talk to friends and family about what is going on, talk to your health care team about how you are feeling, take a support person to appointments or treatment
• Improve your thinking and memory – in conversation focus carefully and repeat what has been said, break down new information into smaller chunks, take a class to learn a new skill, try doing something creative
• Try cognitive rehabilitation – a trained health professional will assess you and help you work on developing strategies to overcome specific challenges.

At times your appetite may be impacted by cancer treatment, but where possible it is always recommended that you eat a balanced diet. Nutritious, healthy food can help to improve your energy levels, sexuality and sleeping patterns, and in turn support your mental wellbeing. If you find that you don’t feel like eating anything, try a small snack until your appetite returns.

Physical activity can help improve your mental wellbeing, so be activeactive, if possible, but be kind to yourself if you can’t do it. Minimise stressful activities; try more gentle activities that can still help with cancer and memory loss, such as meditation or relaxation.