What is brain fog? (chemo brain)

Brain fog is a side effect of cancer treatment that can cause problems with your ability to concentrate and your memory. It’s sometimes also called ‘chemo brain’, but people who haven’t had chemo can experience brain fog too. These aren’t medical terms, but you might hear your care team or other young people talking about them. Some people say that during and after treatment they struggle to concentrate or find it hard to think clearly.   

These side effects can last for a short time or for a number of months, even after you’ve finished treatment. When these side effects continue after treatment they’re often called ‘late effects’. 

Late effects are delayed responses to treatment, you can get these months or even years after treatment. These effects can be related to the cancer itself or can be the direct result of cancer treatment. Monitoring and scans to check for late effects can be needed for years after your treatment is finished – your care team will let you know how regularly you’ll need check-ups at the end of your treatment.  

Brain fog is sometimes called chemo brain, as the symptoms were linked to chemo treatment at first, but it can impact people who haven’t had chemo too. You might also see it called cognitive changes or cancer-related cognitive changes. 

Common symptoms of brain fog include: 

• Struggling to concentrate  
• Forgetting things that you usually wouldn’t (memory loss) 
• Finding it hard to think of the right word 
• Getting distracted more than you usually would 
• Difficulty doing more than one thing at once (multi-tasking) 
• Fatigue (extreme tiredness) 
• Being more disorganised than you usually are 
• A foggy feeling in your brain or feeling spaced out 
• Feeling like you can’t think clearly or feeling confused more often 

These symptoms are usually mild and temporary but can be very frustrating and can get in the way of your day-to-day life. Not everyone who has cancer gets brain fog. Talk to your care team if you think you might have brain fog or you’re feeling worried about it. 

Some of these symptoms might also sound similar to the symptoms of depression. A diagnosis of cancer can affect your mental health before, during and after treatment. If you’re struggling with your mental health, try to talk to your someone in your care team about it. 

They’ll be able to give you support and will be able to connect you with people you can talk to, if that’s something you want. You can find more information about mental health here. 

At the moment, doctors don’t know exactly why some people experience brain fog as the exact causes are unclear. It’s also unclear how long brain fog is likely to last for each person. 

While not everyone with a cancer diagnosis gets brain fog, it can affect people of all ages and at different times in their treatment. It also affects people with different types of cancer, who have different types of treatment.  

Under UK law, a diagnosis of cancer is considered a disability in the Equality Act 2010. This means that whether you think of yourself as disabled or you don’t, you’re legally protected from discrimination at work and in education. This isn’t just while you’re having treatment, but for the rest of your life, including if you don’t have cancer anymore (if you’re in remission).   

This means that it’s illegal for your employer or tutor to discriminate against you once you’ve told them you have cancer or you had it in the past. Discrimination might look like getting into trouble for taking sick leave (which might be for appointments or due to fatigue) or for being late to class because of fatigue.    

Brain fog can get in the way of your daily life and make it difficult to concentrate on your studies or work. Your employer or school/uni might be able to make some changes that mean you can still attend lessons or go to work – these are called ‘reasonable adjustments’. 

Your care team might be able to offer assessments for some people after treatment if you’re struggling with concentration at school or work. This can be helpful to show school or work so they know how they can best help you. It’s always worth asking for support if you’re struggling. 

Reasonable adjustments are changes that should give you additional support to do your job or to study. The idea is to reduce any disadvantages you have at work or school in comparison to someone without a cancer diagnosis.  

At work, these changes could involve:  

• working shorter hours  
• working from home  
• making the building more accessible 

If you’re a student, you can also talk to your teacher or tutor at your place of education about reasonable adjustments. This might involve:   

• attending class from home  
• getting extensions on deadlines  
• having someone to write for you during an exam (a scribe)  

 You can find some more examples of reasonable adjustments here.  

You don’t have to tell your employer or tutor that you have cancer if you don’t want to. You’re never obligated to tell anyone about your diagnosis if it’s not something you want to share. If you decide not to tell them about your diagnosis, they are not legally required to make reasonable adjustments. 

If you decide to tell your employer or tutor about your diagnosis, then they are legally required to make reasonable adjustments. If you’ve told them about your diagnosis and they refuse to consider making reasonable adjustments, you could make a discrimination claim under the Equality Act.  

There aren’t any specific treatments for brain fog, but it can still be helpful to talk to your care team if you have it. They might check to see if there are any other side effects or symptoms that are making your brain fog worse, or if it could be because of particular medication you’re taking, if you take medication.  

Here are some things that might help if you’re struggling with brain fog: 

• Try to avoid doing too many things at once 
• Write yourself notes and lists 
• Use the calendar on your phone for reminders and events 
• Do things you find difficult earlier in the day 
• Try not to overdo it or make yourself over-tired 
• Sleep when you need to 
• Avoid tasks that you find stressful if you can or ask someone for help with them 
• Try to have conversations somewhere quiet to help with concentration problems 

Remember that it’s ok to ask for help – you could talk to your tutor about difficulties you’re having or ask your family to help you remember things.