How Chemotherapy Changes the Way You Think

Have you heard the term, "cognitive domains?" That's how mental health experts explain which areas of the brain do what. People who have gone through chemotherapy often take a hit in some of these domains. Look at the categories below. Do any describe what you may be calling chemo brain or post-chemo brain or brain fog? What you may be suffering is actually a deficit in your executive functioning. A mouthful, I know. Okay, let's go back to chemo brain...

1. EXECUTIVE FUNCTIONING (You have problems making decisions, keeping track of things, multitasking, etc.)

2. INFORMATION PROCESSING SPEED (Your brain still works but a sea cucumber moves faster).

3. LANGUAGE (What the heck is that word?)

4. ATTENTION and MEMORY (distraction is the devil)


If you're struggling with any of these issues, it may help for you to know that you're not alone. In researching and co-authoring "Your Brain After Chemo: A Practical Guide to Lifting the Fog and Getting Back Your Focus" (with Dr. Dan Silverman at UCLA), I interviewed many, many survivors who shared their stories (I also went through chemo and experienced some of the same issues until the fog cleared - perhaps that's why). Many told me how changes in their thinking abilities after treatment had affected their competence at work and home. Marriages had suffered. Socially, some had withdrawn, embarrassed that others would notice they weren't the sharp person they used to be.

Oncologists don't always disclose to patients that cognitive impairment is a potential side effect of chemotherapy. So hopefully my blogposts will help fill in the knowledge gap.

If you believe your thinking abilities have declined, ask your doctor to refer you to a neuropsychologist, a specialist who can evaluate how you process information.

You will find more detailed explanations about these cognitive domains in "Your Brain After Chemo: A Practical Guide to Lifting the Fog and Getting Back Your Focus" by Dan Silverman MD, PhD and Idelle Davidson. There we have an entire chapter devoted to how neuropsychologists measure forgetfulness and other problems with thinking and mood.