Clear thinking

Richard Henry, a lecturer in cancer nursing, talks about thinking clearly after cancer treatment

Most of us will be familiar with the term ‘chemo brain’. It sounds almost like a term of abuse flung across a school yard, but it describes difficulties in thinking clearly after cancer treatment. For many people, it can be an alarming and distressing experience.

As many as three quarters of people with cancer experience cognitive problems during treatment, with perhaps one third experiencing problems for months afterwards.

While these problems are often associated with chemotherapy, their causes are much more varied and widespread. Those receiving cranial radiotherapy and brain surgery, for example, report cognitive difficulties associated with a range of medications including analgesia, antibiotics, anxiolytics and antidepressants.

Cognitive problems after treatment can include a reduced attention span and short-term memory loss. In more extreme cases, these problems can cause disorientation and confusion, behavioural and emotional changes, and difficulties in judgement and reasoning.

There is also a higher incidence of anxiety and depression in people who experience thought or memory problems after chemotherapy.

Many people are prepared for adverse effects of chemotherapy, such as nausea, mucositis or alopecia, that often improve and disappear on completion of treatment, but greater emphasis is needed on the potential for cognitive problems, which can linger for years.

A greater understanding is needed of how chemo brain affects quality of life in the long term as well as the acute phase. Cancer nurses should also be alert to the multiple, often intertwined, factors that affect cognitive function to optimise the care they provide.

About the author

Richard Henry is a lecturer in cancer nursing at Queen’s University Belfast and UKONS president elect. Visit the UKONS website


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