Some cancers and treatments can result in cognitive changes that affect thinking, learning, processing or remembering information. These changes can affect many aspects of life such as the ability to work or even to do everyday tasks. Find out whether you have an increased risk of cognitive changes.
Cognitive changes can happen suddenly (acute onset) or slowly over time (gradual onset). These types of changes can be different in adults and children. We’ll focus here on cognitive changes in adults with cancer. Talk with your health care team if you have questions related to children who experience cognitive changes.
Cognitive changes are sometimes related to higher dose chemotherapy and the use of immunotherapy to boost the immune system. Those who have cancer involving the brain may also experience cognitive changes as a result of the tumor or the treatment of the tumor. While cognitive changes associated with brain surgery often occur immediately, changes associated with radiation and chemotherapy can develop more gradually over time.
Some changes after cancer are very minor and will go away. Other cognitive changes may be more noticeable and may not be reversible. Discuss any signs or symptoms with your health care team.
Discuss all of these possible causes of cognitive problems with your health care team. This will help you receive the correct diagnosis and treatment.
Sometimes survivors experience changes in their ability to remember or concentrate after they have chemotherapy. This typically mild form of cognitive change is sometimes called "chemo-brain." Even these typically mild cognitive changes can disrupt daily living and the ability work. Symptoms include:
A tumor or cancer cells in the brain can injure healthy cells and can cause cognitive changes. Chemotherapy, radiation and surgery are treatments that are used to remove or destroy cancer cells. However, they can also damage some of the surrounding healthy cells either by direct administration or by impacting the brain indirectly. Depending on how much damage occurs, there could be noticeable symptoms such as with thinking, memory, speech, visual-spatial problems and behavior changes.
Acute onset cognitive changes are those that occur suddenly. Some acute changes, such as delirium, come and go with no real pattern. This can happen during treatment with certain medications and chemotherapy agents, and may be reversible. Symptoms include:
Dementia is a term used in this document to describe cognitive changes due to medical conditions other than Alzheimer's disease. Gradual onset cognitive changes come about slowly over time and may be long lasting. Symptoms of dementia might not appear until active treatment for cancer is finished. Symptoms include:
Chemotherapy may cause fatigue and anemia, which may also lead to cognitive problems, particularly with the ability to pay attention. In addition, a survivor can experience other conditions that cause cognitive changes that may or may not be related to cancer or treatment. Some of these conditions are reversible—some are not. Conditions include:
Cognitive changes can occur at any point during your experience with cancer. Sometimes they are the first sign of a brain tumor. These changes may also happen after completing cancer treatment or after taking certain medications.
Whether cognitive changes will improve or be permanent depends on their cause. Acute cognitive changes (delirium) that occur because of certain medicines often improve when you stop taking the medicine. Chronic changes (dementia) are often not reversible. However, some medications may enhance cognitive function, or there may be some improvement if the cause of the problems can be corrected.
If you notice changes in your thinking, memory or behavior, keep a record of the problems that you experience. Ask your family or friends to also watch for changes. Talk to your health care team about these symptoms as soon as possible. Request a neuropsychological evaluation with a neuropsychologist to help diagnose the nature, severity and possible causes of your cognitive changes. A neuropsychologist may suggest interventions to improve your functioning. Treating the underlying condition often lessens or eliminates the cognitive problems.