Attention, Thinking and Memory Problems

People with cancer may experience problems with mental tasks related to their attention span, thinking or memory. These mental changes are collectively called “cognitive problems”, and can occur at any time during or after cancer treatment. Some people notice very small changes, such as experiencing a little more difficulty remembering things, while others have greater memory or concentration problems that can impact their daily lives.

Causes of Cognitive Problems

The exact cause of cognitive problems is not always known, and may be due to a combination of factors, such as:

Chemotherapy
Radiation therapy (particularly to the brain)
Brain surgery or cancer involving the brain
Hormonal treatments or hormonal changes
Medications (e.g. steroids, anaesthetic drugs, anti-nausea drugs, analgesic drugs)
Low red blood counts
Sleep problems or tiredness
Infection
Electrolyte imbalances
Depression, anxiety or other emotional stresses

What you need to look out for

Some examples of cognitive problems are:

Short attention span
Difficulty concentrating on a single task
Problems with remembering details of recent events
Feeling fatigued or mentally “slower” than usual
Confusing dates of appointments
Misplacing objects
Fumbling for the right word or phrase

How it can be treated

For conditions that can be treated (e.g. infection, electrolyte imbalances), cognitive problems should go away after the condition is treated. Cognitive problems related to cancer treatments like chemotherapy or radiation therapy may improve or go away but unfortunately can also be long term. Your healthcare team may treat them by:

Providing practical advice to cope with your day to day activities
Prescribing medications such as cognition-enhancing drugs on a case by case basis
Referring you to a cognitive rehabilitation program

What you can do

While cognitive problems related to cancer and its treatment may not be preventable, the following tips may help you cope better:

Plan your day Keep to a daily routine Do things that need the most concentration at the time of day when you feel best Get extra rest and plenty of sleep at night
Exercise your body and mind Do light physical exercises. Exercise can provide a sense of wellbeing, decrease stress and help you to feel more alert Exercise your brain by reading, knitting, playing musical instruments, board games or puzzles, or learning a new hobby Reduce stress levels by listening to music, going for a walk or doing something you enjoy	Avoid spending too much time focusing on how the mental changes are affecting you as it may make you feel worse
Get help to remember things Use a daily planner or your phone to help you keep track of appointments and remember important activities / events Store or place important numbers in your mobile phone or next to your home phone Use sticky notes at home and at work to remind you of important tasks. Before you see your doctor, write down a list of questions to ask Focus on one thing at a time to avoid distractions Prepare for the next day by setting out the things you will need the night before Colour code or label your cabinets or drawers to keep track of where things are kept Place things (e.g. keys) back in the same place every time so you can easily find them	Avoid cluttering your house as it makes things difficult to find
Seek help from others Bring along a friend or family member for your doctor’s appointment, so that he or she can help you to take note of important information	Don’t be afraid to get help on daily activities from your family and friends, as it can help save on mental energy

Plan your day

Keep to a daily routine

Do things that need the most concentration at the time of day when you feel best

Get extra rest and plenty of sleep at night

Exercise your body and mind

Do light physical exercises. Exercise can provide a sense of wellbeing, decrease stress and help you to feel more alert

Exercise your brain by reading, knitting, playing musical instruments, board games or puzzles, or learning a new hobby

Reduce stress levels by listening to music, going for a walk or doing something you enjoy

Avoid spending too much time focusing on how the mental changes are affecting you as it may make you feel worse

Get help to remember things

Use a daily planner or your phone to help you keep track of appointments and remember important activities / events

Store or place important numbers in your mobile phone or next to your home phone

Use sticky notes at home and at work to remind you of important tasks. Before you see your doctor, write down a list of questions to ask

Focus on one thing at a time to avoid distractions

Prepare for the next day by setting out the things you will need the night before

Colour code or label your cabinets or drawers to keep track of where things are kept

Place things (e.g. keys) back in the same place every time so you can easily find them

Avoid cluttering your house as it makes things difficult to find

Seek help from others

Bring along a friend or family member for your doctor’s appointment, so that he or she can help you to take note of important information

Don’t be afraid to get help on daily activities from your family and friends, as it can help save on mental energy

When to call your cancer care team

It is important to identify the causes of cognitive problems because many can be treated quickly and effectively. Please inform your doctor or nurse as soon as you notice any cognitive problems as mentioned above, or if your symptoms worsen.

If you have any questions regarding the above, please call the Cancer Helpline at +65 6225 5655 or approach your doctor or nurse for further details.

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The above contents are made available as part of TEMASEK FOUNDATION-ACCESS (Accessible Cancer Care to Enable Support for Survivors) PROGRAMME, a holistic care programme to support cancer patients during their care and recovery journey.

The contents have been approved by the Cancer Education Information Service, National Cancer Centre Singapore (NCCS), for people with cancer and their families and caregivers. However, this information serves only as a guide and should not be used as a substitute for medical diagnosis, treatment or advice. For specific medical conditions, please seek expert medical advice from your healthcare team.

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