General Information About Cognitive Problems in Cancer Survivors

Cognition is the mental process of learning and understanding.

Cognition is the process of gaining knowledge and understanding through thought, experience, and the senses.

The thinking process includes being able to do the following:

• Focus on the important information, thoughts, and actions.
• Pay attention to a task or activity for a long period of time.
• Predict what may happen, plan, and solve problems.
• Take in new information quickly.
• Have a sense of where objects are around you.
• Understand and communicate by speaking or writing.
• Learn and remember new information.

This summary is about cognitive changes that occur in cancer patients and cancer survivors who do not or did not have cancer in the central nervous system (brain or spinal cord).

Memory and thinking problems may occur in cancer patients and cancer survivors.

Changes in memory and thinking are common in cancer patients and cancer survivors and are to be expected. Your thinking process may change, making it harder for you to pay attention and remember information the same way as you did before your cancer treatment.

Talk to your doctor about memory and thinking problems that may happen with your type of cancer or after treatment.

Diagnosis of Cognitive Problems

Possible signs of cognitive problems include trouble learning or remembering.

Other conditions may also cause cognitive problems. Talk to your doctor if you have any of the following problems:

• Trouble focusing on one thing.
• Being unable to complete tasks.
• Memory loss.
• Trouble understanding what people are saying.
• Trouble remembering names and common words.
• Being unable to recognize familiar objects.
• Trouble following instructions.
• Being unable to manage your money well. For example, you may have trouble paying bills or balancing your checkbook.
• Disorganized behavior or thinking.
• Loss of motivation.
• Change in how you see the world around you.

Cancer treatments or other diseases may cause cognitive problems.

Factors that may cause cognitive problems in cancer patients and cancer survivors include the following:

• Older age.
• Being weak or frail.
• Cancer treatments, such as chemotherapy or radiation therapy, or other medications, and their side effects.
• Being postmenopausal.
• Having emotional distress, such as anxiety or depression.
• Having certain symptoms, such as pain, fatigue, or trouble sleeping.
• Having other diseases or conditions.
• Using alcohol or other substances that change your mental state.

Your doctor will examine you to better understand the problems you are having.

Your doctor will do an exam to check for signs of disease. Your doctor will also ask you about factors that cause cognitive problems, and your education, job, and daily activities.

Treatment of Cognitive Problems

Treatment of cognitive problems may include activities that help your attention, memory, and thinking.

Cognitive rehabilitation

The goal of cognitive rehabilitation is to improve your memory, thinking, organization, and decision-making skills. Cognitive rehabilitation includes the following:

• Learning how the brain works.
• Learning ways to take in new information and perform new tasks or behaviors.
• Using tools to help stay organized, such as calendars or electronic diaries.
• Doing activities over and over, usually on a computer, that become more challenging over time.

Movement therapy

Movement therapy or exercises, such as tai chi, qigong, or yoga, may help improve your thinking and ability to focus.

Attention restoration

Attention restoring activities may help you to focus and concentrate. These include walking, gardening, bird watching, and caring for pets.

Meditation

Meditation may help improve your cognitive function. Meditation is a mind-body practice in which a person focuses his or her attention on something, such as an object, word, phrase, or breathing. This will help keep you from being distracted or having stressful thoughts or feelings. Mindfulness-based stress reduction is a type of meditation that focuses on bringing attention and awareness to each moment.

Certain drugs are being studied to treat cognitive problems.

Several drugs have been studied to treat cognitive problems in cancer patients and survivors, such as psychostimulants and erythropoietin -stimulating agents, but results are mixed. More research is needed.

About This PDQ Summary

About PDQ

Physician Data Query (PDQ) is the National Cancer Institute’s (NCI’s) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish.

PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.

Purpose of This Summary

This PDQ cancer information summary has current information about expert-reviewed information summary about causes and management of cognitive impairment in people with cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.

Reviewers and Updates

Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary (“Updated”) is the date of the most recent change.

The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Supportive and Palliative Care Editorial Board.

Clinical Trial Information

A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become “standard.” Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

Clinical trials can be found online at NCI’s website. For more information, call the Cancer Information Service (CIS), NCI’s contact center, at 1-800-4-CANCER (1-800-422-6237).

Permission to Use This Summary

PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].”

The best way to cite this PDQ summary is:

PDQ® Supportive and Palliative Care Editorial Board. PDQ Cognitive Impairment in Adults with Non−Central Nervous System Cancers. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: https://www.cancer.gov/about-cancer/treatment/side-effects/memory/cognitive-impairment-pdq. Accessed <MM/DD/YYYY>.

Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in Visuals Online. Visuals Online is a collection of more than 3,000 scientific images.

Disclaimer

The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the Managing Cancer Care page.

Contact Us

More information about contacting us or receiving help with the Cancer.gov website can be found on our Contact Us for Help page. Questions can also be submitted to Cancer.gov through the website’s E-mail Us.

Last Revised: 2018-07-06

If you want to know more about cancer and how it is treated, or if you wish to know about clinical trials for your type of cancer, you can call the NCI’s Cancer Information Service at 1-800-422-6237, toll free. A trained information specialist can talk with you and answer your questions.