Post-chemotherapy cognitive impairment: “Chemo-brain”

Kelsey Bednarz –Graduate-Student Clinician
Paige Bailey –Graduate Student Clinicia
Matthew Frederick, M.S., CCC-SLP

The term “chemo-brain” refers to post chemotherapy cognitive impairments. Research supports different causes for this cognitive change in patients. These cognitive impairments are real measurable side effects from chemotherapy, radiation, infections, cancer, and medications1. Furthermore, additional factors such as lack of sleep and fatigue will also impact cognitive function. Not all patients undergoing chemotherapy will experience chemo-brain. However, some studies suggest that 3 out of 4 people experience this side effect while undergoing chemotherapy and 1 out of 3 people experience this side effect for up to 10 years post chemotherapy treatment2.

Chemo-brain is often described as a “mental fog” due to its effects on memory, attention, word finding, visuospatial skills, visuomotor skills, and new learning1. A speech-language pathologist can help patients improve these deficits through cognitive rehabilitation and the use ofcognitive strategies.

Cognitive rehabilitation programs may be used to improve memory, attention, executive function skills, and visuospatial skills. This is accomplished with targeted tasks during therapy in a 1:1 or small group setting. It can also be accomplished via use of computer/tablet applications or take home assignments. Determining these specific therapy tasks as well as setting difficulty and support levels for each task are obtained from administration of standardized and non-standardized cognitive test batteries during a comprehensive speech-language evaluation.  A speech-language evaluation will look at many areas impacting communication in addition to cognitive-linguistic factors.  These areas will include: speech, language, voice, hearing, social interaction, and fluency.

Patients can also implement the use of cognitive strategies. These strategies may include; making lists on a notepad or smartphone, using a daily planner, and setting an alarm for important reminders. Other helpful strategies include avoiding distractions, having conversations in quiet places, keeping an active mind through the use of brain games, proofreading documents using auditory playback, and improving focus and memory using auditory cues1,2.

In summary, although “chemo-brain” is a real measurable side effect of chemotherapy which effects cognitive skills, many treatment techniques are available to compensate for deficits.


Matthew Frederick, MS, CCC-SLP is the Lead Rehabilitation Therapist in Rehabilitation Services at St. Vincent Cancer and Wellness Center, One Eaton Place, Worcester, MA 01608.

St. Vincent Hospital offers 1:1 individual therapy as well as a games based therapy group called “Brain Games”. The “Brain Games” group is offered 1 time a week for an hour at no cost or obligation to patients  .Please call (508) 363-6805 for more information.


  1. Attention, Thinking, or Memory Problems. (2016). Retrieved from
  2. Managing Chemo Brain for Cancer Survivors. (n.d.). Retrieved from