I had to laugh when a gift recently arrived from Laura, a cousin on my mom’s side who lives in Colorado and is a cancer survivor. We’re 2nd cousins, as our grandmothers were sisters. Laura was, by all accounts, a cancer patient with a fierce attitude, determined to defeat her cancer, and she gave no quarter during her treatments. She wore a shirt like this proudly, and sent one to me along with a lot of useful advice based on her own experience during chemo. Now that I’ve finished chuckling over its message, I’ll be looking for opportunities to show it off.
It was from Laura that I first heard the term “chemo brain.”
Lately, I think I’m beginning to understand what she meant, based on my own limited experience with the layer of brain fog that settles in on certain days. On good days, I’ve described it as something like a cap wrapping the top 15% of my brain, leaving me a little unsteady but fully able to function. On bad days, I find myself just wanting to go back to bed, unable to muster the energy and focus to do much reading or writing, much less anything more demanding.
What I’m learning is that physical fatigue acts as a real multiplier for this fog. The mental sluggishness rarely stays static throughout the day—it hits hardest when energy wanes, or after a period of sustained mental effort. Managing it often comes down to simple energy management. Learning to tackle writing or important thinking during peak morning hours, taking micro-breaks, and not trying to push through when brain fatigue sets in.
The term “chemo brain” was originally coined by patients—particularly breast cancer survivors in the 1980s and 1990s to describe persistent cognitive issues like memory loss and mental fog after treatment. Early reports were often dismissed by doctors as mere stress or fatigue, but persistent patient advocacy eventually led to formal clinical research and recognition by the mid-1990s.
As it turns out, “chemo brain” is something of a misnomer. The medical world often refers to it now as cancer-related cognitive impairment because it isn’t caused by chemotherapy alone. According to the American Cancer Society, these cognitive changes can also stem from radiation, surgery, immunotherapy, hormone treatments, or even medications like steroids and anti-nausea drugs. In some cases, changes happen before treatment even starts.
So far, my experience has been limited to the “fog” and varying degrees of dizziness, rather than major memory loss or confusion.
I’m able to live with a touch of brain fog for now, pacing myself and hoping it won’t get any worse.
And on the off days, having Laura’s shirt around is a needed reminder of the importance of her positive attitude, as well as my deep appreciation of her support, and that of all the readers of this blog.
