Memory and thinking changes

Many cancer survivors say they have difficulty concentrating, focusing and remembering things. This is called cancer-related cognitive impairment. Other terms used to describe this include “chemo brain” and “cancer fog”.

Researchers still aren’t sure exactly what causes the memory and concentration changes experienced by some cancer survivors, but there is ongoing research to try to find out.

Memory and thinking changes may be caused by:

  • the cancer itself
  • cancer treatments, such as chemotherapy, radiation therapy, immunotherapy, hormone therapy, surgery and anaesthesia
  • medicines such as steroids, anti-nausea drugs or pain-killers
  • fatigue and sleep problems
  • emotional concerns, such as stress, anxiety or depression
  • infections
  • vitamin or mineral deficiencies (e.g. iron, vitamin B, folic acid)
  • other health problems, including anaemia
  • tumours, cancer or metastases in the brain
  • ageing.

These problems usually improve with time, although for some people it may take a year or more to see improvements. Tell your doctor about any memory or thinking problems you are having. Ask for a referral to a health care professional such as an occupational therapist who can advise you on strategies to overcome these difficulties and improve memory.

Listen to our podcast on Brain Fog and Cancer

Managing memory and thinking problems

  • Get plenty of sleep. Deep sleep is important for memory and concentration.
  • Do some gentle exercise, including strength training, each day to help you feel more alert.
  • A psychologist can help with a cognitive training program. These mental exercises may help improve thinking, memory and concentration.
  • Some people find puzzles and brain training apps helpful.
  • Use your mobile phone, calendar or daily planner to keep track of appointments, tasks, social commitments, birthdays, etc.
  • Plan activities so you do things that require more concentration when you are more alert. You may find it helpful to have a daily schedule.
  • Discuss these problems with your partner, family or workplace and ask for their support or assistance.
  • Do tasks one at a time rather than multi-tasking.
  • Set aside time each day to read and respond to emails.
  • Let phone calls go straight to your answering machine or voicemail. You can listen to them when ready and prepare how you will respond.
  • If you are working and have your own office, close the door when you don’t want to be interrupted.
  • Carry a small notepad or download an app to your phone so you can jot down things you need to remember.
  • Before your appointments, write down a list of items you would like to discuss. Don’t be afraid to write down notes during the appointment or to take a support person with you.
  • Put personal items (e.g. wallet, keys) in a dedicated place at home and at work so you can find them easily.

Click on the icon below to download a PDF booklet on Changes in Thinking and Memory.

    Understanding Changes in Thinking and Memory

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Apple devices

The iBooks application must be installed on your Apple device before you can read the EPUB.
Different ways to download an EPUB file to your Apple device:

  • email EPUB files to yourself and transfer the attachment to iBooks.
  • copy EPUB files into DropBox (or a similar service) and use the DropBox app to send them to iBooks.
  • open EPUB files directly from Mobile Safari and open them in iBooks, where they are saved automatically by downloading the EPUB from the website.

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To download an EPUB file to your Kobo from a Windows computer:

  • download and save the EPUB directly onto your desktop.
  • connect your Kobo to your computer using the USB cable and tap “Connect” on your eReader.
  • select “Open folder to view files” to view the contents of your Kobo.
  • navigate to where you have stored your EPUB file in “Finder”, in documents or downloads, and drag and drop it into the Kobo window. You can now disconnect your Kobo to read the eBook.

To download an EPUB to your Kobo from a Mac:

  • download and save the EPUB directly onto your desktop.
  • connect your Kobo to your computer using the USB cable and tap “Connect” on your eReader.
  • open your “Finder” application.
  • select “Kobo eReader” from the listed devices to view the contents of your Kobo.
  • navigate to where you have stored your EPUB file in “Finder”, probably in documents or downloads, and drag and drop it into the Kobo window. You can now disconnect your Kobo to read the eBook.

Turn on your Kobo and your EPUB will be located in “eBooks”, while a PDF will be located in “Documents”.
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Sony Reader

To download an EPUB file on your Sony Reader™:

  • ensure you have already installed the Reader™ Library for PC/Mac software
  • select the eBook you want from our website and click the link to download it.
  • connect the Reader™ to your computer.
  • open the Reader™ Library software and click “Library” in the left-hand pane and select the eBook to view it.

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Amazon Kindle 2nd Generation devices

EPUB files can’t be read on the Amazon Kindle™. However, like most eReaders, Kindle™ 2nd Generation devices are able to display PDFs. We recommend that you download the PDF version of this booklet if you would like to read it on a Kindle™.
To transfer a PDF to your Kindle™ via USB cable from your computer or Mac:

  • download the PDF directly onto your computer.
  • connect the USB cable to your computer’s USB port, and the micro USB end of the cable to your Kindle™. Note: the Kindle™ won’t be available as a reading device while it is connected to your computer until it has been disconnected.
  • open the Kindle™ drive and several folders will appear inside. The “Documents” folder is where you will need to copy or drag the PDF to.
  • safely eject your Kindle™ from your computer and unplug the USB cable. Your content will appear on the Home Screen.

Kindle also provides a Kindle Personal Documents Service that allows users to send documents as an attachment directly to your eReader. For more information on this service, visit
For more information on accessing a PDF on your Kindle™, visit, log in to your account and click on Personal Document Settings.
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Android and PC

You can also download and open eBooks on Android devices and PCs with appropriate apps or software installed. Suitable eReader apps for Android include Google Play Books, FBReader and Moon+ Reader. Suitable software for PCs include Calibre and Adobe Digital Editions.

This information was last reviewed in April 2018
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