Surviving Cancer

Memory, Pain, and Nervous System Problems

After cancer treatment, some people find that they can't pay attention or remember things the way they used to, have pain that remains, or have problems with damage to their nervous system. These changes may be side effects of treatment.

Memory and "Chemobrain"

Some survivors notice that they can't focus on the job at hand or they have trouble remembering details like names and dates. Sometimes it takes them longer to finish tasks, because their thinking and processing seems to be slower. For older adults, it can be hard to tell whether changes in memory and concentration are because they are getting older or are the result of treatment.

These changes, sometimes called "chemobrain," can begin during cancer treatment or they can occur much later. The exact causes are unknown, but people who have had chemotherapy or who have had radiation to the head seem to be more likely to experience these problems.

The best thing you can do about memory and concentration problems is to talk with your doctor. Discuss whether medications you are taking, depression, problems sleeping, or anxiety could be contributing to your problems. If these problems last for a long time, your doctor may suggest that you see a specialist who can help.

Tips to Help Memory and Concentration

Here are some ideas that can help with your memory and concentration.

  • Jot it down. Write down your appointments, important dates, and phone numbers. Make lists and write down plans for your day.
  • Put small signs around the house to remind you of things to do, such as locking the doors.
  • Whisper each step to yourself when doing a task with several steps, such as cooking.
  • Repeat what you want to remember. Saying it a couple of times can help your mind hold on to the information.

Pain: Types and Levels Vary

Some people have a lot of pain after cancer treatment, while others have relatively little. Some types of pain associated with cancer include pain from surgery and pain or numbness in the hands or feet caused by nerve injury following some treatments.

Another type of pain is called phantom pain. If you have had a limb or breast removed, you may still feel pain or unusual feelings that seem to be coming from the absent (phantom) body part.

Many older adults are reluctant to ask for help to relieve their pain. Some may believe that pain is just part of having cancer and of aging, or fear that taking pain medications will cause drug addiction. Some think that mentioning pain or discomfort makes them a problem for caregivers. Others are afraid that their doctor won't focus on curing the cancer if they spend their time treating pain.

Controlling Pain

But you don't have to be in pain. Controlling your pain is a way to help you feel better and stay active. And newer medications made available in this past decade have helped control cancer-related pain better than ever before.

Talk to your doctor. Describe your pain as clearly as possible and point out where it hurts. Describe how it feels -- sharp, throbbing, etc. Explain how often it occurs, how long it lasts, and what seems to trigger it, make it worse, or lessen the pain. Explain how the pain affects your daily life.

Keep a Pain Diary

It may be useful to keep a "pain diary" or record of your pain that includes

  • where and what kind of pain you felt (e.g. sharp and shooting, throbbing, dull aching, pinching)
  • the time of day you experienced the pain
  • how much pain you had -- usually based on a scale of 0-10, where "0" is no pain and "10" is the worst pain imaginable
  • the activity you were doing when you felt the pain
  • how well medications worked to relieve your pain.

Based on the severity of your pain and what seems to be causing it, your doctor may recommend pain-relief or other types of medications, physical therapy, or other things that may help control your pain such as relaxation techniques, acupuncture, or meditation.

Nervous System Problems: Neuropathy

Sometimes cancer treatment can cause damage to your nervous system or problems with nerve functions. This is called neuropathy and the severity and symptoms vary widely from person to person.

Neuropathy can occur at any age, but it is more common in older adults. It can also be caused or made worse by other conditions that are a concern for older adults, including diabetes, kidney failure, and malnutrition.

Symptoms of Neuropathy

Most people first notice symptoms, such as tingling or numbness, in their hands or feet. Other common symptoms include sudden or sharp pain sensations, loss of sensation of touch, loss of balance or difficulty walking, trouble picking up objects or buttoning clothes, and being more -- or less -- sensitive to heat and cold.

Symptoms can start during or after treatment. Symptoms can improve over time, but it may take up to a year or more. If you start to notice these types of symptoms, talk to your doctor or health care professionals right away. They may suggest medications or pain patches to help alleviate symptoms, or other approaches such as physical therapy.

Tips to Manage Neuropathy

Here are some steps you can take to help manage nervous system changes.

  • Pay attention when handling knives, scissors, or sharp objects. Neuropathy can reduce pain sensation, so you could get a wound and not feel it.
  • Avoid falls. Pay attention when you walk and if necessary, use a cane to help steady yourself. Remove objects that you could trip over.
  • Wear shoes with rubber soles.
  • Avoid extreme heat or cold. Wear gloves and hats when needed.