The cognitive side effects of chemotherapy are unfamiliar to most Asian breast cancer patients despite the fact that these disturbances have significantly affected their daily lives, revealed a series of discussions with such women, conducted by researchers at the National University of Singapore (NUS).

“Our results suggested that a culturally relevant approach should be adopted to evaluate and manage cognitive changes in these patients,” concluded Alexandre Chan, an associate professor in the pharmacy department at NUS Faculty of Science, and colleagues, in Annals of Oncology.

A total of 43 patients with breast cancer who were receiving chemotherapy participated in 8 focus-group discussions conducted in English or Chinese by trained psychosocial oncologists and medical social workers. The participants were unfamiliar with and averse to both the English term “chemobrain” and its Chinese-translated equivalent.


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Most of the patients reported having memory loss, difficulty making decisions, and speech problems after undergoing chemotherapy—symptoms of “chemobrain.” However, they attributed these cognitive disturbances to fatigue, anxiety, and mood changes. They explained that they were overwhelmed by the physical side effects of chemotherapy but were oblivious to cognitive changes.

Married patients expressed frustration that their cognitive deterioration limited their conservative roles as homemakers.

To help regulate their moods and reduce their fatigue, the patients reported turning to such mind-stimulating activities as playing mahjong and practicing qi gong, and taking complementary alternative medicines such as walnut and ginkgo extracts.