Mild cognitive impairment (MCI)
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
Home > Cancer information > Living with and after cancer > Symptoms & side effects > Other symptoms &
side effects > Mild cognitive impairment (MCI)
Mild cognitive impairment (MCI)
This information is about mild cognitive impairment (MCI). This means changes in memory or concentration
that can sometimes happen during and/or after cancer treatment. It’s also known as cognitive dysfunction, or
sometimes as ‘chemo-brain’ or ‘chemo-fog’.
On this page
What is mild cognitive impairment (MCI)?
Symptoms
Who gets MCI?
Causes and risk factors
Can MCI be prevented or treated?
Coping with MCI
Research into MCI
References and thanks
What is mild cognitive impairment (MCI)?
The word ‘cognitive’ refers to thinking or the way we process information. Impairment or dysfunction means
that something isn’t working properly.
Mild cognitive impairment is a term used to describe changes in memory, concentration, and the ability to
think clearly and put thought into action. Some people notice these kinds of changes happening during and
after cancer treatment.
Originally, these problems were first noticed by women who had treatment for breast cancer. They reported
changes in memory and concentration, which they linked to their chemotherapy treatment, and called it
‘chemo-brain’. However, the term ‘chemo-brain’ is probably misleading as research has shown that changes
in memory and concentration can also happen in people who have had cancer but who have never had
chemotherapy.
At the moment it’s not clear which treatments may cause these problems, or whether they may be caused
by the cancer itself or by emotions such as anxiety and depression. So the term that’s now usually used to
describe these problems is mild cognitive impairment (MCI) or cognitive dysfunction.
MCI can be very frustrating as it can have quite a big impact on your life. Its effects are usually temporary,
but it can interfere with your normal activities. It may delay some people from going back to work, school or
to social events.
Symptoms
The symptoms of MCI are usually mild or subtle, and vary from person to person. Most people are able to do
everyday things, but they may find certain things are more difficult than usual. Common symptoms may
include:
being unusually disorganised
difficulty concentrating and not being able to focus on what you’re doing
trouble finding the right word or being unable to finish sentencestrouble remembering facts you would usually remember such as names and dates
extreme tiredness (fatigue)
mental ‘fogginess’
difficulty doing more than one thing at the same time (multitasking), such as answering the phone
while cooking
taking longer than usual to complete simple tasks
difficulty learning new skills.
If you think you may have symptoms of MCI you should discuss them with your doctor.
It can be helpful to keep a record of your symptoms to show the doctor, so that they can see how often and
how much they are affecting you.
Who gets MCI?
It’s not clear how many people develop these problems with their concentration or memory during or after
cancer treatment. Different research studies suggest quite different figures, ranging from about 1 in 6 people
(16%) to more than two-thirds (69%). MCI can affect both men and women.
Causes and risk factors
The causes of mild cognitive impairment are unclear. Research suggests that it may be caused by a
combination of factors. Some of the following may be possible causes and/or risk factors:
Cancer treatments, including chemotherapy, hormonal therapy, radiotherapy and surgery.
How or where in the body treatment is given. For example, chemotherapy into the fluid around the
spinal cord (intrathecal chemotherapy), high-dose chemotherapy or radiotherapy, a combination of
chemotherapy and radiotherapy (chemoradiation), and radiotherapy to the brain may make it more
likely that you’ll experience MCI.
Side effects of cancer treatment, such as infection, low number of red blood cells (anaemia), extreme
tiredness (fatigue), sleep problems, poor nutrition and menopause.
Emotional reactions to cancer and treatment such as anxiety and depression.
Other factors could be your age, and non-cancer medicines such as painkillers or anti-sickness (anti-
emetic) medicines.
Can MCI be prevented or treated?
It’s difficult to prevent or treat MCI as it’s not clear what causes it. A number of drugs have been tried to help
people with MCI, but as yet none has definitely been proven to be successful. Research is ongoing to find an
effective treatment.
MCI doesn’t affect everyone and its effects are usually mild. It’s worth remembering that the benefits of your
cancer treatment will usually far outweigh any risks of developing MCI. Your doctor or nurse will be happy to
discuss your treatment with you if you’re worried about MCI.
Coping with MCI
The symptoms of MCI are usually temporary and improve with time. There are a number of things you can do
to help yourself. Your doctors or specialist nurse can give you more information and support.
Keep a diary
Keeping a record of your symptoms may help you identify when you’re more distracted, or whether certain
things make your memory worse. For example, you may notice that symptoms seem worse first thing in the
morning, or when you’re tired or hungry. Noticing triggers or patterns like this can help you to plan your day
so that you do more difficult tasks when you feel at your best.
Learn new coping strategies
You may find it helps to do some things a bit differently, to help you to concentrate and remember more. For
example:carry a notebook and make notes during conversations, after meeting new people or after making
arrangements
use Post-it® notes with reminders on them and put them where you can easily see them
keep a calendar or diary - or use your mobile or smartphone calendar if you have one - to help you
remember important dates and appointments
when making arrangements, check with people at the time to make sure you have the right
information
make lists, such as a shopping list or a ‘to-do’ list, so that you feel confident that you won’t forget
anything.
Mental exercises
Memory and repetitive exercises may help to train your brain and improve your memory and concentration.
You can help keep your mind active by doing crosswords, word games or number puzzles like Sudoku.
It can also help to do some physical exercise as this can help you feel more alert and reduce fatigue.
Try to reduce stress
Stressful situations can affect everyone’s memory. Relaxation can help to reduce stress and may help to
improve your memory and concentration.
Try doing some activities that will help you relax, such as listening to music or going for a walk. You could
try using relaxation CDs or DVDs, or do some relaxation exercises.
Talk to your family and friends
Many people find that talking to family and friends about what they are going through can help. Mild cognitive
impairment is often less obvious than other side effects of treatment, so you may need to explain how you’re
feeling and how it’s affecting you.
Your family and friends may not be aware of MCI as a side effect of treatment. If they’ve noticed any
symptoms, they may be relieved to know that they are fairly common and should improve with time.
Your family and friends will be able to support you better when they understand more about how you feel,
and may be able to suggest ways they can help.
Other things that might help
Some other tips that might help are:
keep things simple - don’t take on too much and try not to multi-task
develop a manageable daily routine and try to keep to it
avoid distractions - for example, if you need to concentrate on something, sit in a quiet area and turn
off the TV/radio
eat a healthy, well-balanced diet, especially lots of fresh fruit and vegetables - your doctor or nurse
can give you advice or refer you to a dietitian, if needed
take regular breaks, and get plenty of rest and sleep
seek support from others in a similar situation - perhaps join an online forum or a local support group.
Talk to your doctor or nurse
Tell your doctor or nurse if you think you may have some of the symptoms of mild cognitive impairment.
They should be able to help relieve any side effects of treatment (such as anaemia), that could be
contributing to your MCI. They can also refer you to other people for specialist help, such as a dietitian, a
counsellor for relaxation support, or a support group.
Before you see your doctor, it’s a good idea to write down how MCI is affecting you and to make a list of
questions to ask. If your memory is bad, it may help to take someone with you or to record the conversation
so that you don’t forget anything.
Research into MCITo help understand more about MCI, research is being done to find out:
which chemotherapy drugs or combinations of drugs affect cognitive functioning
whether other cancer treatments affect cognitive functioning
what can be done to reduce the risk
what treatments can be used to improve symptoms of MCI.
To help guide the research, an international group was set up in 2006 by health professionals and patients.
The International Cognition and Cancer Taskforce (ICCTF) aims to coordinate research, produce guidelines
and give information to people affected by cancer. You can get more information about the ICCTF on their
website
You may be asked to take part in a research trial, and your doctor or nurse will explain fully what this
involves. You don’t have to take part in the trial if you don’t want to and you don’t have to give a reason why.
References and thanks
This information has been compiled using information from a number of reliable sources, including:
American Cancer Society. Chemo Brain. (accessed March 2010).
Boykoff N, et al. Confronting chemobrain: an in-depth look at survivors' reports of impact on work,
social networks, and health care response. Journal of Cancer Survivorship. 2009. 3(4): 223–32.
CancerHelp UK. Chemo brain. (accessed March 2010).
DeVita, et al. Cancer: Principles & Practice of Oncology. 8th Edition. 2008. Philadelphia. Lippincott
Williams & Wilkins.
Hurria A, et al. Renaming "chemobrain." Cancer Investigation. 2007. 25373.
Mayo Clinic. Chemo brain. (accessed March 2010).
Schilder CM, et al. Effects of tamoxifen and exemestane on cognitive functioning of postmenopausal
patients with breast cancer: results from the neuropsychological side study of the tamoxifen and
exemestane adjuvant multinational trial. Journal of Clinical Oncology. 2010. 1028(8): 1294–300.
Vardy J, et al. Cancer and cancer-therapy related cognitive dysfunction: an international perspective
from the Venice cognitive workshop. Annals of Oncology. 2008. 19: 623–629.
Vardy J, et al. Cognitive function after chemotherapy in adults with solid tumors. Critical Reviews in
Oncology/Hematology. 2007. 63183.
Thanks to: Dr Fehmidah Munir Senior Lecturer in Psychology, and colleagues; Dr Phil Murray, Consultant
Oncologist; Dr Alistair Ring, Senior Lecturer and Honorary Consultant in Oncology; Dr Peter Wigmore,
Associate Professor in Anatomy; and the people affected by cancer who reviewed this edition.
Thanks to people like you
Thank you to all of the people affected by cancer who reviewed what you're reading and have helped our
information to grow.
You could help us too when you join our Cancer Voices Network - find out more.
Content last reviewed: 1 January 2013
Next planned review: 2015We make every effort to ensure that the information we provide is accurate and up-to-date but it should not be relied upon as a substitute for specialist professional advice tailored to your situation. So far as is permitted by law, Macmillan does not accept liability in relation to the use of any information contained in this publication or third party information or websites included or referred to in it. Macmillan Cancer Support, registered charity in England and Wales (261017), Scotland (SC039907) and the Isle of Man (604). A company limited by guarantee, registered in England and Wales company number 2400969. Isle of Man company number 4694F. Registered office: 89 Albert Embankment, London SE1 7UQ.
You can also read
