Skip to main content

Advertisement

SpringerLink
Log in

Clearing the Air: A Review of Our Current Understanding of “Chemo Fog”

  • Palliative Medicine (A Jatoi, Section Editor)
  • Published:
Current Oncology Reports Aims and scope Submit manuscript

Abstract

An increasing number of cancer survivors has led to a greater interest in the long-term side effects of cancer treatments and their impact on quality of life. In particular, cognitive impairments have been frequently reported by cancer survivors as an adverse effect which they attribute to the neurotoxicity of chemotherapy and have dubbed “chemobrain” or “chemo fog.” Research within the past 15–20 years has explored the many factors thought to contribute to cancer-related cognitive decline in an attempt to determine a potential cause. In spite of many confounding factors, there is growing evidence that the neurotoxicity of chemotherapy does contribute to cognitive changes. This review examines the evolution of “chemo fog” research with a look at methodological issues, the status of our current understanding, and suggestions for future research.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently have been highlighted as: • Of importance •• Of major importance

  1. Boykoff N, Moieni M, Subramanian SK. Confronting chemobrain: an in-depth look at survivors’ reports of impact on work, social networks, and health care response. J Cancer Surviv. 2009;3:323–32.

    Article  Google Scholar 

  2. Wieneke MH, Dienst ER. Neuropsychological assessment of cognitive functioning following chemotherapy for breast cancer. Psychooncology. 1995;4:61–6.

    Article  Google Scholar 

  3. van Dam FS, Schagen SB, Muller MJ, et al. Impairment of cognitive function in women receiving adjuvant treatment for high-risk breast cancer: high-dose versus standard-dose chemotherapy. J Natl Cancer Inst. 1998;90:210–8.

    Article  PubMed  Google Scholar 

  4. Early Breast Cancer Trialists’ Collaborative Group (EBCTCG). Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. Lancet. 2005;365:1687–717.

    Article  Google Scholar 

  5. Maki P, Hogervorst E. HRT and cognitive decline. Best Pract Res Clin Endocrinol Metab. 2003;17:105–22.

    Article  PubMed  CAS  Google Scholar 

  6. Sherwin BB. Estrogen and cognitive functioning in women: lessons we have learned. Behav Neurosci. 2012;126:123–7.

    Article  PubMed  CAS  Google Scholar 

  7. Bender CM, Sereika SM, Berga SL, et al. Cognitive impairment associated with adjuvant therapy in breast cancer. Psychooncology. 2006;15:422–30. doi:10.1002/pon.964.

    Article  PubMed  Google Scholar 

  8. Bender CM, Sereika SM, Brufsky AM, et al. Memory impairments with adjuvant anastrozole versus tamoxifen in women with early-stage breast cancer. Menopause. 2007;14:995–8.

    Article  PubMed  Google Scholar 

  9. Castellon SA, Ganz PA, Bower JE, et al. Neurocognitive performance in breast cancer survivors exposed to adjuvant chemotherapy and tamoxifen. J Clin Exp Neuropsychol. 2004;26:955–69.

    Article  PubMed  Google Scholar 

  10. Collins B, MacKenzie J, Stewart A, et al. Cognitive effects of hormonal therapy in early-stage breast cancer patients: a prospective study. Psychooncology. 2009;18:811–21.

    Article  PubMed  Google Scholar 

  11. Eberling JL, Wu C, Tong-Turnbeaugh R, et al. Estrogen- and tamoxifen-associated effects on brain structure and function. NeuroImage. 2004;21:364–71.

    Article  PubMed  Google Scholar 

  12. Falleti MG, Sanfilippo A, Maruff P, et al. The nature and severity of cognitive impairment associated with adjuvant chemotherapy in women with breast cancer: a meta-analysis of the current literature. Brain Cogn. 2005;59:60–70.

    Article  PubMed  Google Scholar 

  13. Jenkins V, Shilling V, Fallowfield L, et al. Does hormone therapy for the treatment of breast cancer have a detrimental effect on memory and cognition? A pilot study. Psychooncology. 2004;13:61–6.

    Article  PubMed  Google Scholar 

  14. Palmer JL, Trotter T, Joy AA, et al. Cognitive effects of tamoxifen in premenopausal women with breast cancer compared to healthy controls. J Cancer Surviv. 2008;2:275–82.

    Article  PubMed  Google Scholar 

  15. Phillips KA, Aldridge J, Ribi K, et al. Cognitive function in post-menopausal breast cancer patients one year after completing adjuvant endocrine therapy with letrozole and/or tamoxifen in the BIG 1-98 trial. Breast Cancer Res Treat. 2011;126:221–6.

    Article  PubMed  CAS  Google Scholar 

  16. Schilder CM, Seynaeve C, Beex LV, et al. Effects of tamoxifen and exesestance on cognitive functioning of post-menopausal patients with breast cancer: results from the neuropsychological side study of the Tamoxifen and Exesestance Adjuvant Multinational Trial. J Clin Oncol. 2010;28:1294–300.

    Article  PubMed  CAS  Google Scholar 

  17. Shilling V, Jenkins V, Fallowfield L, et al. The effects of hormone therapy on cognition in breast cancer. J Steroid Biochem Mol Biol. 2003;86:405–12.

    Article  PubMed  CAS  Google Scholar 

  18. Vardy J, Wefel JS, Ahles T, et al. Cancer and cancer-related cognitive dysfunction: an international perspective from the Venice cognitive workshop. Ann Oncol. 2008;19:623–9.

    Article  PubMed  CAS  Google Scholar 

  19. • Wefel JS, Vardy J, Ahles T, et al. International Cognition and Cancer Task Force recommendations to harmonise studies of cognitive function in patients with cancer. Lancet Oncol. 2011;12:703–8. An international task force was formed to establish guidelines for research in the area of cognition and cancer.

    Article  PubMed  Google Scholar 

  20. Cimprich B, Reuter-Lorenz P, Nelson J, et al. Pre-chemotherapy alterations in brain function in women with breast cancer. J Clin Exp Neuropsychol. 2010;32:324–31.

    Article  PubMed  Google Scholar 

  21. Schilder CM, Seynaeve C, Linn SC, et al. The impact of different definitions and reference groups on the prevalence of cognitive impairment: a study in postmenopausal breast cancer patients before the start of adjuvant systemic therapy. Psychooncology. 2010;19:415–22.

    Article  PubMed  Google Scholar 

  22. Wefel JS, Lenzi R, Theriault R, et al. “Chemobrain” in breast carcinoma?A prologue. Cancer. 2004;101:466–75.

    Article  PubMed  Google Scholar 

  23. Stewart A, Collins B, Mackenzie J, et al. The cognitive effects of adjuvant chemotherapy in early stage breast cancer: a prospective study. Psychooncology. 2008;17:122–30.

    Article  PubMed  Google Scholar 

  24. Shilling V, Jenkins V, Trapala IS. The (mis)classification of chemo-fog – methodological inconsistencies in the investigation of cognitive impairment after chemotherapy. Breast Cancer Res Treat. 2006;95:125–9.

    Article  PubMed  Google Scholar 

  25. Ouimet LA, Stewart A, Collins B, et al. Measuring neuropsychological change following breast cancer treatment: an analysis of statistical models. J Clin Exp Neuropsychol. 2009;31:73–89.

    Article  PubMed  CAS  Google Scholar 

  26. Jansen CE, Cooper BA, Dodd MJ, et al. A prospective longitudinal study of chemotherapy-induced cognitive changes in breast cancer patients. Support Care Cancer. 2011;19:1647–56.

    Article  PubMed  Google Scholar 

  27. Biglia N, Bounous VE, Malabaila A, et al. Objective and self-reported cognitive dysfunction in breast cancer women treated with chemotherapy: a prospective study. Eur J Cancer Care. 2012;21:485–92.

    Article  CAS  Google Scholar 

  28. Cheung YT, Tan EH, Chan A. An evaluation on the neuropsychological tests used in the assessment of postchemotherapy cognitive changes in breast cancer survivors. Support Care Cancer. 2012;20:1361–75.

    Article  PubMed  Google Scholar 

  29. Hutchinson AD, Hosking JR, Kichenadasse G, et al. Objective and subjective cognitive impairment following chemotherapy for cancer: a systematic review. Cancer Treat Rev. 2012;38:926–34.

    Article  PubMed  Google Scholar 

  30. Pullens MJJ, DeVries J, Roukema JA. Subjective cognitive dysfunction in breast cancer patients: a systematic review. Psychooncology. 2010;19:1127–38.

    Article  PubMed  Google Scholar 

  31. Iconomou G, Mega V, Koutras A, et al. Prospective assessment of emotional distress, cognitive function and quality of life in patients with cancer treated with chemotherapy. J Cancer. 2004;101:404–11.

    Article  Google Scholar 

  32. Ingraham LJ, Aiken CB. An empirical approach to determining criteria for abnormality in test batteries with multiple measures. Neuropsychology. 1996;10:120–4.

    Article  Google Scholar 

  33. Wefel JS, Schagen SB. Chemotherapy-related cognitive dysfunction. Curr Neurol Neurosci Rep. 2012;12:267–75.

    Article  PubMed  CAS  Google Scholar 

  34. Scherling C, Collins B, MacKenzie J, et al. Pre-chemotherapy differences in visuo-spatial working memory in breast cancer patients compared to controls: an fMRI study. Front Hum Neurosci. 2011;5:122. doi:10.3389/fnhum.2011.00122.

    Article  PubMed  Google Scholar 

  35. Scherling C, Collins B, MacKenzie J, et al. Pre-chemotherapy differences in response inhibition in breast cancer patients compared to controls: a functional magnetic resonance imaging study. J Clin Exp Neuropsychol. 2012;34:543–60.

    Article  PubMed  Google Scholar 

  36. Scherling C, Collins B, MacKenzie J, et al. Structural brain differences in breast cancer patients compared to matched controls prior to chemotherapy. Int J Biol. 2012;4:3–25.

    Google Scholar 

  37. Hurria A, Somlo G, Ahles T. Renaming “chemobrain”. Cancer Invest. 2007;25:373–7.

    Article  PubMed  Google Scholar 

  38. •• Deprez S, Amant F, Smeets A, et al. Longitudinal assessment of chemotherapy-induced structural changes in cerebral white matter and its correlation with impaired cognitive functioning. J Clin Oncol. 2012;30:274–81. This longitudinal study examined the relationship between changes in neuropsychological functioning and brain structure following chemotherapy and found significant correlations between these two measures.

    Article  PubMed  Google Scholar 

  39. Ganz PA. Doctor, will the treatment you are recommending cause chemobrain? J Clin Oncol. 2012;30:229–31.

    Article  PubMed  Google Scholar 

  40. •• Collins B, MacKenzie J, Tasca GA, et al. Cognitive effects of chemotherapy in breast cancer patients: a dose-response study. Psychooncology. 2012. doi:10.1002/pon.3163. This is a prospective longitudinal study of cognitive functioning after cumulative exposure to chemotherapy. Patients were assessed at the baseline and following each chemotherapy cycle. A linear decline in cognitive functioning was observed, supporting a dose–response relationship and suggesting that chemotherapy is a cause of cognitive disturbance.

    PubMed  Google Scholar 

  41. Hedayati E, Alinaghizadeh H, Schedin A, et al. Effects of adjuvant treatment on cognitive function in women with early breast cancer. Eur J Oncol Nurs. 2012;16:315–22.

    Article  PubMed  Google Scholar 

  42. Kreukels BPC, Schagen SB, Ridderinkhof KR, et al. Electrophysiological correlates of information processing in breast-cancer patients treated with adjuvant chemotherapy. Breast Cancer Res Treat. 2005;94:53–61. doi:10.1007/s10549-005-7093-3.

    Article  PubMed  CAS  Google Scholar 

  43. Schagen SB, Hamburger HL, Muller MJ, et al. Neurophysiological evaluation of late effects of adjuvant high-dose chemotherapy on cognitive function. J Neurooncol. 2001;51:159–65.

    Article  PubMed  CAS  Google Scholar 

  44. Schagen SB, Muller MJ, Boogerd W, et al. Change in cognitive function after chemotherapy: a prospective longitudinal study in breast cancer patients. J Natl Cancer Inst. 2006;98:1742–5. doi:10.1093/jnci/djj470.

    Article  PubMed  CAS  Google Scholar 

  45. Ahles TA, Saykin AJ, Furstenberg T, et al. Neuropsychologic impact of standard-dose systemic chemotherapy in long-term survivors of breast cancer and lymphoma. J Clin Oncol. 2002;20:485–93. doi:10.1200/JCO.20.2.485.

    Article  PubMed  CAS  Google Scholar 

  46. Brown MS, Simon JH, Stemmer SM, et al. MR and proton spectroscopy of white matter disease induced by high-dose chemotherapy with bone marrow transplant in advanced breast carcinoma. Am J Neuroradiol. 1995;16:2013–20.

    PubMed  CAS  Google Scholar 

  47. Brown MS, Stemmer SM, Simon JH, et al. White matter disease induced by high-dose chemotherapy: longitudinal study with MR imaging and proton spectroscopy. Am J Neuroradiol. 1998;19:217–21.

    PubMed  CAS  Google Scholar 

  48. Stemmer SM, Stears JC, Burton BS, et al. White matter changes in patients with breast cancer treated with high-dose chemotherapy and autologous bone marrow support. Am J Neuroradiol. 1994;15:1267–73.

    PubMed  CAS  Google Scholar 

  49. Seigers R, Fardell JE. Neurobiological basis of chemotherapy-induced cognitive impairment: a review of rodent research. Neurosci Biobehav Rev. 2011;35:729–41.

    Article  PubMed  Google Scholar 

  50. Winocur G, Henkelman M, Wojtowicz JM, et al. The effects of chemotherapy on cognitive function in a mouse model: a prospective study. Clin Cancer Res. 2012;18:3112–21.

    Article  PubMed  CAS  Google Scholar 

  51. de Ruiter MB, Reneman L, Boogerd W, et al. Cerebral hyporesponsiveness and cognitive impairment 10 years after chemotherapy for breast cancer. Hum Brain Mapp. 2011;32:1206–19. doi:10.1002/hbm.21102.

    Article  PubMed  Google Scholar 

  52. Kesler SR, Kent JS, O’Hara R. Prefrontal cortex and executive function impairments in primary breast cancer. Arch Neurol. 2011;68:1447–53.

    Article  PubMed  Google Scholar 

  53. Silverman DH, Dy CJ, Castellon SA, et al. Altered fronto-cortical, cerebellar and basal ganglia activity in adjuvant-treated breast cancer survivors 5–10 years after chemotherapy. Breast Cancer Res Treat. 2007;103:303–11.

    Article  PubMed  CAS  Google Scholar 

  54. Abraham J, Haut MW, Moran MT, et al. Adjuvant chemotherapy for breast cancer: effects on cerebral white matter seen in diffusion tensor imaging. Clin Breast Cancer. 2008;8:88–91.

    Article  PubMed  Google Scholar 

  55. de Ruiter MB, Reneman L, Boogerd W, et al. Late effects of high-dose adjuvant chemotherapy on white and gray matter in breast cancer survivors: converging results from multimodal magnetic resonance imaging. Hum Brain Mapp. 2012;33:2971–83. doi:10.1002/hbm.21422.

    Article  PubMed  Google Scholar 

  56. Deprez S, Amant F, Yigit R, et al. Chemotherapy-induced structural changes in cerebral white matter and its correlation with impaired cognitive functioning in breast cancer patients. Hum Brain Mapp. 2011;32:480–93.

    Article  PubMed  Google Scholar 

  57. Ferguson RJ, McDonald BC, Saykin AJ, et al. Brain structure and function differences in monozygotic twins: possible effects of breast cancer chemotherapy. J Clin Oncol. 2007;25:3866–70.

    Article  PubMed  Google Scholar 

  58. Inagaki M, Yoshikawa E, Matsuoka Y, et al. Smaller regional volumes of brain gray and white matter demonstrated in breast cancer survivors exposed to adjuvant chemotherapy. Cancer. 2007;109:146–56.

    Article  PubMed  Google Scholar 

  59. Koppelmans V, de Ruiter MB, van der Lijn F, et al. Global and focal brain volume in long-term breast cancer survivors exposed to adjuvant chemotherapy. Breast Cancer Res Treat. 2012;132:1099–106.

    Article  PubMed  CAS  Google Scholar 

  60. •• McDonald BC, Conroy SK, Ahles TA, et al. Gray matter reduction associated with systemic chemotherapy for breast cancer: a prospective MRI study. Breast Cancer Res Treat. 2010;123:819–28. This was the first controlled prospective MRI study in the field of CRCI.

    Article  PubMed  CAS  Google Scholar 

  61. Lopez-Zunini RA, Scherling C, Wallis N, et al. Differences in verbal memory retrieval in breast cancer chemotherapy patients compared to healthy controls: a prospective fMRI study. Brain Imaging Behav 2012. doi:10.1007/s11682-012-9213-0.

  62. Jansen CE, Dodd MJ, Miaskowski CA, et al. Preliminary results of a longitudinal study of changes in cognitive function in breast cancer patients undergoing chemotherapy with doxorubicin and cyclophosphamide. Psychooncology. 2008;17:1189–95. doi:10.1002/pon.1342.

    Article  PubMed  Google Scholar 

  63. Ahles TA, Saykin AJ, McDonald BC, et al. Longitudinal assessment of cognitive changes associated with adjuvant treatment for breast cancer: impact of age and cognitive reserve. J Clin Oncol. 2010;28:4434–40. doi:10.1200/JCO.2009.27.0827.

    Article  PubMed  Google Scholar 

  64. Kvale EA, Clay OJ, Ross-Meadows LA, et al. Cognitive speed of processing and functional declines in older cancer survivors: an analysis of data from the ACTIVE trial. Eur J Cancer Care. 2010;19:110–7. doi:10.1111/j.1365-2354.2008.01018.x.

    Article  CAS  Google Scholar 

  65. Quesnel C, Savard J, Ivers H. Cognitive impairments associated with breast cancer treatments: results from a longitudinal study. Breast Cancer Res Treat. 2009;116:113–23. doi:10.1007/s10549-008-0114-2.

    Article  PubMed  Google Scholar 

  66. Tager FA, McKinley PS, Schnabel FR, et al. The cognitive effects of chemotherapy in post-menopausal breast cancer patients: a controlled longitudinal study. Breast Cancer Res Treat. 2010;123:25–34.

    Article  PubMed  Google Scholar 

  67. Vearncombe KJ, Rolfe M, Wright M, et al. Predictors of cognitive decline after chemotherapy in breast cancer patients. J Int Neuropsychol Soc. 2009;15:951–62. doi:10.1017/S1355617709990567.

    Article  PubMed  Google Scholar 

  68. Jansen CE, Miaskowski C, Dodd M, et al. A meta-analysis of studies of the effects of cancer chemotherapy on various domains of cognitive function. Cancer. 2005;104:2222–33.

    Article  PubMed  Google Scholar 

  69. Jansen CE, Miaskowski CA, Dodd MJ, et al. A meta-analysis of the sensitivity of various neuropsychological tests used to detect chemotherapy-induced cognitive impairments in patients with breast cancer. Oncol Nurs Forum. 2007;34:997–1005.

    Article  PubMed  Google Scholar 

  70. • Jim HSL, Phillips KM, Chait S, et al. Meta-analysis of cognitive functioning in breast cancer survivors previously treated with standard-dose chemotherapy. J Clin Oncol. 2012;30:3578–87. This is a meta-analysis of 17 studies examining the long-term effects of chemotherapy on cognitive functioning. The results indicate cognitive deficits of small effect size in patients treated with chemotherapy as compared with healthy controls and patients not treated with chemotherapy.

    Article  PubMed  CAS  Google Scholar 

  71. Stewart A, Bielajew C, Collins B, et al. A meta-analysis of the neuropsychoogical effects of adjuvant chemotherapy treatment in women treated for breast cancer. Clin Neuropsychol. 2006;20:76–89.

    Article  PubMed  Google Scholar 

  72. Anderson-Hanley C, Sherman ML, Riggs R, et al. Neuropsychological effects of treatments for adults with cancer: a meta-analysis and review of the literature. J Int Neuropsychol Soc. 2003;9:967–82.

    Article  PubMed  Google Scholar 

  73. Kopplemans V, Breteler MMB, Boogerd W, et al. Neuropsychological performance in survivors of breast cancer more than 20 years after adjuvant chemotherapy. J Clin Oncol. 2012;30:1080–6.

    Article  Google Scholar 

  74. Kreukels BPC, Schagen SB, Ridderinkhof KR, et al. Effects of high-dose and conventional-dose adjuvant chemotherapy on long-term cognitive sequelae in patients with breast cancer: an electrophysiologic study. Clin Breast Cancer. 2006;7:67–78.

    Article  PubMed  CAS  Google Scholar 

  75. Kreukels BPC, van Dam FSAM, Ridderinkhof KR, et al. Persistent neurocognitive problems after adjuvant chemotherapy for breast cancer. Clin Breast Cancer. 2008;8:80–7.

    Article  PubMed  CAS  Google Scholar 

  76. Kreukels BPC, Hamburger HL, de Ruiter MB, et al. ERP amplitude and latency in breast cancer survivors treated with adjuvant chemotherapy. Clin Neurophysiol. 2008;119:533–41.

    Article  PubMed  Google Scholar 

  77. Collins B, Mackenzie J, Stewart A, et al. Cognitive effects of chemotherapy in post-menopausal breast cancer patients 1 year after treatment. Psychooncology. 2009;18:134–43.

    Article  PubMed  Google Scholar 

  78. Weis J, Poppelreuter M, Bartsch HH. Cognitive deficits as long-term side-effects of adjuvant therapy in breast cancer patients: subjective complaints and objective neuropsychological test results. Psychooncology. 2009;18:775–82. doi:10.1002/pon.1472.

    Article  PubMed  CAS  Google Scholar 

  79. Wefel JS, Saleeba AK, Buzdar AU, et al. Acute and late-onset cognitive dysfunction associated with chemotherapy in women with breast cancer. Cancer. 2010;116:3348–56. doi:10.1002/cncr.25098.

    Article  PubMed  Google Scholar 

  80. Heflin LH, Meyerowitz BE, Hall P, et al. Cancer as a risk factor for long-term cognitive deficits and dementia. J Natl Cancer Inst. 2005;97:854–6.

    Article  PubMed  Google Scholar 

  81. Heck JE, Albert SM, Franco R, et al. Patterns of dementia diagnosis in surveillance, epidemiology, and end results breast cancer survivors who use chemotherapy. J Am Geriatr Soc. 2008;56:1687–92.

    Article  PubMed  Google Scholar 

  82. Baxter NN, Durham SB, Phillips KA, et al. Risk of dementia in older breast cancer survivors: a population-based cohort study of the association with adjuvant chemotherapy. J Am Geriatr Soc. 2009;57:403–11.

    Article  PubMed  Google Scholar 

  83. Du XL, Xia R, Hardy D. Relationship between chemotherapy use and cognitive impairments in older women with breast cancer. Am J Clin Oncol. 2010;33:533–43.

    Article  PubMed  Google Scholar 

  84. Mols F, Thong MSY, Vreugdenhil G, et al. Long-term cancer survivors experience work changes after diagnosis: results of a population-based study. Psychooncology. 2009;18:1252–60.

    Article  PubMed  Google Scholar 

  85. Nieuwenhuijsen K, de Boer A, Spelten E, et al. The role of neuropsychological functioning in cancer survivors’ return to work one year after diagnosis. Psychooncology. 2009;18:589–97.

    Article  PubMed  Google Scholar 

  86. Reid-Arndt SA, Yee A, Perry MC, et al. Cognitive and psychological factors associated with early post-treatment functional outcomes in breast cancer survivors. J Psychosoc Oncol. 2009;27:415–34.

    Article  PubMed  Google Scholar 

  87. Ahles TA, Saykin AJ, Noll WW, et al. The relationship of ApoE genotype to neuropsychological performance in long-term cancer survivors treated with standard dose chemotherapy. Psychooncology. 2003;12:612–9.

    Article  PubMed  Google Scholar 

  88. Jenkins V, Shilling V, Deutsch G, et al. A 3-year prospective study of the effects of adjuvant treatments on cognition in women with early stage breast cancer. Br J Cancer. 2006;94:828–34.

    Article  PubMed  CAS  Google Scholar 

  89. Schagen SB, Muller MJ, Boogerd W, et al. Late effects of adjuvant chemotherapy on cognitive function: a follow-up study in breast cancer patients. Ann Oncol. 2002;13:1387–97.

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of Interest

Erin O’Farrell declares no conflict of interest.

Joyce MacKenzie declares no conflict of interest.

Barbara Collins declares no conflict of interest.

Author information

Authors and Affiliations

  1. School of Psychology, University of Ottawa, Ottawa, ON, Canada

    Erin O’Farrell & Barbara Collins

  2. The Ottawa Hospital – Civic Campus, 1053 Carling Ave, Room A628, Ottawa, ON, K1Y 4E9, Canada

    Joyce MacKenzie & Barbara Collins

Authors
  1. Erin O’Farrell
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Joyce MacKenzie
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Barbara Collins
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Barbara Collins.

Rights and permissions

Reprints and permissions

About this article

Cite this article

O’Farrell, E., MacKenzie, J. & Collins, B. Clearing the Air: A Review of Our Current Understanding of “Chemo Fog”. Curr Oncol Rep 15, 260–269 (2013). https://doi.org/10.1007/s11912-013-0307-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11912-013-0307-7

Keywords

Search

Navigation