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Navigating Neurological Side Effects During Cancer Treatment

When you’re coping with cancer, your health care providers will recommend treatments like chemotherapy, radiation and immunotherapy. These powerful treatments can help slow or stop the spread of cancer.

Unfortunately, many of these treatments can also cause neurological side effects in various parts of the body. Ramya Tadipatri, MD, a neuro-oncologist with Banner MD Anderson Cancer Center, explained more about how these treatments affect the nervous system, and what you and your health care team can do to combat them.

Neuro side effects that could occur 

Not everyone who is treated for cancer has the same side effects. The type of cancer, type of treatment, your overall health and other factors can make a difference in your experience. 

Depending on your therapy, you may notice:

  • Cognitive changes, such as trouble with memory, concentration or processing information. You may forget names, struggle to multitask or feel like your thinking is foggy. Chemotherapy may cause these changes, which are sometimes referred to as “chemo brain.”
  • Peripheral neuropathy, which is a condition that affects the peripheral nerves and causes tingling, numbness or pain in your arms and legs. It can make it hard to do daily activities like walking or buttoning a shirt. It can lead to tremors, spasms, gait (walking) imbalance and sexual dysfunction.
  • Fatigue, which can be physically and mentally challenging since it can be exhausting to do simple tasks.

By understanding these side effects and sharing them with your health care team, you can take steps to minimize them and reduce their impact on your life. 

Pay attention to your symptoms

When you’re in the middle of cancer treatment, you may have a lot going on in your life. But you’ll want to make sure you recognize your symptoms and communicate with your provider. They can help you find ways to cope. 

It’s a good idea to keep a symptom diary. In it, write down any challenges you have with thinking, neuropathy or fatigue. Note how long your symptoms last and how intense they are. 

You may also want to track how your daily activities are changing. What you can or can’t do can show how these side effects are impacting your life. Activities like cooking, driving or working might be more challenging or might take more of your energy. 

Share your concerns with your provider

If you have sudden or severe neurological symptoms like extreme changes in your ability to think, intense pain, loss of coordination or seizure, get medical care right away.

Stroke is a rare side effect of some cancer treatments, so call 911 if you notice facial drooping, arm weakness, speech slurring or weakness or numbness on just one side of the body. 

Be sure to attend all of your scheduled health care appointments and talk to your provider about any changes, questions or concerns. That way, they can help you find ways to manage your side effects. 

“Communicate any symptoms to your provider, even if they are minor. Your provider can monitor them, even if they do not warrant intervention,” Dr. Tadipatri said. “Describe what you are experiencing. It is helpful to know when the symptoms started, what part of the body is affected, if the symptoms are changing and if anything makes them better or worse.”

Your provider may recommend tests for vitamin deficiencies, diabetes, thyroid disorders or other conditions in case something other than your cancer treatment is causing your symptoms.

How to cope

“We want to make sure that we are doing more good than harm with your treatment. If the symptoms are debilitating, you may want to talk with your oncologist about whether it is worth continuing with the treatment and whether any alternatives are available. There may also be medications to alleviate the symptoms in some cases,” Dr. Tadipatri said.

You can take steps to reduce the impact of neurological side effects from cancer treatment. 

Cognitive changes

These tips can help you cope with chemo brain and changes in the way you think:

  • Use organizational tools like calendars, planners and checklists to keep track of appointments, schedules and tasks. 
  • Set up your workspace so it minimizes distractions and helps you stay focused.
  • Put items back in consistent places so it’s easier to remember where they are.
  • Try mental exercises and puzzles like crosswords, sudoku or brain-training apps to help keep your brain sharp. 
Peripheral neuropathy

Tingling, numbness or pain in the hands and feet is a common side effect of cancer treatment. Gentle exercise like walking, swimming or stretching can improve your circulation and nerve health. A physical therapist can help you find activities that work. Medication may help with tingling or pain, but not with numbness.

If you have peripheral neuropathy, taking good care of your feet is important. Wear comfortable and supportive footwear, moisturize your feet so the skin doesn’t get dry and cracked, be careful about hot or cold temperatures since you might not sense them well and inspect your feet regularly for cuts or sores. 

Take steps to reduce your risk of falls. Remove tripping hazards, secure rugs and install handrails if needed. Ask family or friends for help with activities that could lead to falls. 


During cancer treatment, you may feel exhausted. It can help to balance rest and activity. Try breaking down the things you need to do into smaller, manageable tasks with rests in between. Pay attention to your energy levels and tackle harder activities when you have the most energy.

Make sure you get plenty of sleep. And add deep breathing or meditation to your routine to help reduce stress.

What you eat can also help with fatigue. Choose a well-balanced diet rich in vegetables, fruit, lean protein and whole grains. Try having smaller meals and snacks throughout the day to maintain your energy. Talk to your provider about supplements. And be sure to drink plenty of water.

If you’ve tried these options and you’re still struggling with symptoms from your cancer treatment, other specialists may be able to help. Your health care provider may recommend:

Dealing with the emotions that come with treatment side effects

It can be emotionally challenging to cope with the thinking challenges, neuropathy and fatigue that may come along with cancer treatment. It can help to share your experiences with family and friends. It may also be comforting to join an in-person or online support group to connect with people facing the same challenges. 

You may also want to work with a mental health professional. A therapist or counselor can help you navigate your emotional challenges and cope with any stress, anxiety or depression you may be experiencing.

The bottom line

Some cancer treatments can cause neurological side effects such as changes in thinking, neuropathy and fatigue. Be sure to track your symptoms and share them with your health care team so they can help you find ways to minimize their impact on your quality of life.

A Banner Health provider can help review your cancer treatments and symptoms and find ways to keep you feeling as healthy as possible during your journey with cancer. 

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