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  • Kate Middleton Opens Up About ‘Chemo Fog’ During Cancer Recovery: Understanding the Cognitive Effects of Chemotherapy

    Kate Middleton Opens Up About ‘Chemo Fog’ During Cancer Recovery: Understanding the Cognitive Effects of Chemotherapy

    Kate Middleton, the Princess of Wales, has shared new details about one of the most unexpected challenges she faced during her cancer treatment: the cognitive difficulties commonly known as “chemo fog” or “chemo brain.”

    Speaking candidly during a visit to a cancer treatment center, she described struggling to read and concentrate while undergoing chemotherapy, offering a glimpse into a side effect that many cancer patients experience but is often overlooked.

    Her remarks have resonated with patients, healthcare professionals and supporters alike, bringing renewed attention to the lasting mental and emotional effects that can accompany cancer treatment, even after therapy has ended.

    The Royal’s Reflection On Her ‘Chemo Fog’ Experience and an Unexpected Hobby She Gained

    While visiting patients at The Christie NHS Foundation Trust in Manchester, Kate reflected on the cognitive changes she experienced during chemotherapy. She explained that one of the most difficult aspects of treatment was her inability to focus on activities she had previously enjoyed.

    “I don’t know about you, but I didn’t have the ability to read or really focus on anything,” she shared while speaking with fellow patients.

    Instead of reading, Kate said she found comfort in an unexpected hobby: coloring. She explained that coloring allowed her to remain creative without the pressure of producing a finished piece.

    “[Coloring] was my way of exploring interesting things and being able to do something that did not require an end product, or an end finished piece,” she said.

    Kate, who announced she was in remission following her cancer treatment, has increasingly spoken about the realities of recovery, emphasizing that the journey does not end when chemotherapy is completed. Her openness has been widely praised by patients and advocacy groups, many of whom say it helps normalize conversations about the less visible side effects of cancer treatment.

    Peering Through the Chemo Fog

    According to the Mayo Clinic and the Cleveland Clinic, chemo fog, also known as chemo brain or cancer-related cognitive impairment, describes a collection of thinking and memory problems that may occur during or after cancer treatment.

    Although chemotherapy is commonly associated with the condition, experts believe cognitive changes may also result from several overlapping factors, including the cancer itself, radiation therapy, hormonal treatments, medications, fatigue, poor sleep, stress, anxiety, and depression.

    Common Symptoms

    People experiencing chemo fog may notice:

    • Difficulty concentrating
    • Memory lapses
    • Trouble finding the right words
    • Slower thinking or information processing
    • Difficulty multitasking
    • Problems staying organized
    • Shortened attention span
    • Mental fatigue

    Symptoms vary considerably between individuals. Some experience mild, temporary changes, while others continue to notice cognitive difficulties for months or even years after treatment.

    How Is It Diagnosed?

    There is no single test that confirms chemo fog.

    Healthcare providers typically diagnose it by:

    • Reviewing symptoms and medical history
    • Performing neurological and physical examinations
    • Assessing memory, attention, and executive function
    • Ruling out other possible causes such as thyroid disorders, vitamin deficiencies, depression or medication side effects

    Treatment and Management

    There is currently no specific cure for chemo fog, but many patients improve over time.

    Doctors often recommend strategies such as:

    • Treating underlying conditions like anemia or sleep disorders
    • Regular physical activity
    • Maintaining consistent sleep habits
    • Keeping calendars, reminders, and written notes
    • Completing mentally demanding tasks when energy levels are highest
    • Brain-training exercises and cognitive rehabilitation
    • Stress reduction through mindfulness or relaxation techniques

    Creative hobbies, which include drawing, coloring, puzzles or music, may also help some patients stay mentally engaged while reducing frustration, much like Kate described during her own recovery.

    A Hopeful Way to Cope With ‘Chemo Fog’ and Treating Cancer

    The Princess’ experience shines a light on a side effect of cancer treatment that many patients quietly endure. While hair loss, nausea and fatigue are widely recognized, cognitive changes can be equally disruptive, affecting work, family life and everyday activities long after treatment ends.

    Her willingness to discuss struggling with concentration and finding comfort through coloring may help reassure patients that these experiences are both common and valid. It also reinforces the importance of comprehensive cancer care that addresses emotional and cognitive recovery in addition to physical health.

    For the general public, Kate’s story offers greater understanding of the long-term challenges cancer survivors may face. For people undergoing chemotherapy, it serves as a reminder that recovery is often gradual, and seeking support for cognitive symptoms is just as important as managing the physical effects of treatment. With appropriate coping strategies, medical guidance, and patience, many individuals are able to regain confidence and improve their cognitive function as they continue their recovery journey.

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  • Study opens door to a rethink of colonoscopy guidelines — Harvard Gazette

    Study opens door to a rethink of colonoscopy guidelines — Harvard Gazette


    A new analysis of nearly 200,000 adults shows that those with a clean result on their first colonoscopy may not need another for longer — perhaps significantly longer — than the current recommendation of 10 years.

    The result is a bit of good news about a cancer whose increasing rates in younger patients has worried experts, including the Harvard Chan School’s Mingyang Song, for several years. Colorectal cancer is the nation’s second-deadliest after lung cancer, killing an estimated 52,550 in 2023. While rates among older patients have been declining, younger patients — those 40 to 49 — have seen cases rise 15 percent between 2000 and 2026. Experts aren’t sure of the cause, but in 2021, the U.S. Preventive Services Task Force lowered the recommended age of first screening to 45 from 50. They also recommend that those with average risk get screened 10 years afterward.

    Song, an associate professor of clinical epidemiology and nutrition at the Chan School, said that the increase in screenings has also increased appointment wait times.

    “Especially with the lowered age, the clinic is overwhelmed,” said Song, also an associate professor at Harvard Medical School. “It was overwhelmed before, now it’s even worse.”

    In the work, published last month in JAMA Oncology, Song and colleagues examined colorectal cancer screening results and colorectal cancer incidence among 195,453 participants in three long-running studies: the Nurses’ Health Study, Nurses’ Health Study II, and the Health Professionals Followup Study. They compared incidence between two groups: those who received negative results in their initial colorectal cancer screening — meaning no polyps or cancer — and those who had not yet been screened.

    They found that the risk of developing colorectal cancer was significantly lower among those who had received a negative cancer screening than those who had not yet been screened. The research team, led by first author Markus Knudsen, a postdoctoral fellow in Song’s lab, then divided the negative screening result group according to lifestyle risk factors for colorectal cancer. The work was supported in part by the National Institutes of Health.

    The results showed that it took 16 years for those with a negative screening result and an intermediate-risk lifestyle to have the same colorectal cancer incidence of the unscreened group at 10 years. Those with negative screening and a low-risk lifestyle — including a healthy diet and exercise — didn’t reach the 10-year cancer incidence of the unscreened group until 25 years from their negative screening.

    The results, Song said, show that cancer screening should be individualized and discussed between patient and physician. While it is likely that additional evidence will be needed before national screening guidelines are changed, those with a negative screening result may be able to safely extend the screening interval beyond the recommended 10 years and, for those also living a low-risk lifestyle, perhaps as long as 20 years.

    What this more tailored approach would do, Song said, is spare those who might get little benefit from a colonoscopy while focusing increasingly scarce resources where they’re most needed: on people who’ve never been screened — only about 70 percent of eligible U.S. adults have been screened — on disadvantaged groups with historically lower screen rates, and on those whose lifestyle or family history puts them at increased risk.  

    “What we have seen generally is that the more advantaged groups of individuals are more likely to receive colonoscopy, whereas those who are disadvantaged and who actually have a higher risk of developing colon cancer are less likely to receive colonoscopy,” Song said. “We’ve tried to correct this mismatch and improve colonoscopy delivery at the population scale.”


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