Ask the Expert: Brain Tumours and Cognition

Sometimes Brain Tumours Affect Thinking: What Can You Do About It?

The brain is a complex organ with many different functions; it controls your physical being, emotions and thoughts. If you have changes to your thinking in particular these often take a back seat to medical concerns. However, these same changes have a big impact on quality of life. Members of your health care team (neuropsychologists, occupational therapists, speech-language pathologists) can help you identify challenges and give you coping strategies. 

Impact on Attention and Memory

Brain tumours can make it difficult for you to pay attention. It may be harder to filter out distractions and you may find you are more easily overwhelmed, or it may take longer for you to process information and think through things than it did previously. When you have trouble focusing, it also makes it harder to learn new information. You may also mix-up information or forget things (e.g. medication, bills, and details of events).

Impact on Communication

The brain helps you understand language and also express yourself. Brain tumours can interfere with either or both, making it difficult to communicate. They can also impact the ability to understand non-verbal social cues, so those subtle signs we give each other (e.g. looking at our watch when we want something to be over) can be harder to interpret. These changes can make it harder for you to understand others or be understood.

Impact on Executive Functioning 

“Executive functions” are called that because they are like the “boss” or “executive” in a workplace. The boss problem solves, strategizes plans, considers options, sees the “big picture”, and directs the team. The frontal lobes and their connections in your brain are like this “executive”. When brain tumours affect this system, your ability to perform these tasks can be affected. Your ability to make big decisions, multi-task, problem-solve, organize and think in an abstract way may be impacted.

Strategies to Cope

There are many things that you can do to improve your quality of life despite cognitive challenges. Here are some tips:

  • Take frequent rests from activity
  • Reduce excess noise and distractions (e.g. turn off the TV/radio when trying to focus)
  • Make a to-do list and finish one task before moving on to the next
  • Set aside more time to complete tasks
  • Don’t pretend to understand something when you don’t (ask people to repeat themselves)
  • Use visual cues (e.g. pictures, hand signals) or written information to help with communication
  • Be organized! Always keep your things in the same place. Structure your days so you do the same tasks on the same day
  • Use memory aids (e.g. electronic devices, day planners), but don’t use sticky notes because they can be easily misplaced
  • Leave your medication in a prominent place to help you remember it (e.g. dossette box on kitchen table)
  • Ask family for reminders
  • Have others whom you trust assist you in making big decisions
  • Give your family and friends “license to nag” when you need occasional reminders

Even when you can’t change your brain, you can still change how you do things or change the environment around you. Small changes can make a big difference in helping you cope. Don’t be afraid to ask family, friends, and your health care team to help!


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Thank you to Dr. Lisa Walker for providing this Ask the Expert information sheet.

Dr. Walker is a Clinical Neuropsychologist at the Ottawa Hospital with academic appointments at the Ottawa Hospital Research Institute as well as the University of Ottawa in both the Faculty of Medicine and School of Psychology.  She is on the Executive of the endMS Québec-Ottawa Regional Research and Training Centre, is an Associate Member of the Heart and Stroke Foundation Centre for Stroke Recovery. In addition to her clinical role she teaches and leads a funded research program. Dr. Walker is also a member of the Professional Advisory Group for the Brain Tumour Foundation of Canada and as spoken at various events including the Ottawa Brain Tumour Information Day. 

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