Very few studies exist, with no shared approach. The signal remains positive for fatigue, mood and quality of life, and adverse effects are minimal, but the one published randomised trial did not change the cognitive complaint itself.
Updated :
What the research shows
EEG neurofeedback — standard amplitude training
(alpha, theta/beta, SMR-beta); the AAPB level is a joint biofeedback/neurofeedback rating
Ages
Adult (18+)
Techniques
Alpha training, Theta/beta ratio, Sensorimotor rhythm (SMR), Beta training
AAPB2Possibly efficaciousNeuroLogic2Possibly efficacioussame vs AAPB
Level 2 maintained. The AAPB level is a joint biofeedback/neurofeedback rating; on the neurofeedback side it rests on Alvarez 2013 (23 women treated for breast cancer, a 4-week waitlist period then 20 twice-weekly sessions, performance back within normal ranges 4 weeks after training) and Sideroff 2022 (nine women, two-channel SMR-beta training, about 40 % of abnormal qEEG bands normalising, with gains in processing speed, set-shifting and visual attention). The only randomised trial published since is null on cognition: Fink 2023 randomised 56 cancer patients to 10 sessions of alpha and theta/beta neurofeedback or to mindfulness group therapy, with no change in perceived cognitive impairment in either arm (P = .079), distress, depression and anxiety improving over time in both groups without a between-group difference, and alpha power rising across sessions. Luctkar-Flude 2022 (16 survivors, 10-week waitlist design) reports reduced perceived cognitive deficits and fatigue. Three systematic reviews in childhood-cancer survivors find no transfer effect after neurofeedback (Egset 2025; Liu 2026; Tariq 2025); a network meta-analysis in breast cancer survivors ranks neurofeedback among the interventions superior to conventional therapy for verbal memory (Zeng 2024). Nothing yet supports a raise.
Biofeedback
(very limited evidence base); the AAPB level is a joint biofeedback/neurofeedback rating
Ages
Adult (18+)
Techniques
Other biofeedback
AAPB2Possibly efficaciousNeuroLogic2Possibly efficacioussame vs AAPB
Level 2 maintained. The AAPB level is a joint biofeedback/neurofeedback rating and, on the biofeedback side, it rests on a single randomised trial that is only loosely psychophysiological: Miki 2014 assigned 78 elderly patients who had completed treatment for breast or prostate cancer to 4 weeks of weekly bicycle-ergometer training with speed feedback or to no intervention, and found the feedback group higher on executive function at the end. No trial of EMG, thermal, electrodermal or heart-rate-variability biofeedback for cancer-related cognitive impairment appears in the 2022-2026 window, and the recent systematic review of non-pharmacological interventions targeting the nervous system in this population identifies none either (Dosa 2026). The level is held rather than lowered because the joint rating does rest on one adequately sized randomised study with a defined outcome; it is not evidence for the biofeedback modalities used in clinical practice, which remain untested here.
In short
Clinical reading
NeuroLogic Level 2, the same as the joint AAPB rating, for neurofeedback and for biofeedback. Neurofeedback: two positive quasi-experimental studies (Alvarez 2013, Sideroff 2022) and one waitlist study (Luctkar-Flude 2022), but an RCT against mindfulness therapy null on the cognitive complaint (Fink 2023). Biofeedback: a single randomised trial, of bicycle-ergometer speed feedback.
Protocols
ADHD-style attentional protocols — theta and high-beta inhibits with SMR-beta rewards at central sites — or alpha enhancement; 10 to 20 sessions in the published studies; no consensus protocol.
Limits
Almost no literature, weak or absent controls, short courses, heterogeneous cognitive complaints and prior oncological treatments. Self-reported cognitive complaint correlates poorly with neuropsychological performance. No clinical biofeedback modality (EMG, thermal, HRV) has been tested in this indication. In childhood-cancer survivors the systematic reviews show no transfer effect of neurofeedback; the entry stays adult, for want of a paediatric base of its own.
Study base
Two quasi-experimental studies and one randomised trial of neurofeedback, one randomised trial of speed feedback; 2022-2026 base: 6 publications indexed in the archive, mostly systematic reviews in which neurofeedback is one intervention among several.
Brendan's perspective
Level 2, unchanged, and I would not move it. Alvarez 2013 and Sideroff 2022 are encouraging in the way small uncontrolled studies are encouraging; Fink 2023 is the one randomised trial and it is null on the cognitive complaint against mindfulness group therapy — with ten sessions, which is not a course of neurofeedback in my terms. Sideroff 2022 also let the software hold the reward rate near eighty per cent, which is precisely the arrangement I argued in Parsons 2026 makes for a weaker test. On the biofeedback side the level rests on feedback of pedalling speed on a bicycle ergometer. That is not the biofeedback a clinic delivers. This is not a population I see often, and when I do I train the attentional picture the qEEG shows rather than a chemobrain protocol. Tell the client the honest thing: mood, fatigue and quality of life may move; the cognitive complaint may not, and it correlates poorly with neuropsychological testing. None of which is a reason to stay away from oncology. I think neurofeedback is a genuinely interesting complement to conventional care for people with cancer, before or after treatment — for the cognitive side, and at least as much for the emotional one, whether that presents as post-traumatic symptoms, anxiety or depression. Outlook is not a soft variable in oncology; it is a documented factor in how treatment goes. If neurofeedback or biofeedback can contribute to a person's outlook and sense of control while the rest of the care does its work, that is worth putting in place. I say that knowing the research does not back it yet, and I would rather say it plainly than dress it up as evidence.
Alvarez et al. (2013) The effect of EEG biofeedback on reducing postcancer cognitive impairment doi:10.1177/1534735413477192
Sideroff et al. (2022) A neurotherapy protocol to remediate cognitive deficits after adjuvant chemotherapy: A pilot study doi:10.1515/jcim-2021-0537
Miki et al. (2014) Feasibility and efficacy of speed-feedback therapy with a bicycle ergometer on cognitive function in elderly cancer patients in Japan doi:10.1002/pon.3501
Fink et al. (2023) Neurofeedback Treatment Affects Affective Symptoms, But Not Perceived Cognitive Impairment in Cancer Patients: Results of an Explorative Randomized Controlled Trial doi:10.1177/15347354221149950
Luctkar-Flude et al. (2022) Exploring the effect of neurofeedback on postcancer cognitive impairment and fatigue: A pilot feasibility study doi:10.5737/23688076322214222
Dosa et al. (2026) Chemotherapy-related cognitive impairment and non-pharmacological interventions targeting the nervous system: a systematic review doi:10.3389/fpsyt.2026.1789794
