A new study published in the March issue of JNCCN-Journal of the National Comprehensive Cancer Network reports that structured exercise can help people with cancer maintain mental clarity and daily functioning while undergoing chemotherapy on a two-week cycle. The nationwide, multicenter phase III trial involved 687 patients from 20 community oncology practices across the United States who were part of the University of Rochester Cancer Center NCI Community Oncology Research Program Research Base. Participants were randomized to receive an individualized exercise prescription, Exercise for Cancer Patients (EXCAP), which included tailored walking and resistance band exercises alongside their usual chemotherapy treatment.
The research is significant because it addresses concerns about cognitive impairment, often referred to as "chemo brain," that many patients experience during chemotherapy. Maintaining cognitive function is important for preserving independence, continuing work, and sustaining quality of life during treatment.
Patients receiving two-week chemotherapy cycles who followed the EXCAP program reported less cognitive impairment and mental fatigue compared to those who did not have an exercise plan. They also maintained their daily walking routines, whereas those without structured exercise reduced their walking by half. "It was striking to find that without a structured exercise plan, patients receiving chemotherapy often reduce their daily walking by half and experience notable increases in problems with thinking, memory, and mental fatigue," said co-lead author Po-Ju Lin, PhD, MPH, RD, from Wilmot Cancer Institute at University of Rochester Medical Center. Lin added that non-pharmacologic interventions like exercise are safe and accessible options for managing cognitive issues during chemotherapy.
The researchers noted that side effects such as tiredness or muscle weakness often lead patients to walk less during treatment. However, they found that the two-week cycle may be optimal for participating in EXCAP since benefits were not observed in those on three- or four-week cycles. They suggested future studies could expand these findings to broader patient populations.
Lindsay L. Peterson, MD, MSCR—a medical oncologist at Washington University School of Medicine in St. Louis who was not involved in the study—said: "Many patients who need chemotherapy worry that they'll experience 'chemo brain.' This study offers encouraging news: there may be something patients can do to reduce their risk of cognitive impairment during chemotherapy-exercise!" Peterson also emphasized: "Participants receiving chemotherapy every two weeks who were randomized to an individually tailored exercise program experienced less cognitive impairment compared with those in the control arm... These findings reinforce the recommendation in the NCCN Guidelines for Survivorship that survivors with cancer-related cognitive dysfunction engage in routine physical activity."
