Exercise Eases Chemo Brain in Cancer Patients, Rochester Study Finds

A common over-the-counter pain reliever paired with home exercise helped reduce cognitive problems in cancer patients on chemotherapy, according to a University of Rochester study.

Researchers tested physical activity and low-dose ibuprofen on patients experiencing chemo brain, or chemotherapy-related cognitive impairment. This side effect hits memory, concentration and multitasking. Previous studies show up to 80 percent of chemotherapy patients face some cognitive decline.

The phase 2 trial involved 86 adult cancer patients in New York undergoing chemotherapy. Their average age was 53, and nearly 89 percent were women. Patients were split randomly into four groups: home exercise alone, exercise plus ibuprofen at 200 milligrams twice daily, ibuprofen alone or placebo alone.

The exercise regimen featured low- to moderate-intensity progressive walking and resistance band training, tailored for cancer patients.

"This is one of the first studies specifically designed to assess these interventions for cancer-related cognitive impairment during chemotherapy in patients with multiple diseases using both performance-based cognitive assessments and patient-reported outcomes," said lead author Michelle C. Janelsins, Ph.D., MPH, of the University of Rochester and the Wilmot Cancer Institute.

After six weeks, exercise produced the strongest gains in attention and cognitive function, based on reports from family and friends. The exercise-plus-placebo group outperformed the placebo-only group on attention measures.

Patients taking ibuprofen alone also beat the placebo group on cognitive tests. Ibuprofen offered some gains, but they were smaller and less steady than with exercise. The results hint that inflammation plays a part in chemo brain and anti-inflammatory drugs might help.

"We are encouraged by the findings of this trial that suggest possible benefits of both interventions for some cognitive domains," Janelsins said. "Clearly, we saw a more pronounced effect with exercise, which is notable considering the multiple health benefits of exercise for cancer survivors."

No adverse effects turned up in the trial. The findings appear in Cancer, the American Cancer Society's peer-reviewed journal.

Researchers pointed to limits: small sample size, short six-week run and uneven results across cognitive tests. With most participants women, the outcomes may not apply widely.

The team plans phase 3 trials to test if ibuprofen and exercise reliably fight chemo brain. "Since we saw cognitive benefits in some domains and not others, we will also consider additional doses and longer durations in future research trials," Janelsins said.