Up to 80% of people receiving chemotherapy experience cancer-related cognitive impairment. This often includes mild to moderate changes, such as decreased attention, memory loss, and difficulty multitasking. A new Phase II trial found that exercise and low-dose ibuprofen each helped reduce cognitive problems and protect patients’ cognitive function. The findings are published on Wiley Online. cancera peer-reviewed journal of the American Cancer Society.
Both exercise and anti-inflammatory drugs may improve cognitive outcomes in a variety of disease settings, but little is known in the cancer setting. Because exercise and ibuprofen both reduce inflammation through different pathways, their combined use may have additive or synergistic effects in reducing cancer-related cognitive impairment.
For the study, researchers randomly assigned 86 cancer patients undergoing chemotherapy who reported cognitive impairment to four study arms: Exercise for Cancer Patients (EXCAP) plus low-dose ibuprofen, EXCAP plus placebo, low-dose ibuprofen alone, and placebo alone for six weeks. (EXCAP is a prescription for home-based, low-to-moderate-intensity progressive walking and resistance exercise.)
After 6 weeks, participants in the EXCAP + Placebo group had significantly improved attentional performance compared to the Placebo group. The ibuprofen-only group also showed greater improvement than the placebo group. Compared to placebo participants, both EXCAP + ibuprofen and EXCAP + placebo participants showed improvement on a measure assessing how often friends, family, and colleagues commented on or noticed a patient’s cognitive impairment. However, the ibuprofen group showed no improvement in measures of short-term verbal memory compared to the group not receiving ibuprofen, and further investigation is needed.
The findings suggest that exercise may have a positive impact on cognitive function in people undergoing chemotherapy. Ibuprofen may also help improve some cognitive functions, but probably to a lesser extent (and less consistently). Phase III trials are needed to further investigate these findings.
We are encouraged by the results of this trial, which suggest potential benefits of both interventions for some cognitive domains. Clearly, the effect of exercise was more pronounced. This is noteworthy considering the wide range of health benefits that exercise provides for cancer survivors. This is one of the first studies specifically designed to evaluate these interventions for cancer-related cognitive impairment during chemotherapy in patients with multiple diseases using both performance-based cognitive assessments and patient-reported outcomes. ”
Michelle C. Janelsins, PhD, MPH, lead author, University of Rochester and Wilmot Cancer Institute
Dr. Janelsins noted that future studies should consider varying the duration and dose of both exercise and low-dose ibuprofen interventions. She also emphasized that any intervention for cognitive issues should be discussed with a health care provider to ensure there are no contraindications.
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Reference magazines:
Janelsins, M. C., et al. (2026). A phase 2 trial of exercise and low-dose ibuprofen for cancer-related cognitive impairment in patients receiving chemotherapy. cancer, 132(8). https://doi.org/10.1002/cncr.70323. https://acsjournals.onlinelibrary.wiley.com/doi/10.1002/cncr.70323
