Many people undergoing chemotherapy often experience a frustrating side effect called “chemobrain.” These cognitive changes may include difficulty concentrating, memory problems, and difficulty juggling multiple tasks. According to researchers, as many as 80% of chemotherapy patients experience some degree of cancer-related cognitive impairment.
Phase II clinical trials now suggest that two relatively simple interventions, exercise and low-dose ibuprofen, may help alleviate some of these cognitive challenges. This study cancera peer-reviewed journal of the American Cancer Society.
Exercise and ibuprofen testing
Scientists have long known that both physical activity and anti-inflammatory drugs can support brain health in a variety of medical conditions. However, their effects on cancer-related cognitive impairment have not been well studied.
Because exercise and ibuprofen reduce inflammation through different biological pathways, the researchers wanted to determine whether either approach, or a combination of both, could help protect cognitive function during chemotherapy.
The study enrolled 86 cancer patients receiving chemotherapy who reported cognitive impairment. Participants were randomly assigned to one of four groups for 6 weeks: Exercise for Cancer Patients (EXCAP) + low-dose ibuprofen, EXCAP + placebo, low-dose ibuprofen only, or placebo only.
(EXCAP is a prescription for home-based, low-to-moderate-intensity progressive walking and resistance exercise.)
Exercise has the most powerful cognitive effects
After six weeks, patients in the EXCAP + placebo group performed significantly better on tests of attention than those in the placebo group. Participants who received only low-dose ibuprofen showed greater improvement than placebo participants on measures of alertness.
The researchers also looked at how often people around the participants noticed their cognitive impairment. Compared to the placebo group, individuals in both the EXCAP + ibuprofen and EXCAP + placebo groups showed improvement on measures assessing whether friends, family, or colleagues commented on or observed cognitive problems.
Results for ibuprofen were more mixed. Patients taking ibuprofen showed less improvement in short-term verbal memory than those not taking the drug. Researchers say this finding requires further investigation.
Overall, the results of this study indicate that exercise may help preserve cognitive function during treatment and reduce some of the symptoms of chemical brain. Ibuprofen may also have an effect in certain areas, but its effects appear to be less consistent.
Further research still needed
The researchers emphasize that larger phase III clinical trials are needed to confirm the results and better understand the potential role of both interventions.
“We are encouraged by the results of this trial, which suggest potential benefits of both interventions for some cognitive domains. Clearly, the more pronounced effects were seen with exercise, which is noteworthy given the multiple health benefits of exercise for cancer survivors,” said first author Michelle C. Janelsins, PhD, MPH, of the University of Rochester and Wilmot Cancer Institute. “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.”
Dr. Janelsins said future studies should examine different durations and doses of both exercise programs and low-dose ibuprofen. He also noted that patients experiencing cognitive problems during cancer treatment should consult their health care provider before starting any intervention to ensure it is appropriate for their individual circumstances.
