When researchers recommended a customized, scientifically validated exercise program to patients undergoing chemotherapy for cancer, the patients who followed the exercise regimen on a two-week chemotherapy schedule were better able to maintain their step goal, use a resistance band, and stay mentally sharp than those who did not exercise.
This national study on exercise and cancer, led by Karen Mustian, PhD, MPH, and Po-Ju Lin, PhD, MPH, RD, of the Wilmot Cancer Institute at the University of Rochester, is important for the following reasons:
- Up to 75% of cancer patients report cancer-related cognitive impairment, or “chemobrain.” What is chemobrain? Patients report general brain fog and problems managing money, medication, and maintaining a home. Although there is no gold standard treatment for chemical brain, research shows that consistent exercise may reduce symptoms of chemical brain and improve executive function during and after cancer treatment.
- The study builds on previous research by Wilmot and others showing that patients can benefit from even mild to moderate exercise during cancer treatment. Studies have shown that exercise has anti-inflammatory properties and promotes a healthy immune system.
- Working with exercise experts from the American College of Sports Medicine, Mustian developed the exercise prescription (called EXCAP) used in the study. It was designed to provide safe exercise during chemotherapy, to be practical, low-cost, home-based, and customizable to the patient’s physical abilities. This includes a prescription for graded aerobic walking and resistance band exercise.
The study is published in the March issue of the magazine. JNCCN – Journal of the National Comprehensive Cancer Network.
Exercise during chemotherapy: how it helps
“This is a safe and simple exercise regimen that can be an important part of supportive care for people undergoing chemotherapy,” said Mustian, professor and chair of the Department of Surgery and Cancer Control and associate director of population sciences at Wilmot University.
“Cancer care providers should educate patients about at-home options such as walking and resistance band exercise as part of optimal care, and refer patients to exercise as appropriate. Oncologists can tailor programs to individual abilities,” he said.
In this Phase 3 clinical trial, researchers reported secondary outcomes from a previous study that enrolled nearly 700 patients from 20 community oncology clinics across the United States who were receiving chemotherapy for the first time for a variety of cancers.
Participants were randomly assigned to two groups: those who received standard treatment with no exercise or those who received chemotherapy and a six-week exercise regimen. All participants recorded their daily steps and exercise.
Before chemotherapy, all patients walked an average of 4,000 to 4,500 steps per day. (During chemotherapy, people who are not on a formal exercise regimen typically walk less due to fatigue, weakness, nausea, or other factors, researchers note.)
In this study, many people in the exercise group were able to maintain their normal daily step count while undergoing chemotherapy, while those in the standard-of-care group who did not exercise saw their daily step count decrease by 53%.
Patients who exercised during chemotherapy also reported feeling more mentally alert.
Mr. Lin believes that a systematic exercise regimen is essential to achieving good results.
“We were shocked to find that without a structured exercise regimen, patients undergoing chemotherapy experienced a reduction in daily walking volume by half and significant increases in problems with thinking, memory, and mental fatigue,” said Lin, a research assistant professor and member of Wilmot College’s Cancer Prevention and Control Research Program.
Why do some patients benefit more?
The benefits of exercise during chemotherapy applied primarily to patients receiving treatment every two weeks, as opposed to those receiving chemotherapy in three- or four-week cycles.
Scientists don’t know why.
This needs to be studied further, but speculation is that patients receiving two-week cycles of chemotherapy may be able to remain more active because they are receiving drugs with different toxicities and less severe side effects. Once you begin to reduce your activity level, it becomes more difficult to return to and maintain your baseline activity. Patients receiving chemotherapy in 3- or 4-week cycles may be experiencing more toxicity and more side effects. ”
Dr. Karen Mustian, MPH, Wilmot Cancer Institute, University of Rochester
benefits of exercise
Regardless of the chemotherapy schedule, Lin emphasized that “non-pharmacological” interventions such as exercise, cognitive training, and mindfulness are important for managing brain fog because they are safe, easy to use, and often cost less than expensive or clinic-based treatments or can be performed at home.
Through the Pluta Integrative Oncology and Wellness Center in Henrietta, Wilmot offers free, evidence-based services on exercise, nutrition, mindfulness and massage therapy during cancer treatment, as well as a video library for all Wilmot patients.
Additional guidelines for patients interested in exercise during cancer treatment can be found through the National Comprehensive Cancer Network.
This research was conducted through a unique mechanism: the University of Rochester/National Cancer Institute Regional Oncology Research Program (NCORP) Research Base, a national translational science network for conducting clinical trials.
sauce:
University of Rochester Medical Center
Reference magazines:
Mustian, K.M. Others. (2026). Effects of exercise on cognitive impairment in patients receiving chemotherapy: a multicenter phase III randomized controlled trial. Journal of the National Comprehensive Cancer Network. DOI: 10.6004/jnccn.2025.7118. https://jnccn.org/view/journals/jnccn/24/3/article-p91.xml
