Researchers led by Karen Mustian and Po-Ju Lin at the Wilmot Cancer Institute conducted a phase 3 clinical trial to test whether a structured exercise prescription can reduce chemo-related cognitive problems. The trial enrolled nearly 700 patients from 20 community oncology clinics across the US; all were receiving chemotherapy for the first time for a variety of cancers. Participants were randomly assigned to standard care without exercise or to a six-week EXCAP program during chemotherapy.
EXCAP was developed with American College of Sports Medicine exercise professionals and is a low-cost, home-based, personalized program combining progressive aerobic walking with resistance-band exercises. All participants recorded daily steps and exercises. Before chemotherapy, patients walked an average of 4,000 to 4,500 steps a day. The researchers note that treatment often reduces activity because of fatigue, weakness, nausea or other side effects.
Many people in the exercise group were able to maintain their usual daily steps, while those in the standard-care group reduced daily steps by 53%. Patients who followed the exercise prescription also reported being mentally sharper. The benefits were strongest for patients on two-week chemotherapy cycles; Mustian suggested these patients may receive drugs with different toxicities and less-severe side effects, which could let them stay more active.
Po-Ju Lin said a structured exercise prescription appears essential to a good outcome, and emphasized that non-pharmacologic interventions such as exercise, cognitive training and mindfulness are safe, easy to use, and often affordable or home-based. The study appears in JNCCN—Journal of the National Comprehensive Cancer Network and was carried out through the University of Rochester/National Cancer Institute Community Oncology Research Program Research Base.
Difficult words
- clinical trial — a study testing treatments in human participants
- prescription — a written plan for treatment or actionexercise prescription
- cognitive — related to thinking, memory, or mental processes
- assign — to place someone into a group or conditionassigned
- fatigue — extreme tiredness or lack of energy
- resistance-band exercises — strength exercises using elastic bands at home
- non-pharmacologic interventions — treatments that do not use medicines
- mindfulness — mental practice of present-moment awareness and calm
- side effect — an unwanted medical reaction to treatmentside effects
Tip: hover, focus or tap highlighted words in the article to see quick definitions while you read or listen.
Discussion questions
- What challenges might patients face when trying to follow a home-based exercise program during chemotherapy?
- How could community oncology clinics help patients maintain physical activity during treatment?
- Do you think non-pharmacologic interventions like exercise and mindfulness should be recommended alongside standard care? Why or why not?
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