Many people undergoing chemotherapy experience a frustrating side effect often called “chemo brain.” These cognitive changes can include trouble 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.
Now, a Phase II clinical trial suggests that two relatively simple interventions, exercise and low-dose ibuprofen, may help reduce some of these cognitive challenges. The study was published in CANCER, a peer-reviewed journal of the American Cancer Society.
Exercise and Ibuprofen Put to the Test
Scientists have long known that both physical activity and anti-inflammatory medications can support brain health in various 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, 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 difficulties. Participants were randomly assigned to one of four groups for six weeks: Exercise for Cancer Patients (EXCAP) + low-dose ibuprofen, EXCAP + Placebo, low-dose ibuprofen only, and Placebo only.
(EXCAP is a home-based, low-to-moderate intensity, progressive walking and resistance exercise prescription.)
Exercise Delivered the Strongest Cognitive Benefits
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 also showed greater improvement than placebo participants on measures of attention.
Researchers also examined how often cognitive difficulties were noticed by people around the participants. Compared with those receiving placebo, individuals in both the EXCAP + ibuprofen and EXCAP + Placebo groups showed improvement on a measure assessing whether friends, family members, or coworkers had commented on or observed cognitive problems.
The results for ibuprofen were more mixed. Patients taking ibuprofen showed less improvement in short-term verbal memory than those who were not taking the medication. Researchers say this finding will require additional investigation.
Overall, the findings indicate that exercise may help preserve cognitive function and lessen some symptoms of chemo brain during treatment. Ibuprofen may also provide benefits in certain areas, although the effects appeared less consistent.
More Research Still Needed
The researchers emphasize that larger Phase III clinical trials will be needed to confirm the findings and better understand the potential role of both interventions.
“We are encouraged by the findings of this trial that suggest possible benefits of both interventions for some cognitive domains. Clearly, we saw a more pronounced effect with exercise, which is notable considering the multiple health benefits of exercise for cancer survivors,” said lead author Michelle C. Janelsins, PhD, MPH, of the University of Rochester and the Wilmot Cancer Institute. “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.”
Dr. Janelsins said future research should explore different durations and doses for both exercise programs and low-dose ibuprofen. She also noted that patients experiencing cognitive problems during cancer treatment should consult their healthcare provider before starting any intervention to ensure it is appropriate for their individual situation.