Can exercise fight the fog of ‘chemo brain’?

Karen Mustian says most people receiving chemo are encouraged to take it easy during treatments, but her work suggests a program of mild exercise may help fight side effects, like brain fogginess. (Credit: Guigo .eu/Flickr)

People receiving chemotherapy may benefit from doing exercises, like walking or resistance-band training. Researchers tested the concept with more than 600 people and found those who exercised had lower levels of chronic inflammation and “chemo-brain,” the cognitive impairment that’s often a side effect of chemo.

“To think that a very simple, low-cost, self-directed exercise prescription can create an anti-inflammatory response similar to a drug and protect against cognitive decline in people with cancer is innovative and very exciting,” says Karen Mustian, associate professor of surgery and radiation oncology at the University of Rochester.

“Sometimes patients are encouraged to take it easy throughout their treatments. It’s often accepted that their physical activity will just naturally decline. But our study demonstrates that we need to strongly encourage them to maintain or increase their activity compared to what they were doing at the beginning of chemotherapy.”

Exercise prescription

Mustian and colleagues developed a program called EXCAP (Exercise for Cancer Patients) several years ago and have been evaluating it in clinical trials.

At the American Society of Clinical Oncology (ASCO) meeting on June 1, she presented findings from a phase III randomized study for early-stage cancer patients. Half received standard care (no prescribed exercise during chemotherapy) and half took part in the exercise program. Those patients wore a pedometer, walked daily, and used resistance bands as instructed.


At the start of cancer treatment, most study participants were walking about 4,000 steps a day, roughly the equivalent of two miles, which is considered sedentary.

Healthy people need to walk about 5,000 steps daily to be low-active, 7,500 steps to be somewhat active, 10,000 steps to be active, and 12,500 steps to be highly active.

By the end of six weeks, however, the non-exercisers had dropped off to an average of about 3,800 steps (sedentary) but the exercisers were walking about 5,000 steps (low active). The EXCAP group also performed resistance band training five days a week for 10 minutes at a low to moderate intensity. The other group did not do any strength training.

Non-exercisers not only lost mobility, but reported more brain fogginess and memory problems, and they had higher levels of blood inflammation, according to tests conducted during the study.

Further, exercisers who received chemotherapy in two-week cycles (as opposed to different timing) reported the greatest physiological and psychological benefits.

Source: University of Rochester