Exercise And Ibuprofen Can Limit Chemotherapy-Induced Cognitive Decline: Study

Exercise and ibuprofen can help reduce the cognitive side effects that many cancer patients face during chemotherapy. A recent Phase II clinical trial shows promising results for these interventions. The study was published by Wiley online in CANCER, a peer-reviewed journal of the American Cancer Society. Cancer treatments like chemotherapy are known to be beneficial, however, it has its own drawbacks. Chemotherapy can cause 'chemo brain' which can affect up to 80% of patients. It can cause trouble focusing, forgetting things, and struggling with multiple tasks at once.

The new study offers hope by testing exercise and a common pain reliever, ibuprofen, to fight these issues.

What is Chemo Brain?

Cancer-related cognitive impairment, or CRCI, shows up as mild to moderate brain fog during or after chemo. Patients might have a hard time paying attention, remembering short-term details, or handling daily mental tasks. These problems can last months or years, impacting quality of life, work, and relationships.

Inflammation plays a big role in CRCI, as chemo triggers body-wide swelling that affects the brain. Both exercise and ibuprofen helps to fight inflammation in different ways. Exercise boosts blood flow and natural anti-inflammatories, while ibuprofen blocks certain chemicals causing swelling. Combining them might work even better.

Study Overview

Researchers led by Michelle C. Janelsins from the University of Rochester randomised 86 cancer patients on chemo who reported cognitive issues into four groups for six weeks. Groups were: home-based Exercise for Cancer Patients (EXCAP) plus low-dose ibuprofen, EXCAP plus placebo, ibuprofen only, and placebo only.

EXCAP is a simple, progressive program done at home with low-to-moderate walking and resistance exercises, like light weights or bodyweight moves. Ibuprofen was low-dose, about 200 mg three times a day. No serious side effects linked to the study occurred. They measured cognition with tests like the Trail Making Test for attention and memory tasks, plus patient surveys on daily function and comments from others.

Key Findings

The EXCAP plus placebo group showed much better attention scores than placebo alone, patients finished tasks faster by a clear margin. The ibuprofen-only group also improved attention over placebo, though slightly less.

Both exercise groups (with or without ibuprofen) reported fewer comments from friends or family about their cognitive slips, per the FACT-Cog survey. This suggests real-life benefits beyond lab tests. Short-term verbal memory improved less in the ibuprofen group compared to non-ibuprofen ones, raising questions for future checks. Overall, exercise had a stronger, more consistent effect.

Michelle C. Janelsins, PhD, MPH, lead author, University of Rochester and the Wilmot Cancer Institute, said, "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. 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."

Why It Works

Exercise helps reduce inflammation, improves brain blood flow, and grows new brain cells in areas hit by chemo. Studies before this one linked physical activity to better processing speed post-chemo.

Ibuprofen, which is an over-the-counter NSAID, reduces inflammatory signals that chemo increases. Past trials showed that it helps cognition in other conditions, but this is one of the first for CRCI during active treatment. No synergy showed from combining them this time, but longer trials might reveal more. The study included patients with various cancers, which made the results widely useful .

The authors note that exercise and low-dose ibuprofen improved some domains of cognitive function, although effects were not observed across all measures. Phase 3 trials are needed.

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