Can Exercise Help with Chemo Brain?
Chemotherapy is often essential for treating breast cancer but comes with significant side effects, including cognitive impairment. Many patients report trouble with memory, focus, and clear thinking, a condition often called "chemo brain." This cognitive struggle can persist and impact daily life and overall well-being.
The ACTIVATE trial, a randomized controlled study conducted in Ottawa and Vancouver, Canada, set out to see if aerobic exercise could help women undergoing chemotherapy maintain or improve their cognitive function. The trial involved 57 women aged between 29 and 70 with stage I–III breast cancer who had not yet begun chemotherapy. The participants were split into two groups: one group began an aerobic exercise program during their chemotherapy, while the control group did not start exercising until after completing chemotherapy.
The Intervention: Aerobic Exercise The exercise group engaged in a supervised aerobic program that included activities like cycling and treadmill walking for 12 to 24 weeks, depending on their chemotherapy schedule. The aim was to meet or surpass exercise guidelines for cancer patients, focusing on activities that could be done both in-person and at home, especially during COVID-19 restrictions.
Findings of the Study Interestingly, the study found that the group engaging in aerobic exercise did not show significant improvements in objective cognitive tests compared to the control group. These tests measured various mental skills such as memory, attention, and processing speed. However, self-reported results told a different story. Women who exercised reported a noticeable improvement in how they felt about their cognitive abilities and the effect of those abilities on their quality of life. This suggests that, while aerobic exercise might not show measurable changes in cognitive function during tests, it can improve how patients perceive their mental capabilities.
Why Do Self-Reported and Objective Results Differ? One reason could be the difference between structured test settings and real-world experiences. Objective tests measure performance at a given time, while self-reported questionnaires allow patients to reflect on their day-to-day experiences over time. Patients may be more aware of subtle changes that are not captured in clinical tests.
Conclusion and What This Means for Patients The ACTIVATE trial showed that aerobic exercise might not make a difference in formal cognitive testing but can help improve how patients perceive their mental health and quality of life during chemotherapy. For patients, this highlights the importance of exercise not just for physical health but for mental well-being, especially when facing challenging treatments like chemotherapy.
Future Directions More research is needed to confirm these findings and explore whether different types of exercise or longer programs could show broader benefits. Understanding how exercise impacts cognitive health and quality of life can lead to better care and support for those undergoing cancer treatment.
In conclusion, if you're starting chemotherapy or supporting someone who is, consider discussing an appropriate exercise plan with a medical team. Even if it doesn’t directly change cognitive test scores, it might help patients feel more mentally resilient and improve overall well-being.
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About Dr. Sourabh Kharait
Dr. Sourabh Kharait (MD / PhD) is Clinical Nephrologist and Medical Director of Clinical Trials at Summit Nephrology Medical Group, and the Founder and CEO of IGH Naturals, a platform company that designs Functional Foods and Nutritional products for athletes and patients with chronic diseases.
