A structured home exercise programme significantly reduced cognitive impairment in cancer patients undergoing chemotherapy, according to a large phase III trial — offering a simple, low-cost tool to tackle one of treatment’s most feared side effects.
The study enrolled 687 patients across 20 community oncology practices in the US, randomising them to either receive a tailored exercise prescription alongside their chemotherapy or to continue with standard care. The exercise programme, known as EXCAP, combined individually adjusted walking targets tracked by pedometer with simple resistance band exercises, and was designed to be carried out at home.
Among patients receiving chemotherapy on a two-week cycle, those who followed the EXCAP programme reported significantly less overall cognitive decline, perceived mental impairment and mental fatigue than those who did not. They also maintained their daily walking levels throughout treatment — while patients without an exercise plan reduced their daily steps by 53 per cent.
The effect was not replicated in patients on three- or four-week chemotherapy cycles, which the researchers suggest may reflect differences in recovery time between treatments.
“It was striking to find that without a structured exercise plan, patients receiving chemotherapy often reduce their daily walking by half and experience notable increases in problems with thinking, memory, and mental fatigue,” said co-lead author Dr Po-Ju Lin of the Wilmot Cancer Institute at the University of Rochester Medical Center.
Co-lead author Dr Karen Mustian said the findings had direct implications for clinical practice. “Cancer care providers should consider incorporating structured, home-based exercise prescriptions, such as walking and resistance band exercises, into routine chemotherapy care,” she said.
The trial, the first nationwide multicentre phase III study of its kind, was conducted across US community oncology practices, with the majority of participants being women who had undergone surgery and had breast cancer. All were receiving chemotherapy for the first time.
Commenting on the findings, medical oncologist Dr Lindsay Peterson said the results offered patients a concrete way to protect their cognitive function during treatment. “For many patients, maintaining the ability to think clearly, remember details, and stay mentally engaged during treatment is essential to preserving independence, continuing to work and care for their families, and sustaining overall quality of life,” she said.