A new clinical trial suggests that aerobic exercise during chemotherapy treatment could help breast cancer patients manage cognitive side effects.
Summary: Women with breast cancer who participated in an aerobic exercise program while undergoing chemotherapy reported improved cognitive function compared to those receiving standard care, though objective tests showed no significant differences between groups.
Estimated reading time: 5 minutes
For many breast cancer patients, chemotherapy treatment comes with an unwelcome side effect commonly known as “chemo brain” or “brain fog.” This cognitive impairment can affect memory, concentration, and thinking abilities both during and after treatment. However, a recent clinical trial offers hope that aerobic exercise may help combat these cognitive challenges.
The ACTIVATE Trial
The Aerobic exercise and CogniTIVe functioning in women with breAsT cancEr (ACTIVATE) trial, published in the journal CANCER, examined the effects of aerobic exercise on cognitive function in women undergoing chemotherapy for breast cancer. The study included 57 Canadian women diagnosed with stage I-III breast cancer who were beginning chemotherapy treatment.
Participants were randomly assigned to two groups:
- An exercise group that started a 12-24 week aerobic exercise program at the beginning of chemotherapy
- A control group that received standard care during chemotherapy and started the exercise program after completing treatment
Key Findings
The study’s lead author, Dr. Jennifer Brunet of the University of Ottawa, summarized the results:
“Women who participated in the aerobic exercise program during chemotherapy self-reported better cognitive functioning and felt their mental abilities improved compared with those who received standard care without exercise.”
Specifically, the exercise group reported improvements in:
- Perceived cognitive impairments
- Perceived cognitive abilities
- Overall cognitive function
- Quality of life related to cognitive function
However, it’s important to note that when participants underwent objective neuropsychological testing, there were no significant differences in cognitive performance between the two groups after chemotherapy completion.
Implications for Cancer Care
These findings have important implications for cancer care. Dr. Brunet emphasized:
“Our findings strengthen the case for making exercise assessment, recommendation, and referral a routine part of cancer care; this may help empower women living with and beyond cancer to actively manage both their physical and mental health during and after treatment.”
The researchers advocate for collaboration across various sectors – academic, healthcare, fitness, and community – to develop exercise programs specifically designed for women with breast cancer. Dr. Brunet noted that these programs should be “easy to adopt and implement widely, helping to make the benefits of exercise more accessible to all women facing the challenges of cancer treatment and recovery.”
Understanding the Discrepancy
The difference between self-reported improvements and objective test results raises interesting questions for future research. Possible explanations include:
- Exercise may impact everyday cognitive functioning in ways not captured by standardized tests
- Self-reported improvements could reflect overall well-being rather than specific cognitive changes
- The timing of assessments may have missed short-term cognitive benefits of exercise
Limitations and Future Directions
While promising, the study had some limitations. The COVID-19 pandemic disrupted recruitment and forced some aspects of the trial to be conducted virtually. Additionally, the sample size was smaller than initially planned.
Future research could explore:
- Longer intervention periods
- Combining aerobic exercise with other forms of physical and cognitive training
- The effectiveness of virtual exercise programs
- More diverse patient populations
The Bottom Line
While more research is needed to fully understand the relationship between exercise and cognitive function during cancer treatment, this study provides compelling evidence that aerobic exercise can improve breast cancer patients’ perception of their cognitive abilities and quality of life during chemotherapy.
Quiz: Test Your Knowledge
- What was the main self-reported benefit of the exercise program for breast cancer patients? a) Reduced fatigue b) Improved cognitive function c) Better physical fitness d) Decreased nausea
- How long did the aerobic exercise program last? a) 4-8 weeks b) 8-12 weeks c) 12-24 weeks d) 24-36 weeks
- What was the discrepancy between self-reported and objective measures in the study? a) Self-reported improvements were not reflected in objective tests b) Objective tests showed improvements not reported by patients c) Both self-reported and objective measures showed equal improvements d) Neither self-reported nor objective measures showed any change
Answer key:
- b
- c
- a
Glossary of Terms
- Chemotherapy-related cognitive impairment (CRCI): Cognitive side effects experienced by cancer patients during or after chemotherapy treatment.
- Neuropsychological testing: Standardized tests used to assess various aspects of cognitive function.
- Aerobic exercise: Physical activity that increases heart rate and breathing, typically sustained for a period of time.
- Quality of life (QOL): A measure of an individual’s overall well-being and life satisfaction.
- Randomized controlled trial: A type of study where participants are randomly assigned to different treatment groups to compare outcomes.
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