Exercise may help cognition during chemo

Clinical takeaway: Exercise showed a clear supportive-care benefit for cancer-related cognitive impairment during chemotherapy. Consider encouraging patients to incorporate exercise as they are able.

Problems with clear thinking during chemotherapy are common, but few trials have tested treatments while patients are actively receiving therapy. This study examined whether exercise, low-dose ibuprofen, or both could ease cancer-related cognitive impairment during chemotherapy.

Investigators randomized 86 patients with cancer receiving chemotherapy who reported cognitive problems to 6 weeks of home-based exercise plus placebo, home-based exercise plus ibuprofen, ibuprofen alone, or placebo alone. The exercise program combined progressive walking and resistance-band training, and ibuprofen was given at 200 mg twice daily.

The clearest result was in favor of exercise. Patients assigned to exercise without ibuprofen showed better attention than the placebo group on a standard performance test, and exercise groups also improved on a patient-reported measure of whether others noticed cognitive problems. Ibuprofen alone showed some improvement on attention measures compared with placebo, but the overall pattern was less consistent, and ibuprofen was also associated with less improvement on delayed verbal memory.

These phase 2 findings suggest exercise may help preserve or improve selected cognitive domains during chemotherapy, especially attention. Ibuprofen may help some domains, but the signal was mixed.

Next steps are larger phase 3 trials of exercise during chemotherapy and more study of ibuprofen dose, duration, and domain-specific effects. Future work also needs longer follow-up to assess whether any benefit lasts, as well as broader biomarker testing to clarify mechanisms.

“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,” said Michelle C. Janelsins, PhD, MPH, of the University of Rochester and the Wilmot Cancer Institute.

Source: Janelsins MC. Cancer. 2026 Apr 20. Phase 2 trial of exercise and low-dose ibuprofen for cancer-related cognitive impairment in patients receiving chemotherapy