Cancer-related brain fog may improve with 2 simple treatments, scientists say
A common over-the-counter medication combined with a home exercise program could help ease cognitive issues for cancer patients.
That’s according to a study from the University of Rochester, which tested the effects of physical activity and low-dose ibuprofen on patients receiving chemotherapy treatment.
"Chemo brain" (also called chemotherapy-related cognitive impairment, or CRCI) is a known side effect of cancer treatment that can affect memory, concentration and multitasking ability. Up to 80% of people who receive chemo experience some degree of cognitive impairment, previous studies have shown.
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Rochester’s phase 2 trial studied 86 adult cancer patients in New York undergoing chemotherapy who were experiencing cognitive problems. The average age was 53 and nearly 89% of participants were women, according to a university press release.
Patients were randomly assigned to one of four groups. One group participated in home exercise designed specifically for cancer patients, a second group combined the exercises with ibuprofen (200 milligrams, or one pill, twice a day), the third group took ibuprofen alone and a fourth took a placebo alone.
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The exercise program consisted of low to moderate-intensity activity, including progressive walking and training with resistance bands.
"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," said lead author Michelle C. Janelsins, Ph.D., MPH, of the University of Rochester and the Wilmot Cancer Institute, in the press release.
After six weeks, exercise was linked to the clearest improvements in attention and cognitive function, according to input from family and friends. Those in the group who combined exercise and placebo showed better attention levels compared to those who took just a placebo.
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Participants who took only ibuprofen also showed greater cognitive improvements than the placebo group.
The findings suggest that ibuprofen may provide some improvement in cognitive function, although the benefits appeared to be smaller and less consistent than those seen with exercise.
This suggests that inflammation may contribute to cancer-related cognitive impairment, and that anti-inflammatory medications could be an effective therapeutic approach.
"We are encouraged by the findings of this trial that suggest possible benefits of both interventions for some cognitive domains," Janelsins said. "Clearly, we saw a more pronounced effect with exercise, which is notable considering the multiple health benefits of exercise for cancer survivors."
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No adverse side effects were reported during the trial.
The findings were published in Cancer, the peer-reviewed journal of the American Cancer Society.
There were some limitations of the study, the researchers noted, including the small sample size and short duration. The effects were also not consistent across every measure of cognitive function.
As the majority of participants were women, the findings may not be generalized to broader populations.
Researchers are planning larger phase 3 trials to confirm whether ibuprofen and exercise can effectively improve chemo-related cognitive impairment.
"Since we saw cognitive benefits in some domains and not others, we will also consider additional doses and longer durations in future research trials," said Janelsins.
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Investigators emphasized that patients should speak with their oncology team before starting ibuprofen or exercise interventions during chemotherapy, as certain treatments or medical conditions could increase the risk of side effects and complications.