Boost Brain Power with Aerobics During Breast Cancer Chemo

On Oct 24, 2024

How Aerobic Exercise Can Combat Chemotherapy-Induced Cognitive Decline in Breast Cancer Patients

Are you aware of the effects of aerobic exercise on cognitive function in breast cancer patients undergoing chemotherapy? The ACTIVATE trial (NCT03277898), a significant study in this domain, brings to light some promising findings. The study, as reported in a renowned medical journal, Cancer, reveals that women with breast cancer who started an aerobic exercise regimen concurrently with chemotherapy reported enhanced cognitive function and quality of life. This compared favorably to the experience of those who only received standard care.

An unfortunate side effect of chemotherapy often noted by patients is a decrease in cognitive abilities, commonly referred to as “chemo-brain” or “brain fog.” ¹ This has prompted experts to explore possible solutions to mitigate these effects.^1,2

About The ACTIVATE Trial

The ACTIVATE trial, a randomized, controlled experiment, was conducted across two centers: Ottawa and Vancouver. The study included 57 women (median age: 48.8 ± 10 years) diagnosed with Stage I to Stage III breast cancer who were about to receive chemotherapy. The women were randomly assigned to either start aerobic exercise with chemotherapy (n = 28) or receive standard care during chemotherapy and begin aerobic exercises after it (n = 29). The intervention period varied between 12 to 24 weeks and involved supervised aerobic training and at-home exercise.^2,3

Objective cognitive function, measured with 13 neuropsychological tests, was the primary outcome. Secondary outcomes included self-reported cognitive function and impact on quality of life, which were evaluated using questionnaires.^1-3

Trial Name: Aerobic Exercise and Cognitive Functioning in Women With Breast Cancer (ACTIVATE)

ClinicalTrials.gov ID: NCT03277898

Sponsor: University of British Columbia

Completion Date (Estimated): January 1, 2022

Key Findings of The ACTIVATE Trial

According to the study findings, the women diagnosed with breast cancer who actively participated in the aerobic exercise program alongside their chemotherapy regimen self-reported better cognitive function. They also noted improved mental abilities as compared to those who received standard care without the inclusion of an exercise routine. Interestingly, despite 4 of 6 self-reported cognitive function outcomes being higher in the aerobic exercise group, the neuropsychological testing revealed similar performance between the two groups at the end of chemotherapy.^1,2

A Call for Routine Exercise Assessment in Cancer Care

Jennifer Brunet, PhD, of the University of Ottawa and the study’s lead author, emphasized the importance of incorporating routine exercise assessment, recommendation, and referral into cancer care. “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,” she said.¹

Study Limitations and Future Research Directions

The study’s limitations, as noted by the researchers, include a small sample size and potential influence of the COVID-19 pandemic on recruitment. Other limitations were the lack of consideration of chemotherapy-related adverse events, potential biases from recall and social desirability in questionnaires, and lack of generalizability of the findings. Despite these limitations, the researchers suggest that such intervention methods can still have beneficial impacts on quality of life.²

The authors proposed that future research should include longer intervention periods, the introduction of virtual interviews and exercise methods to improve accessibility, and more diverse sampling from both sociodemographic and medical standpoints.²

“To address this, we advocate for collaboration across various sectors—academic, health care, fitness, and community—to develop exercise programs specifically designed for women with breast cancer,” Brunet said in the news release. “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.”¹

REFERENCES

1. Wiley. Can aerobic exercise help prevent brain fog caused by chemotherapy? News release. October 21, 2024. Accessed October 23, 2024.

2. Brunet J, Sharma S, Zadravec K, et al. Aerobic exercise and CogniTIVe functioning in women with breAsT cancEr (ACTIVATE): a randomized controlled trial. Cancer. 2024; 1-14. doi:10.1002/cncr.35540

3. Aerobic Exercise and Cognitive Functioning in Women With Breast Cancer (ACTIVATE). ClinicalTrials.gov identifier: NCT03277898. Updated on February 11, 2021. October 23, 2024. Read more