How the right dose of exercise can help mitigate some side effects of chemotherapy


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Researchers at the University of Rochester Wilmot Cancer Institute have discovered something simple and — better yet — inexpensive that can help reduce neuropathy in hands and feet due to chemotherapy.

It's exercise.

The researchers compared the neuropathic symptoms in patients who didn't exercisers with the pain reported by patients who took part in a specialized six-week walking routine with gentle, resistance-band training at home.

Patients who exercised reported significantly fewer symptoms of neuropathy — which includes shooting or burning pain, tingling, numbness and sensitivity to cold. Furthermore, the effects of exercise seemed to be most beneficial for older patients.

Not all chemotherapy drugs cause neuropathy, but 60% of people with breast cancer and other solid tumors who receive taxanes, vinca alkaloids and platinum-based chemotherapies will likely suffer this type of side effect, explains lead author Ian Kleckner, PhD, a biophysicist and research assistant professor in Wilmot's Cancer Control and Survivorship program.

Neuropathy is more commonly associated with diabetes or nerve damage. No FDA-approved drugs are available to prevent or treat chemotherapy-induced neuropathy, added Kleckner.

Wilmot's specialized exercise program, called EXCAP (Exercise for Cancer Patients), was developed several years ago at the UR by Karen Mustian, PhD, MPH, an associate professor in the Cancer Control program.

Last year at ASCO, Mustian presented data from a randomized, controlled study of 619 patients showing that EXCAP reduced chronic inflammation and cognitive impairment among people receiving chemotherapy.

Kleckner's study involved a subset of patients from Mustian's trial, which is the largest phase 3 confirmatory exercise study ever conducted among cancer patients during chemotherapy. Their work is funded by the National Cancer Institute and Mustian's PEAK lab.

"Exercise is like a sledgehammer because it affects so many biological and psycho-social pathways at the same time — brain circuitry, inflammation, our social interactions — whereas drugs usually have a specific target," he said. "Our next study is being designed to find out how exercise works, how the body reacts to exercise during cancer treatment and how exercise affects the brain."

"Twelve years ago when we started this work a lot of people said it was not safe for most cancer patients to exercise," says Mustian. "Now we know it can be safe when done correctly, and that it has measurable benefits. But more exercise isn't always better for patients who are going through chemo — so it's important to continue our work and find a way to personalize exercise in a way that will help each individual. "