Ibuprofen and exercise may ease chemo brain symptoms, Rochester study finds

A common over-the-counter medication combined with a home exercise program can help alleviate cognitive problems in cancer patients.

That's according to a study from the University of Rochester, which examined the effects of physical activity and low-dose ibuprofen on patients undergoing chemotherapy.

“Chemo brain” (also called chemotherapy-related cognitive impairment, or CRCI) is a well-known side effect of cancer treatment that can affect memory, concentration and multitasking abilities. 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 had cognitive problems. The average age was 53 and about 89% of the participants were women, according to a university press release.

Patients were randomly assigned to one of four groups. One group took part in home exercises specially designed for cancer patients, the second group combined the exercises with ibuprofen (200 milligrams, or one pill, twice a day), the third group took ibuprofen alone and the fourth took a placebo alone.

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The exercise program consisted of low to moderate intensity activity, including progressive walking and resistance band training.

“This is one of the first studies specifically designed to evaluate this intervention for cancer-related cognitive impairment during chemotherapy in patients with multiple diseases using both performance-based cognitive tests and patient-reported outcomes,” said lead author Michelle C. Janelsins, Ph.D., MPH, of the University of Rochester and the Wilmot Cancer Institute, Wilmot Cancer Institute.

Up to 80% of people who receive chemo experience some degree of cognitive impairment.

After six weeks, exercise was linked to very clear improvements in attention and cognitive function, according to input from family and friends. Those in the group that combined exercise and placebo showed better levels of attention compared to those who took just placebo.

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Participants who took only ibuprofen also showed greater cognitive improvement than the placebo group.

The findings suggest that ibuprofen may provide some improvement in cognitive function, although the benefits appear to be smaller and less consistent than those seen with exercise.

“Chemo brain” (also called chemotherapy-related cognitive impairment, or CRCI) is a well-known side effect of cancer treatment that can affect memory, concentration and multitasking abilities. (Stock)

This suggests that inflammation may contribute to cancer-related cognitive impairment, and that anti-inflammatory drugs may be an effective treatment option.

“We are encouraged by the findings of this study that suggest potential benefits of both interventions in other cognitive domains,” Janelsins said. “Clearly, we saw a clear effect with exercise, which is remarkable considering the many health benefits of exercise in cancer survivors.”

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No adverse side effects were reported during the trial.

The findings are published in Cancer, the peer-reviewed journal of the American Cancer Society.

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There were some limitations to the study, the researchers noted, including a small sample size and short time period. Effects were also inconsistent across measures of cognitive functioning.

Since most of the participants were women, the findings may not be generalizable to the general population.

“Obviously, we saw a clear effect with exercise, which is remarkable considering the many health benefits of exercise in cancer survivors,” said the researcher. (Stock)

Researchers are planning large phase 3 trials to confirm whether ibuprofen and exercise can effectively improve chemo-related cognitive impairment.

“Since we have seen conceptual benefits in some domains and not in others, we will also consider additional doses and longer durations in future studies,” Janelsins said.

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The investigators stressed that patients should talk to their oncology team before starting ibuprofen or exercising during chemotherapy, as other treatments or medical conditions can increase the risk of side effects and complications.