Exercise Can Alleviate the Side Effects of Chemotherapy

woman on chemotherapy running on the beach



Chemotherapy produces some nasty side effects, but new research suggests that exercise can alleviate one of the most painful side effects, peripheral neuropathy, in cancer patients.





Unfortunately, cancer treatment produces some very unpleasant side effects for the patients that receive them. The side effects can be so severe that patients are forced to pause or withdraw from potentially lifesaving therapy. One of the most painful side effects of chemotherapy is neuropathy, which produces sharp tingling sensations, numbness and hot or cold feelings. The pain usually manifests in the fingers or toes before progressing up the extremities. The pain, like diabetic neuropathy, likely originates from damage or inflammation to the peripheral nerves although the mechanism is not completely understood. Unfortunately, relieving chemotherapy-induced peripheral neuropathy relies on symptomatic treatment, often requiring opiates that carry their own set of short-term and long-term consequences. 

A clinical trial examining the ability of exercise to alleviate peripheral neuropathy symptoms in cancer patients receiving chemotherapy has yielded promising results (Effects of exercise during chemotherapy on chemotherapy-induced peripheral neuropathy: a multicenter, randomized controlled trial, 2018. Ian Kleckner, et al.). The trial was a large, randomized control trial accruing patients at 20 community cancer centers who were receiving neurotoxic chemotherapy such as taxanes, platinum-based chemotherapy or vinca alkaloid-based chemotherapy. The exercise intervention consisted of 6 weeks of unsupervised walking exercise and 6 weeks of unsupervised exercise with resistance bands. Following exercise just 36.5% of patients reported neuropathic symptoms compared to 49.2% of patients that did not exercise. The patients who exercised reported significantly reduced severity of neuropathic pain as well as less hot and cold symptoms. There was a trend toward reduced numbness and tingling in the exercise group (see figure below). 

Exercise reduces the severity of chemotherapy-induced peripheral neuropathy symptoms per patient-reported numbness and tingling (left; trend-level effect) and hot/coldness in hands/feet (right). Error bars show 95% confidence intervals from 170 exercise patients and 185 control patients. The p-values correspond to differences in exercise and control conditions from linear regression.

The results of this study suggest that walking and resistance exercise can be used to alleviate neuropathic symptoms in cancer patients receiving neurotoxic chemotherapy. The exercise regimens were relatively easy to perform and this allowed the patients to perform the exercises at home. Further studies will need to be conducted to determine the optimal exercise regimens for cancer patients with neuropathic pain. 

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