Ibuprofen and Exercise Reduce Cognitive Impairment During Chemotherapy

A phase 2 clinical trial has found that exercise and low-dose ibuprofen, either alone or in combination, can help reduce cognitive impairment in patients undergoing chemotherapy, a condition commonly referred to as “chemo brain.”

The study, led by Michelle Janelsins, PhD, MPH, professor of Surgery, Cancer Control at the University of Rochester Medicine and a member of Wilmot’s Cancer Prevention and Control research program, involved patients receiving chemotherapy who reported cognitive problems. Participants were randomized into one of four study arms for six weeks in a 2 × 2 factorial design, testing the effects of exercise, ibuprofen, both, or neither.

Patients in the ibuprofen group took 200 mg of the over-the-counter anti-inflammatory twice daily. Researchers noted that up to 80% of chemotherapy patients experience brain fog during and after treatment, describing difficulties with memory, attention and multitasking.

The trial showed that both exercise and ibuprofen — whether used separately or together — lessened cognitive impairment, though exercise appeared to be the most beneficial intervention. Janelsins emphasized that even patients who are sedentary or feeling unwell on certain days can benefit from doing as much as they can.

One unique aspect of the study was its use of observational feedback from family members and friends to measure improvements in patients’ cognitive function, providing an external perspective on changes in daily functioning.

Janelsins noted that while anti-inflammatory medicines had been studied in preclinical settings for cancer-related cognitive issues, this trial represents the first to examine ibuprofen specifically in individuals undergoing chemotherapy who reported cognitive problems.

The findings build on years of research from the Wilmot Cancer Institute, which has consistently investigated exercise as an intervention for cancer-related symptoms. Prior studies have shown that activities such as walking, resistance bands, and yoga can help reduce cognitive issues, fatigue, anxiety, and insomnia in cancer patients.

The study was published in the journal Cancer, of the American Cancer Society. Researchers caution that while the results are promising, further study is needed to understand the long-term effects and optimal use of these interventions during cancer treatment.