Physical Activity During Chemotherapy May Prevent Nerve Damage: JAMA Study

Cancer treatments often result in nerve damage, leading to long-lasting symptoms for patients. Traditional medications have proven largely ineffective in addressing this issue. However, a sports scientist at the University of Basel, collaborating with an interdisciplinary team from Germany, has demonstrated that simple physical exercises can effectively prevent nerve damage caused by chemotherapy.

The findings were published in the journal JAMA Internal Medicine.

Cancer treatments have significantly advanced over the years, shifting the focus from merely surviving the disease to ensuring a good quality of life after recovery.

Unfortunately, many cancer medications, including chemotherapy and modern immunotherapies, can damage nerves as well as tumour cells. Drugs like oxaliplatin or vinca alkaloids cause 70 to 90 percent of patients to experience pain, balance problems, or sensations of numbness, burning, or tingling. These symptoms can be very debilitating. While they may disappear after cancer treatment ends, about 50 percent of patients continue to suffer from these issues long-term. This condition is known as chemotherapy-induced peripheral neuropathy (CIPN).

In the study, 158 cancer patients, both male and female, undergoing treatment with either oxaliplatin or vinca-alkaloids were randomly divided into three groups. The first group, serving as the control, received standard care. The other two groups participated in exercise sessions twice a week during their chemotherapy, with each session lasting between 15 and 30 minutes. One exercise group focused on balancing on increasingly unstable surfaces, while the other trained on a vibration plate.

Regular examinations over the next five years revealed that the incidence of chemotherapy-induced peripheral neuropathy (CIPN) was approximately twice as high in the control group compared to the exercise groups. This means that the exercises performed alongside chemotherapy reduced the occurrence of nerve damage by 50 to 70 percent. Additionally, these exercises improved the patients' perceived quality of life, reduced the need to lower their chemotherapy doses, and decreased mortality rates in the five years following treatment.

Patients treated with vinca-alkaloids who participated in sensorimotor training experienced the greatest benefits.

“Significant investments have been made over the years to reduce the incidence of chemotherapy-induced peripheral neuropathy (CIPN). This side effect can directly impact clinical treatment, often requiring adjustments to chemotherapy cycles, dosages, or even leading to treatment termination. Despite these efforts, no effective pharmacological treatments have been found to prevent or reverse CIPN. In contrast, exercise has shown a proven positive effect on reducing nerve damage and is cost-effective. The potential of physical activity in mitigating CIPN is greatly underestimated. The recent study's findings highlight the need for more sports therapists in hospitals to fully harness this potential and improve patient outcomes,” said the authors.

Reference: Streckmann F, Elter T, Lehmann HC, et al. Preventive Effect of Neuromuscular Training on Chemotherapy-Induced Neuropathy: A Randomized Clinical Trial. JAMA Intern Med. Published online July 01, 2024. doi:10.1001/jamainternmed.2024.2354