An Exercise Program May Help Reduce “Chemo Brain” During Cancer Care

A structured exercise program may reduce cognitive decline, often referred to as “chemo brain,” and better equip patients receiving chemotherapy for the first time to handle daily tasks, work and social activities, according to findings from a nationwide phase 3 randomized trial published in the March 2026 issue of the Journal of the National Comprehensive Cancer Network (JNCCN).

Patients undergoing chemotherapy on a two-week treatment cycle who participated in the guided exercise program experienced significantly less cognitive impairment and mental fatigue compared with those who received chemotherapy alone. However, this benefit was less pronounced in patients who received chemotherapy every three-to-four weeks.

The study evaluated an exercise intervention called Exercise for Cancer Patients (EXCAP), which combines individualized walking plans with simple resistance-band exercises performed at home during treatment.

“This means that a safe, simple exercise program could be an important part of supportive care for people going through chemotherapy,” said co–lead study author Karen M. Mustian in a press release announcing the findings. “Cancer care providers should consider incorporating structured, home-based exercise prescriptions into routine chemotherapy care.”

Mustian is a Dean’s Professor of Surgery, Cancer Control; a professor of Radiation Oncology; and co-leader of the Cancer Prevention and Control Research Program at the Wilmot Cancer Institute.

Exercise for cancer patients study details

The EXCAP study evaluated 687 patients from 20 community oncology practices across the United States participating in the University of Rochester Cancer Center NCI Community Oncology Research Program Research Base. All participants were receiving chemotherapy for the first time, did not have distant metastases and were enrolled between 2009 and 2014.

Most participants were women, many with breast cancer, and many had previously undergone surgery.

Patients were randomly assigned to follow the EXCAP exercise program, which included daily walking goals tracked with a pedometer, resistance-band exercises, and a daily activity diary. Those on the control arm did not participate in the exercise program.

Patients receiving chemotherapy every 2 weeks who followed the exercise program reported:

• Less overall cognitive decline
• Reduced perceived cognitive impairment
• Lower levels of mental fatigue

Participants in the EXCAP group also maintained their daily walking levels during treatment, while those without an exercise prescription reduced their daily walking activity by about 53%.

“It was striking to find that without a structured exercise plan, patients receiving chemotherapy often reduce their daily walking by half and experience notable increases in problems with thinking, memory, and mental fatigue,” co–lead study author Po-Ju Lin added in the press release.

Lin is a research assistant professor in the Department of Surgery, Cancer Control (SMD), at the Wilmot Cancer Institute.

Potential benefits associated with an exercise program

Cognitive difficulties such as memory problems, slower thinking and mental fatigue are common during chemotherapy and can interfere with daily tasks, as well as work responsibilities and social activities.

According to Dr. Lindsay L. Peterson, a medical oncologist at Washington University, the findings provide encouraging evidence for patients concerned about chemo brain.

“Many patients who need chemotherapy worry that they’ll experience ‘chemo brain,’. This study offers encouraging news: there may be something patients can do to reduce their risk of cognitive impairment during chemotherapy: exercise,” she said in the press release.

Peterson added, “For many patients, maintaining the ability to think clearly, remember details and stay mentally engaged during treatment is essential to preserving independence, continuing to work and care for their families, and sustaining overall quality of life... Interventions that are accessible and low cost, such as structured physical activity, give us a powerful opportunity not only to support long-term survivorship, but to help patients remain as cognitively sharp and mentally resilient as possible throughout treatment.”

She also serves as an associate professor in the Division of Oncology, John T. Milliken Department of Medicine at WashU Medicine.

Additional findings and takeaways from the exercise for cancer patients study

Because researchers also found that the benefits of exercise were less pronounced among patients who received chemotherapy every three-to-four weeks, they suggested that two-week treatment schedules may represent a “sweet spot.” This, according to researchers, allows patients enough time between treatments to recover and remain physically active.

“Non-pharmacologic interventions, such as exercise, cognitive training and mindfulness, are important for managing cognitive impairment during chemotherapy because they are safe, accessible and can often be delivered at low cost or even at home, making them easier for patients to use, compared with expensive or clinic-based treatments,” Lin emphasized.

The researchers noted that additional studies involving broader patient populations will be needed to confirm and expand these findings.

References

1. “Structured Exercise Programs May Help Combat “Chemo Brain” According to New Study in JNCCN,” by National Comprehensive Cancer Network. News release; March 12, 2026.
2. “Effects of Exercise on Cognitive Impairment in Patients Receiving Chemotherapy: A Multicenter Phase III Randomized Controlled Trial,” by Karen M. Mustian, et al. Journal of the National Comprehensive Cancer Network (JNCCN).

For more news on cancer updates, research and education, don’t forget to subscribe to CURE®’s newsletters here.