Exercise During Chemotherapy May Sharpen the Mind and Keep Patients Moving, New Study Finds

For patients with cancer undergoing chemotherapy, a simple prescription—a daily walk and a resistance band—may offer more than physical benefits. A nationwide study finds that a structured, home-based exercise program can help patients maintain their activity levels and stay mentally sharper during treatment, offering fresh hope in the fight against "chemo brain."

Published in the Journal of the National Comprehensive Cancer Network, the findings draw on a phase 3 clinical trial enrolling nearly 700 patients across 20 community oncology clinics throughout the United States.¹

The Chemo Brain Problem

Up to 75% of cancer patients experience cancer-related cognitive difficulties during or after treatment. The phenomenon patients and clinicians often call "chemo brain” is more than forgetfulness. Patients describe struggling to manage medications, handle finances, or maintain their households. Attention, memory, and processing speed can all suffer. Currently, no gold-standard treatment exists for these cognitive impairments.¹

Making Exercise Accessible

The exercise program used in the study, called EXCAP (Exercise for Cancer Patients), was developed by Karen Mustian, PhD, MPH, and Po-Ju Lin, PhD, MPH, RD, from the Wilmot Cancer Institute at the University of Rochester, in collaboration with American College of Sports Medicine professionals.¹

The program is intentionally accessible: low-cost, home-based, and tailored to each individual's physical abilities. Patients receive a kit with resistance bands, a pedometer, and a personalized exercise plan and are guided through it during a single 60-minute clinic session at the start of their first chemotherapy cycle.¹

The program calls for daily low-to-moderate-intensity walking, which targets 60% to 85% of heart rate reserve, and resistance-band exercise. Both are progressing gradually over 6 weeks. Participants received brief check-in calls every 2 weeks to stay on track.¹

Exercise Results In Patients Receiving Chemotherapy

Before chemotherapy began, patients in both groups averaged between 4000 and 4500 steps per day. Patients who followed the exercise prescription largely maintained that baseline. Those in the standard care group, who received no exercise guidance, reduced their daily steps by 53%. They also reported significantly more difficulty with thinking, memory, and mental fatigue.¹

"It was striking to find that without a structured exercise prescription, patients receiving chemotherapy reduce their daily walking by half," said Lin.²

Who Benefits Most—and Why

The cognitive and physical benefits were most pronounced among patients on 2-week chemotherapy cycles. Researchers speculate these patients may face fewer severe side effects, making it easier to stay active. Once activity levels drop, regaining momentum becomes increasingly difficult—a pattern the exercise prescription appears to interrupt.¹

Scientists believe exercise helps by regulating the body's inflammatory response, promoting immune function in ways that may directly counteract the cognitive damage chemotherapy can cause.¹

"Cancer care providers should educate their patients about home-based options such as walking and resistance band exercises as part of optimal care," said Mustian, urging referrals to exercise oncology specialists when needed. The message is clear: movement may be one of the most powerful tools patients have.²

REFERENCES

1. Mustian KM, Lin P, Chakrabarti A, et al. Effects of Exercise on Cognitive Impairment in Patients Receiving Chemotherapy: A Multicenter Phase III Randomized Controlled Trial. J Natl Compr Canc Netw. March 2026. doi:10.6004/jnccn.2025.7118

2. Can exercise help chemo brain? New research adds promising results. News Release. March 13, 2026. Accessed March 17, 2026. https://www.eurekalert.org/news-releases/1119904