Exercise Can Reduce Side Effects of Cancer Treatment

Regular physical activity is a prescription that can lessen nerve pain associated with chemotherapy. Here's what you should know about exercise and cancer.

Nausea and hair loss are well known side effects of cancer treatments. Patients can also experience chemotherapy-induced peripheral neurotoxicity (CIPN) — nerve pain in their hands and feet, including shooting or burning sensations, hypersensitivity to cold, tingling, and numbness.

Nearly 70 percent of people receiving chemotherapy affecting their nerves — which may include drugs called taxanes, vinca alkaloids, and platinum-based chemotherapy — end up with CIPN, which is usually at its worst the first month after treatment.

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Doctors are likely to prescribe duloxetine, a well-tolerated medication for neuropathy related to diabetes, which has been found not to interfere with chemotherapy.  But duloxetine helps only some people and may not reduce pain enough. Although the pain tends to wear off over time, it may not go away completely.

Several other treatments show promise, including:

• A drug called MR309
• Scrambler therapy that sends electronic signals to nerves to replace pain signals
• Topical menthol
• Massage
• Marijuana
• Acupuncture
• Yoga

If you are looking for alternatives, don’t neglect exercise. Research suggests that workouts raise a patient’s pain threshold in a variety of chronic pain syndromes. An overview of exercise interventions for CIPN concluded that they reduced symptoms.

The evidence comes largely from studies with breast cancer patients. One randomized controlled study found that a six-week home-based progressive walking and resistance exercise program reduced CIPN, compared to a control group, especially in older men and breast cancer patients.

Another randomized controlled clinical trial found exercise to be more effective than cold application and standard care for chemotherapy-related numbness in women with breast cancer. A third of breast cancer patients taking taxanes had less pain when they followed a home-based exercise program.

The exercise can be simple, such as walking and stretching with light resistance bands, in one small study. You might consider yoga, which has helped breast cancer survivors with muscle pain.

Exercise may seem an obvious health move, but some time ago people believed that exercise might not be safe for cancer patients. A large body of research now suggests that exercise improves other common cancer-related challenges, including fatigue, anxiety, depression, drops in physical functioning, and health-related quality of life.  

Ideally, patients with CIPN would receive individualized exercise programs, evaluating physical fitness and clinical tests, including bloodwork, sensory testing of neuropathy symptoms, and assessment of functional limitations and balance and gait.

Such programs would help guide recommendations such as hand exercises for cramps or balance moves for people who have numb feet. Some patients are at high risk of falling and may prefer seated exercises.  

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