Regular physical activity is a prescription for nerve pain due to chemotherapy.
Nausea and hair loss are well known side effects of cancer treatments. But cancer patients undergoing chemotherapy can also experience neuropathy — nerve pain in their hands and feet marked by shooting or burning sensations, hypersensitivity to cold, tingling, and numbness.
Unfortunately, there are no medications by the Food and Drug Administration to prevent or treat chemo-induced neuropathy, according to biophysicist, Ian Kleckner, PhD, a research assistant professor in the University of Rochester Wilmot Cancer Center’s Control and Survivorship program.
However, Kleckner and colleagues have discovered a drug-free prescription for reducing nerve pain in cancer patients — regular exercise.
Not all chemotherapies are associated with nerve pain, but some of the treatments are highly likely to cause the painful condition. For example, about 60 percent of people being treated for solid tumors, including breast cancer, who receive drugs called taxanes, vinca alkaloids, and platinum-based chemotherapy, end up with neuropathic pain.
Kleckner headed a study involving more than 300 cancer patients to test whether a six-week exercise regimen called EXCAP (exercise for cancer patients) would have an impact on neuropathy symptoms. The patients who participated in the exercising during cancer treatment program, which included walking and using gentle, resistance bands to workout at home, greatly reduced their chemo-linked neuropathic symptoms compared to patients who didn’t exercise. Older patients appeared to achieve the greatest benefits of all from exercising.
Kleckner presented the findings at the recent American Society of Clinical Oncology meeting. He and colleagues at the University of Rochester Wilmot Cancer Center have long researched the role exercise can play in both cancer prevention and treatment.
"Twelve years ago when we started this work, a lot of people said it was not safe for most cancer patients to exercise," said Karen Mustian, PhD, an associate professor in the University of Rochester Cancer Control program who developed the EXCAP program. “Now we know it can be safe when done correctly, and that it has measurable benefits. But more exercise isn't always better for patients who are going through chemo — so it's important to continue our work and find a way to personalize exercise in a way that will help each individual."
In another study, Mustian and other University of Rochester researchers looked to see if exercise programs based on yoga could help breast cancer survivors who experience joint and muscle pain side effects from hormone therapy (aromatase inhibitors or tamoxifen) prescribed to lower the risk of a malignancy occurrence. The results showed yoga significantly reduced the participants’ aches and pains, especially in those taking aromatase inhibitors.
Kleckner and his colleagues are committed to understanding exactly how exercise during cancer treatment can benefit patients.
"Exercise is like a sledgehammer because it affects so many biological and psycho-social pathways at the same time — brain circuitry, inflammation, and our social interactions — whereas drugs usually have a specific target," he said. "Our next study is being designed to find out how exercise works, how the body reacts to exercise during cancer treatment, and how exercise affects the brain."
The National Cancer Institute offers information and strategies to help cancer patients relieve neuropathy symptoms and cope with treatment-related nerve damage.
September 22, 2016
Janet O’Dell, RN