Exercise May Reduce CIPN Symptoms in Cancer Survivors

Exercise may improve symptoms related to chemotherapy-induced peripheral neuropathy (CIPN), a common side effect characterized by numbness, pain and/or tingling in the hands and feet, for patients with ovarian cancer, according to a study published in the journal JAMA Network.

“Findings of this secondary analysis suggest that exercise is a promising treatment for CIPN, and incorporating exercise program referrals into the standard oncology care may reduce CIPN symptoms and increase quality of life for survivors of ovarian cancer,” the authors wrote.

The study included 134 females with ovarian cancer who had been treated with chemotherapy: 69 were randomly assigned to complete an exercise intervention, while 65 were in a control arm with no exercise protocol assigned.

To track CIPN symptoms, researchers used the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity questionnaire assessing peripheral neuropathy symptoms such as sensory, motor and auditory issues on a scale of 0 to 5, which, when combined, resulted in total CIPN scores ranging from 0 to 44. Baseline CIPN scores were similar between the two groups at the start of the trial, with an average score of 8.1 in the exercise arm and 8.8 in the control arm.

All patients had to have completed chemotherapy a month or more prior to randomization, have received a stage 1 to stage 4 invasive epithelial ovarian cancer diagnosis within the last four years and have a current exercise routine that consists of less than 90 minutes of exercise per week.

Patients enrolled into the exercise group participated in home-based aerobic exercise of moderate intensity (mostly brisk walking) that was offered weekly via telephone counseling from an American College of Sports Medicine/American Cancer Society-certified cancer exercise trainer. Participants in the exercise group were encouraged to increase their exercise to 150 minutes per week. There were no side effects reported by patients in the exercise group.

The control group, however, had weekly health education calls and received a book that contained ovarian cancer survivorship-related information.

After six months, self-reported CIPN scores decreased by 1.3 for the group of patients who did the exercise intervention, compared to an increase of .4 for those in the control group.

“The significant attenuation in CIPN symptoms in the exercise intervention arm could be attributed to both objective improvements in neural functions and subjective improvements in participant perception of these CIPN components,” the authors wrote.

Finding a solution to CIPN is much-needed, according to the study authors, who mentioned that approximately 90% of patients with ovarian cancer receive chemotherapy treatment, with between 30% to 70% experiencing CIPN. Notably, about 60% to 70% of patients who receive paclitaxel — which is a common frontline treatment option for patients with the disease — experience CIPN.

There is currently no cure for CIPN, and the authors noted, “In addition, CIPN can develop or persist after treatment. Approximately 51% of survivors of ovarian cancer reported CIPN symptoms two to 12 years after diagnosis.”

If patients experience a decrease in CIPN symptoms, this might also lead to a better chance of them finishing their chemotherapy treatment, rather than stopping early due to side effects, according to the researchers. However, further studies are needed to confirm these findings.

“Exercise could also prolong survival by improving chemotherapy adherence, if future studies show the effects of exercise on preventing CIPN during chemotherapy for patients with ovarian cancer,” the authors wrote.

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