Health

Chemo-Induced Neuropathy Can Be Alleviated With Simple Exercises

Foundation For PN

Exercises aimed at improving balance have shown remarkable effectiveness in alleviating nerve pain experienced during cancer treatment. Individuals who engaged in regular exercise programs while undergoing chemotherapy were far less likely to suffer from the painful symptoms associated with nerve damage.

Key Insights:

  • Many chemotherapy drugs are known to cause nerve damage, leading to a significant decrease in the quality of life for cancer patients.
  • A recent study revealed that engaging in simple exercises under the guidance of a physical therapist twice a week can lower the risk of developing neuropathy by up to 70%.
  • While some individuals may not wish to incorporate exercise therapy during their cancer treatment, those who do often experience a greater sense of control and empowerment during an otherwise challenging period.

Exercise During Chemotherapy Can Reduce Neuropathy Risk

Participating in simple exercises with a physical therapist during chemotherapy treatment may significantly reduce the chances of developing chemotherapy-induced peripheral neuropathy (CIPN), according to recent research. A clinical trial found that individuals who engaged in exercise therapy saw a 50% to 70% reduction in the onset of neuropathy, depending on the type of chemotherapy used.

“These findings show that not only can we target these debilitating symptoms, but we can also prevent them,” says Fiona Streckmann, PhD, a lead author of the study and a research associate in the Department of Sport, Exercise, and Health at the University of Basel, Switzerland. “This can empower patients to contribute to their own health and maintain their quality of life while receiving their optimal cancer therapy,” she adds.

Neuropathy Affects the Majority of Cancer Patients

Advancements in cancer treatments have led to higher survival rates, making the quality of life after treatment an important focus. Unfortunately, many cancer drugs, including chemotherapy and newer immunotherapies, attack not just tumor cells but also the nervous system, leading to neuropathy. According to Katie Schmitt, DPT, an oncology physical therapist at the Hollings Cancer Center at the Medical University of South Carolina, 65% to 85% of cancer patients experience some degree of neuropathy during treatment. Schmitt was not involved in the study but emphasizes the widespread impact of this condition.

“I’ve had patients describe it as feeling like walking on rocks, or they experience numbness or a vice-like grip sensation,” Schmitt explains. “Neuropathy can affect the hands, making it hard to grip things, and in the legs and feet, it can lead to balance and walking issues.”

Though some people may recover from neuropathy after treatment ends, about 50% of patients experience chronic symptoms. While there are medications available, they are not consistently effective in managing the numbness or tingling often associated with the condition.

Exercise Reduces Neuropathy by Up to 70%

The study, led by Streckmann and a German research team, investigated whether specific exercises could help reduce the onset and severity of CIPN. They divided 158 chemotherapy patients into three groups:

  1. Sensorimotor Training: This group performed balance exercises twice a week for 15 to 30 minutes per session. The exercises included standing as if on a balance beam, focusing on improving stability. Each session consisted of four exercises, repeated three times for 20 seconds with a 40-second rest period between sets.
  1. Whole-Body Vibration Training: Patients in this group stood on a vibration platform that created a tilting motion similar to walking. This training activated muscles in the legs, abdomen, and core. Sessions were conducted twice a week for 15 to 30 minutes, with four sets of 30- to 60-second vibrations followed by a minute of rest.
  1. Standard Care: This group received chemotherapy and any recommended medications without additional physical therapy.

These exercise sessions were conducted alongside chemotherapy treatments, and participants were assessed for neuropathy symptoms both during and after treatment. The oncologists regularly monitored symptoms, and follow-ups occurred 12 weeks post-chemotherapy and over the following five years.

The results were compelling: 70% of those in the standard care group developed CIPN, while only 30% of the sensorimotor training group and 41% of the whole-body vibration group reported symptoms. This represents a reduction of 50% to 70% in neuropathy for those who engaged in exercise therapy.

In addition to fewer neuropathic symptoms, those in the exercise groups experienced better balance, a higher quality of life, and fewer interruptions in their cancer treatment. They were also less likely to need a dose reduction in chemotherapy, which can impact overall treatment success, and they had a lower mortality rate in the five years following treatment.

“These findings demonstrate the potential of exercise to significantly reduce the risk of chemotherapy-induced neuropathy, something we don’t have many treatment options for,” says Streckmann.

Clinical Observations Align with Research

Dr. Schmitt observes similar results in her practice with cancer patients, noting that neuropathy is a common reason for reducing chemotherapy dosages. This can, in turn, affect the overall effectiveness of the treatment.

“I think it’s wonderful that they started the interventions 24 to 48 hours after chemotherapy was introduced,” Schmitt says. “Neuropathy is such a major side effect for many patients, and these exercises could help people receive their optimal treatment while maintaining strength.”

Challenging the Assumption that Neuropathy is Inevitable

Many in the oncology field assume that neuropathy is an unavoidable side effect of chemotherapy. However, Schmitt argues against this notion, highlighting that exercise interventions like those used in the study could make a significant difference in patients’ outcomes.

“That’s not the right answer,” Schmitt emphasizes. “We know that exercise can help, and this study shows that very well. The evidence is growing, and this approach could become a standard therapy alongside chemotherapy to reduce neuropathy.”

Exercise Therapy May Not Be for Everyone

Despite the promising results, the study did have some limitations. Only about 10% of patients screened for the trial ultimately participated, indicating that not everyone is willing or able to incorporate exercise into their cancer treatment routine. Additionally, the average age of participants was 49, about 20 years younger than the median age of cancer patients in the U.S. Furthermore, about one-quarter of participants didn’t attend enough sessions to be included in the final results, underscoring the challenges of consistent adherence to such interventions.

Schmitt acknowledges the difficulties faced by cancer patients, including the emotional toll of diagnosis and treatment. “A cancer diagnosis can be overwhelming on so many levels,” she says. “Between the emotional strain, the time commitment of treatments, and how you physically feel during the process, adding an exercise routine can seem like too much.”

However, Schmitt also highlights the potential benefits. “Not only can these exercises help manage symptoms and improve treatment outcomes, but they can also give patients a sense of control during a process where they often feel powerless.”

Conclusion

Incorporating exercise therapy into cancer treatment has shown great promise in reducing the incidence and severity of chemotherapy-induced peripheral neuropathy. For those who are able to engage in sensorimotor or whole-body vibration exercises, the benefits extend beyond merely minimizing neuropathy. Patients report better balance, fewer treatment interruptions, and an improved overall quality of life. While this approach may not be suitable for everyone, the growing body of evidence suggests that exercise could become a valuable tool in cancer care, helping patients regain some control over their health during a difficult time.