Two co-lead authors argue that non-pharmacologic interventions, especially structured home-based exercise, are safe, accessible, and cost-effective options to help preserve cognitive function and daily functioning during chemotherapy.

They urge integrating a structured, home-based exercise program into routine chemotherapy care, with monitoring of cognitive and fatigue symptoms and referrals to exercise oncology specialists when needed.

Participants generally were undergoing their first chemotherapy course and were part of the URCC NCORP Research Base, with the sample skewing toward breast cancer patients.

The EXCAP program combined individually tailored walking and resistance band exercises with daily activity tracking and teach-back instruction, with participants logging steps and resistance training time in diaries.

Independent oncologist commentary notes the findings support NCCN survivorship guidelines that advocate routine physical activity to manage cancer-related cognitive impairment and help maintain independence and quality of life during treatment.

Experts not involved in the study likewise endorse the results, reinforcing the idea that preserving cognitive function is crucial for work, independence, and daily life during chemotherapy.

In two-week cycles, the EXCAP program maintained walking activity and was designed to be safe, accessible, and feasible at home, leveraging pedometer-based tracking and daily diaries.

The full study, titled Effects of Exercise on Cognitive Impairment in Patients Receiving Chemotherapy: A Multicenter Phase III Randomized Controlled Trial, appears in the March 2026 issue of JNCCN, with NCCN resources for patients and caregivers.

The study enrolled 687 patients from 20 community oncology practices across the United States between 2009 and 2014, with most participants being women, many having breast cancer, and all without distant metastases.

Participants on two-week chemotherapy cycles who followed EXCAP showed less overall cognitive decline, lower perceived cognitive impairment, and reduced mental fatigue compared with standard care.