|LETTER TO EDITOR
|Year : 2020 | Volume
| Issue : 4 | Page : 841-844
Role of exercise in mitigating breast cancer-related cognitive impairment in women
Chidiebere Emmanuel Okechukwu
Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
|Date of Submission||09-Oct-2020|
|Date of Decision||29-Oct-2020|
|Date of Acceptance||30-Oct-2020|
|Date of Web Publication||25-Dec-2020|
Chidiebere Emmanuel Okechukwu
Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Okechukwu CE. Role of exercise in mitigating breast cancer-related cognitive impairment in women. Cancer Res Stat Treat 2020;3:841-4
According to a recent study conducted by Wagner et al., several women with breast cancer experience cognitive impairment (CI) that compromises their mental well-being, judgment, skill to perform daily tasks, and commitment to cancer treatment. DNA methylation plays an important role in cognition, and exercise has been shown to influence DNA methylation. Hence, exercise can be an effective means to mitigate cancer-related CI in women with breast cancer, as it can improve the cognitive function by modulating the epigenome. Breast cancer survivors who participated in a 30-min bout of moderate-intensity treadmill walking gained improvements in the domains of cognitive functioning. Similarly, participating in an 8-week Qigong program resulted in an improvement in cognition among breast cancer survivors.
High-intensity interval training has been shown to improve the executive functioning, episodic memory, working memory, and cerebral blood flow among breast cancer survivors, proving the effectiveness of high-intensity aerobic exercise in mitigating cancer-treatment-related CI. However, introducing a supervised high-intensity exercise program during chemotherapy can be an effective approach to improve the health-related quality of life and reduce cancer-related fatigue and CI among breast cancer survivors.
An integrated, tailored, and supervised exercise intervention comprising aerobic and resistance training and mind-body exercises should be added to the treatment plan for patients with breast cancer undergoing chemotherapy and breast cancer survivors to mitigate cancer-related CI [Table 1]. The exercise regimen should be tailored to patients' tolerance, functional capacity, health status, and preferences. For aging adults who are functionally limited or have chronic diseases that affect their ability to exercise, the physicians should prescribe a low-intensity physical activity, such as light walking or light calisthenics, with an intensity of 1.1–3.0 metabolic equivalents or 35%–50% heart rate reserve (HRR) or 1–3 rating of perceived exertion, at the beginning of the exercise routine, for 30 min, for 5 days/week. Advancing further to a moderate-intensity exercise routine depends on the tolerance and functional capacity of the individuals [Table 2].
|Table 1: Effectiveness of physical activity in mitigating cancer-related cognitive impairment among breast cancer survivors|
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|Table 2: Physical activity based on intensity using metabolic equivalents level, heart rate reserve, and rating of perceived exertion|
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Aerobic exercise has been found to be effective in mitigating the side effects of chemotherapy on cardiovascular health, by improving endothelial function and cardiorespiratory fitness in patients with cancer. The beneficial effects of exercise on the cardiovascular health and cognitive function of patients with cancer is associated with improvement in the quality of life. Moreover, exercise can be combined with other effective non-pharmacological interventions such as cognitive rehabilitation, cognitive behavioral therapy, and cognitive training to rapidly achieve therapeutic goals in the management of cancer-related CI.
In conclusion, an oncologist in cooperation with a physiotherapist and an accredited exercise physiologist should continue to prescribe both supervised and home-based individualized exercise regimens to breast cancer survivors. Moreover, they should be encouraged often to maintain and adhere to their exercise routine so as to improve their mental health and cognitive performance. However, further studies are needed to investigate the underlying mechanisms for exercise-mediated improvement in cognitive performance among patients with breast cancer undergoing treatment and breast cancer survivors.
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Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2]