Evidence summary (Updated 2022)
In a systematic review 2 RCTs demonstrated an improvement in executive function and reported cognitive function in patients that had received chemotherapy for breast cancer(1).
In a recent review of the evidence 9 reviews demonstrate that physical activity has a definite positive effect on cognitive function(2–11).
Two of 9 studies reported an improvement seen during the treatment stage(7,8). Six of nine reported on interventions during and post treatment(2,3,5,6,10,11). One review reported on improved cognition with PA interventions following cancer treatment(4). One did not specify the treatment stage of the interventions(9).
While 4 reported on multiple cancer types(5,6,9,10), several reported on a single cancer only; improved cognitive function with the physical activity intervention group was seen in breast cancer(2–4), gastrointestinal(7), prostate(8), and brain(11) cancer patients.
When considering the intervention type, studies considered multiple or combination physical activity/exercise interventions(2,8,9,11). Combined aerobic and anaerobic activities were evaluated(3). Other interventions shown to be effective included aerobic exercise(5,7), HIIT(10), mind-body/ traditional Chinese activities(6) such as Tai Chi, and Qigong. Physical activity interventions with wearable technology was also found to have a positive effect on cognitive function in cancer patients(4).
Interventions of any frequency, intensity and duration were included in several the studies. Improvements in cognitive function is seen in moderate(8), moderate-vigorous(7,11) and vigorous(10) intensity interventions.
Quality of evidence
Grade B – Moderate
Strength of recommendation
Grade 2 – weak
A growing number of systematic reviews are showing a link between physical activity and improved cognition in cancer patients. Better quality evidence is needed. However, it is likely any risks are outweighed by the benefits of exercise.
- Chan RJ. Systematic review of pharmacologic and non-pharmacologic interventions to manage cognitive alterations after chemotherapy for breast cancer. Eur J Cancer. 51(4):437–50.
- Floyd R, Dyer AH, Kennelly SP. Non-pharmacological interventions for cognitive impairment in women with breast cancer post-chemotherapy: A systematic review. J Geriatr Oncol [Internet]. 2021 Mar 1 [cited 2022 Oct 13];12(2):173–81. Available from: https://pubmed.ncbi.nlm.nih.gov/32536427/
- Schutz S, Aidar FJ, Souza RLM, dos Santos JL, Voltarelli FA, Vieira Junior RC, et al. Different Methods of Physical Training Applied to Women Breast Cancer Survivors: A Systematic Review. Front Physiol [Internet]. 2021 Apr 14 [cited 2022 Oct 12];12. Available from: https://pubmed.ncbi.nlm.nih.gov/33935799/
- Blount DS, McDonough DJ, Gao Z. Effect of Wearable Technology-Based Physical Activity Interventions on Breast Cancer Survivors’ Physiological, Cognitive, and Emotional Outcomes: A Systematic Review. J Clin Med [Internet]. 2021 May 1 [cited 2022 Oct 13];10(9). Available from: https://pubmed.ncbi.nlm.nih.gov/34066752/
- Binarelli G, Joly F, Tron L, Arbogast SL, Lange M. Management of Cancer-Related Cognitive Impairment: A Systematic Review of Computerized Cognitive Stimulation and Computerized Physical Activity. Cancers (Basel) [Internet]. 2021 Oct 1 [cited 2022 Oct 13];13(20). Available from: https://pubmed.ncbi.nlm.nih.gov/34680310/
- Song Y, Sun D, István B, Thirupathi A, Liang M, Teo EC, et al. Current Evidence on Traditional Chinese Exercise for Cancers: A Systematic Review of Randomized Controlled Trials. Int J Environ Res Public Health [Internet]. 2020 Jul 2 [cited 2022 Oct 13];17(14):1–22. Available from: https://pubmed.ncbi.nlm.nih.gov/32664702/
- Le Q, Wang C, Shi Q. Meta-Analysis on the Improvement of Symptoms and Prognosis of Gastrointestinal Tumors Based on Medical Care and Exercise Intervention. J Healthc Eng [Internet]. 2021 [cited 2022 Oct 13];2021. Available from: https://pubmed.ncbi.nlm.nih.gov/34804454/
- Fang YY, Lee YH, Chan JC, Chiou PY, Chou XY, Chiu WT, et al. Effects of exercise interventions on social and cognitive functioning of men with prostate cancer: a meta-analysis. Support Care Cancer [Internet]. 2020 May 1 [cited 2022 Oct 13];28(5):2043–57. Available from: https://pubmed.ncbi.nlm.nih.gov/31907651/
- Zeng Y, Dong J, Huang M, Zhang J e., Zhang X, Xie M, et al. Nonpharmacological interventions for cancer-related cognitive impairment in adult cancer patients: A network meta-analysis. Int J Nurs Stud [Internet]. 2020 Apr 1 [cited 2022 Oct 13];104. Available from: https://pubmed.ncbi.nlm.nih.gov/32004776/
- Lavín-Pérez AM, Collado-Mateo D, Mayo X, Liguori G, Humphreys L, Copeland RJ, et al. Effects of high-intensity training on the quality of life of cancer patients and survivors: a systematic review with meta-analysis. Sci Rep [Internet]. 2021 Dec 1 [cited 2022 Oct 12];11(1). Available from: https://pubmed.ncbi.nlm.nih.gov/34301995/
- Sandler CX, Matsuyama M, Jones TL, Bashford J, Langbecker D, Hayes SC. Physical activity and exercise in adults diagnosed with primary brain cancer: a systematic review. J Neurooncol [Internet]. 2021 May 1 [cited 2022 Oct 10];153(1). Available from: https://pubmed.ncbi.nlm.nih.gov/33907968/