Heading off Peripheral Neuropathy with Exercise: The Hope Study

Early detection methods and novel therapies have increased the life span of individuals with breast cancer. These survivors are living longer lives with the effects of disease and treatment. Chemotherapy-induced peripheral neuropathy (CIPN) has become a significant dose-limiting toxicity of breast cancer treatment with taxane-based chemotherapy such as paclitaxel. The sensory and motor neuron dysfunction accompanying taxane chemotherapy can interfere with physical functioning, and impair quality of life. The purpose of this pilot study was to determine the efficacy or feasibility of an aerobic and strength training exercise program on neuropathic symptoms, gait and balance, and quality of life (QOL) in individuals treated for breast cancer with paclitaxel as compared to those in an attention control group. Nineteen women receiving weekly paclitaxel for two months were randomized to receive a home-based aerobic/strength training exercise program (EG) or breast cancer educational information (AC). Data were collected at before chemotherapy was initiated, and at every 4 weeks during the intervention phase for a total of 12 weeks (4, 8, and 12 weeks), and then at 3 months post-intervention (24 weeks). An intent-to-treat data analysis plan utilizing a combination of linear mixed modeling (LMM) and analysis of covariance (ANCOVA) was employed. Results indicate there was a differential negative trend in neuropathy symptoms, with fewer neuropathy symptoms present at post-intervention and follow-up in the EG compared to AC groups over time. There were no differences in gait and balance and QOL during the intervention period between the AC and EG groups. However, the EG showed improved gait and balance and improved QOL at follow-up.