Breast cancer and exercise: improving quality of life in cancer survivors
This study will investigate if exercise can prevent functional disability in breast cancer survivors
Topic: Breast cancer
Institution: Baker Heart and Diabetes Institute
"We are a young and enthusiastic research team with niche skills. We are extremely grateful for the support from the WCRF for our study"
– Andre Le Gerche
Breast cancer treatment is potentially life-saving, but is also associated with long-term health consequences that can include a decrease in heart function and reduction in fitness and functional capacity (ability to perform simple activities of daily living). It is important to detect changes at an early stage as early interventions with medications and exercise can prevent deterioration. Unfortunately, current tests are poor at identifying early problems and those who will suffer side-effects. Our current tests tend to identify heart damage once it has already happened and is non-reversible. Our group has recently completed a pilot study in 28 women with early stage breast cancer. We found that chemotherapy caused a 16 per cent reduction in peak oxygen uptake (the body’s ability to use oxygen during exercise). This reduction is the equivalent of what we would expect with 16 years of normal ageing but occurred over only four months of chemotherapy treatment. Fortunately, exercise training performed at the same time as treatment prevented most of the decline.
Aims and objectives
Based on our pilot work, we will assess whether a community-based exercise programme can improve physical capacity and wellbeing after chemotherapy. We will also assess if measuring heart function during exercise can identify patients at risk of developing severe functional limitations at an earlier stage than is currently possible.
How it will be done
100 early stage breast cancer patients aged 40–75 years will be recruited and randomised to receive either a 12-month structured exercise programme or usual care. All participants will perform a comprehensive group of tests designed to carefully measure heart, muscle and blood vessel function at rest and in response to exercise. Testing will be performed before starting treatment and after completing anthracycline chemotherapy and after 12 months. The exercise programme will be supervised by an exercise physiologist and individualised for each patient based on chemotherapy cycles and baseline fitness levels.
We aim to provide new evidence demonstrating that exercise testing can identify patients who are at greatest risk of heart problems with chemotherapy and evidence to show that exercise can prevent heart muscle damage and loss of fitness. This will enable us to identify the right treatment for the patients most at need. This is critical given that heart disease is the number one health issue in breast cancer patients.