Breast cancer is the most common cancer among women worldwide. In Canada, approximately 1 in 9 women will be diagnosed with breast cancer this year, including 3,400 women in BC alone. Early detection and treatment advancements have greatly increased 5-year survival among women with breast cancer to 88% in Canada. However, breast cancer therapy including surgery, chemotherapy and radiation, are associated with several adverse effects including fatigue, muscle and bone pain, nausea, lymphedema, peripheral neuropathy and potentially autonomic nervous system changes and other cardiovascular complications. These treatment side effects can persist long after treatment and can impact patient quality of life.
Dr. Kristin Campbell’s lab in the Department of Physical Therapy at UBC conducts research on the beneficial role of exercise and rehabilitation along the cancer continuum, including during and after cancer treatment. There is strong evidence demonstrating exercise is safe, feasible and beneficial during treatment for breast cancer. However, the precise role exercise may play in combating some of the most prevalent and debilitating side effects associated with breast cancer therapy is still unknown.
Most early-stage breast cancer patients who undergo chemotherapy will receive a particular class of chemotherapy drugs known as taxanes. Taxanes are some of the most effective agents used in the treatment of breast cancer today. However, taxanes are neurotoxic and can lead to peripheral nerve degeneration (peripheral neuropathy), resulting in numbness and potentially burning neuropathic pain in the hands and feet. There are currently no pharmaceutical agents shown to be effective in preventing or treating peripheral neuropathy and thus, peripheral neuropathy is the number one cause of chemotherapy delays and cancellations. In addition, these agents may also cause autonomic neuropathy leading to unfavorable changes in heart rate and blood pressure. There is biological plausibility and evidence in non-cancer populations that exercise may be beneficial in combating peripheral and autonomic neuropathy development and progression. Therefore, the primary aim of my Master’s thesis will be to investigate the role of combined aerobic, strength and balance training on these specific side effects during taxane chemotherapy for breast cancer.
Breast cancer patients, recruited from the BC Cancer Agency, will be randomized to either an exercise training group or usual care for the duration of their taxane chemotherapy (8-12 weeks). The exercise group will complete three supervised exercise sessions at Dr. Campbell’s off-campus exercise training facility near the BC Cancer Agency, in addition to two home-based aerobic workouts each week. We will collect a variety of self-reported and objective measures of peripheral neuropathy and cardiovascular autonomic nervous system function. We are excited to be collaborating with Dr. Victoria Claydon’s Cardiovascular Physiology Lab at Simon Fraser University on this project. Dr. Claydon is an expert in the field of cardiovascular autonomic control and collaboration with her lab will allow use to effectively perform a wide-range of comprehensive short-term autonomic function tests.
This project is the first to look at the impact of formal exercise training on taxane chemotherapy side-effects and going forward, may help justify the need to include exercise training as a part of supportive care for breast cancer patients. To-date, we have recruited 21 women into the study and we will continue recruitment over the next 8 months. So far, adherence to our exercise program has been great and we are looking forward to analyzing the results in the coming year!
For more information about the project please contact Kelcey Bland at firstname.lastname@example.org
Kelcey Bland is a 2nd year MSc student in Rehabilitation Sciences at the University of British Columbia. She also holds an undergraduate degree in Human Kinetics from UBC.