They have already endured so much, having fought breast cancer and won.
But the way breast cancer is treated can lead to a host of other issues, including high blood pressure, diabetes and obesity, all of which can further threaten a survivor’s health and perhaps lead to breast cancer recurrence.
What if there was a way to prevent breast cancer recurrence without additional medication or invasive treatments?
That’s what Assistant Professor of Research Christina Dieli-Conwright is investigating with a new exercise study that was recently awarded a $4 million National Institutes of Health grant.
There is strong epidemiological evidence that supports the benefits exercise has on breast cancer risk and breast cancer recurrence.
“There is strong epidemiological evidence that supports the benefits exercise has on breast cancer risk and breast cancer recurrence,” said Dieli-Conwright, a faculty member at the USC Division of Biokinesiology and Physical Therapy. “Not all cancer types have such a strong association.”
Her study will observe 300 sedentary and overweight female survivors of breast cancer to determine if exercise improves inflammation in adipose tissue, or fat tissue.
Inflammation in fat tissue is dangerous because it’s been noted to aid in the growth of cancer or contributing to its recurrence.
“Since obesity is such a huge risk factor for poor cancer prognosis in breast cancer survivors, this will be a unique opportunity for us to be able to answer some questions related to why obesity is so harmful,” she said.
Participants will be randomly sorted into three groups.
Breast cancer recurrence: roles for study participants
The first group will partake in traditional exercise with aerobic exercise followed by a set of resistance exercises.
The second group will partake in high-intensity circuit training. Participants will cycle through intervals of aerobic and resistance exercises at a quicker pace.
The third is the control group, which will not be required to participate in exercise and will maintain current lifestyles.
All workouts will take place under the supervision of certified cancer exercise trainers in Dieli-Conwright’s Integrative Center for Oncology Research in Exercise Laboratory for approximately 75 to 150 minutes a week, as suggested by the American Cancer Society.
“We treat exercise as a drug, so we prescribe it as systemically and precisely as we can so that we know that we can measure the effectiveness,” she said.
The exercise study is 12 months, but Deli-Conwright will follow participants for even longer to observe survival outcomes.
Targeting fat tissue
The study is the first and largest of its kind in which a biomarker in the fat tissue is being targeted with exercise in cancer survivors.
For the study, Dieli-Conwright will partner with Steve Mittleman at UCLA’s Mittleman Laboratory to examine fat biopsies taken from participants before and after the study, as well as a follow-up.
Mittleman will be involved in analyzing the biopsies to determine what is happening to the fat tissue through the various stages of the exercise study.
“If the fat tissue is so problematic during survivorship then we’re hoping that this will give very specific evidence on how we can approach exercise in the future for breast cancer survivors,” Dieli-Conwright said.
If Dieli-Conwright finds that the high-intensity exercise group experiences greater reductions in inflammation in fat tissue than the traditional exercise group, it could one day impact how health care professionals approach exercise for survivors of breast cancer.
“Based on previous work, exercise has a profound impact on the survivor’s quality of life, outlook on prognosis, ability to have social interactions and confidence,” Dieli-Conwright said.
“Even though this is not a behavioral study, the participants are going to learn a lot along the way that hopefully gives them self-efficacy to want to exercise and lead healthier lives.”