Prescription exercise

In Canada today, one in nine women is expected to develop breast cancer, but thanks to modern therapies only one in 28 will die from the disease. For the survivors, quality of life is paramount – and that’s where new MSFHR trainee Amy Kirkham aims to help.

Funded in the latest round of MSFHR Trainee awards, Ms. Kirkham, a Masters student in exercise physiology at the University of British Columbia, will explore women’s physical response to exercise during chemotherapy, which is used to prevent secondary tumours– but which also has negative side effects. Side effects of chemotherapy include fatigue, nausea, hair loss, weight gain, and decreased production of red and white blood cells. Anemia and damage to the heart muscle are two prevalent side effects of chemotherapy that affect the way the heart and blood vessels work.

“Exercise during chemotherapy has been shown to minimize many of the side effects, but it has yet to be determined what parameters of exercise provide the optimal benefits,” says Ms. Kirkham, a former cross country and track athlete who has an undergraduate degree in kinesiology and athletic therapy. “Right now, all we have is anecdotal evidence for how cancer patients respond to exercise.”

Exercise intensity – or degree of effort -- is one of the common parameters for exercise prescription.  Common indicators of exercise intensity include heart rate and VO2max, which is the maximal amount of oxygen that can be consumed and is the criterion of measure for cardio respiratory fitness and indicates capacity for exercise. To date, though, exercise prescriptions do not account for chemotherapy's effects on the body in terms of exercise intensity.

“Typically, the recommendations for exercise are based on the body's response to exercise prior to chemotherapy treatment. Preliminary data suggests that chemotherapy patients are not exercising at the intended intensity which tells us that they are a unique population and a typical exercise prescription is not sufficient,” says Ms. Kirkham, whose research involves testing indicators of physical fitness over time in a group of breast cancer patients who are participating in an exercise and chemotherapy study. “This will allow us to see how the exercise capacity changes over the course of chemotherapy and will help us prescribe better exercise programs for patients.”

By analyzing and comparing changes in VO2max over the course of the chemotherapy, Ms. Kirkham hopes to produce evidence that may lead to revisions in existing guidelines for prescribing exercise intensity in breast cancer patients. Improving the exercise prescription will allow patients to stick with an exercise program which will reduce the effects of chemotherapy thereby improving patients’ quality of life.

Ms. Kirkham’s research is funded in part by the Lotte & John Hecht Memorial Foundation. She feels fortunate to be studying at UBC, with a leader in exercise oncology.

“I’d like to continue in this field, next with a PhD, then perhaps getting a post-doctoral fellowship and eventually going into teaching,” says Ms. Kirkham, who after moving from Ontario to BC last year registered as an elite triathlete and has since competed in two half ironman triathlons.

“I’m happy that this research is recognized as an important area,” she says. “There are a lot of critical health questions right now, and I’m grateful to receive this award in a very competitive year.”