Collaboration between kinesiologists and oncologists shows exercise helps cancer patients
January 17, 2007 - Edmonton -- When it comes to cancer treatment, exercise might seem an unlikely remedy for someone undergoing a draining chemotherapy or radiation regime.
But Dr. Kerry Courneya and his multi-disciplinary team are at the forefront of exercise oncology, a field which studies how exercise can affect the physical and mental health of people with cancer.
"We've had a big revolution in the field of cancer over the last 20 years or so where issues such as supportive care and quality of life and coping with treatments, and these things have become very important," he said. "So, you don't have to necessarily be treating the cancer to have something to offer in the care of cancer patients."
Courneya is a University of Alberta behavioural researcher and Canada Research Chair in Physical Activity and Cancer and is one of a small number of researchers worldwide studying how exercise improves the health and quality of life of cancer patients. This area of study has largely come about due to advances in oncology, which have minimized the harsh side-effects of cancer treatment, like nausea and vomiting, which in previous decades made exercise difficult.
"Now we've got a lot of cancer patients who are going through these treatments who are not too bad. They're coping well; many of them are able to continue work, and so on," he said. "And I think this has also set the stage for the possibility of saying, 'Well now they might be at least in a condition where they can attempt an exercise program,' and whether or not they benefit is what the research program is looking at."
Courneya's research program has involved collaboration between oncologists, epidemiologists, exercise physiologists, biostatisticians, physiotherapists, oncology nurses and others. Since Courneya began cross-disciplinary collaborations at the U of A in 1997, his research has looked at a wide range of subjects, including: how exercise affects the physical well-being of patients during and after treatment, how immune function is affected by exercise, how patients are psychologically affected by exercise, which exercise programs work best for each type of cancer, how exercise programs should be implemented and how exercise can affect the likelihood of cancer returning.
In all of these areas, Courneya's team is breaking new ground.
"Exercise has not been looked at in cancer patients and survivors very much, so almost anything we study is a novel contribution," he said.
The results are promising.
"What we've found so far, at least in the on-treatment phase, is that physical activity can improve physical function during treatment. We're able to help them maintain fitness and improve muscular strength even over the course of these difficult chemotherapy protocols," he said. "We've also found improvements in psycho-social variables like self-esteem, and one of the most novel findings we've just completed in one of our trials, is that exercise resulted in them being able to complete more of their chemotherapy treatments."
Courneya's team has focused primarily on breast and prostate cancer, but is now examining cancers that are under-studied in the field.
None of the research projects would be possible without the help of oncologists, says Courneya.
"I can't overestimate the support I've gotten from the Cross Cancer Institute and the Department of Oncology. That's really what makes the collaboration, when groups of people across disciplines are genuinely excited about collaborating and involved in more than a superficial way," he said, adding that it's particularly important because oncologists will ultimately be the ones to put the research into practice when they make recommendations to patients.
Medical oncologist Dr. John Mackey is one of Courneya's main collaborators. The two have worked together since 1998, and have published more than 20 papers together. Mackey's research focuses on drug therapy for breast cancer patients, which can be associated with uncomfortable side-effects that can affect the patients' likelihood of completing treatment. The two have teamed up to explore how exercise programs can improve the well-being of breast cancer patients. One recent study specifically examined whether exercise could increase the likelihood of a patient completing chemotherapy.
Their results showed that "both aerobic and resistance exercise increases a woman's ability to get through breast cancer treatment with fewer adverse affects." It showed that women who did resistance training could more frequently receive 85 per cent of their chemotherapy doses on time.
"In the chemotherapy literature, survival improves when people get past the 85-per-cent threshold of chemo delivery," he said.
This good news is the product of interdisciplinary collaboration, says Mackey.
"It's impossible to be an expert in everything. And not only is it easier to do good research working with experts in other fields, but it's also much more interesting. I find speaking with my colleagues can be boring compared with speaking with colleagues in different disciplines," said Mackey, who frequently collaborates with biochemists, physicists, cell biologists, physiotherapists, advanced practice nurses, psychologists and exercise physiologists.
But not only is collaborating across disciplines "much more fun," it's also a way for researchers to stretch their understanding of science.
"Let's face it, with someone in your own field you might be able to debate the minutia, but rarely do you have new insights brought to your attention. I find the intellectual challenge of learning someone else's field and a new way of viewing things...has lead to the most interesting work I have ever done."
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