CIHR grants $2.5 million to probe impact of physical activity on breast cancer

1,500 Canadian women to take part in 5-year study

Over the next five years, a diverse, multi-disciplinary team of researchers led by Dr. Kerry Courneya of the University of Alberta and Dr. Christine Friedenreich of Alberta Health Services will conduct a series of five large research projects to probe the impacts of physical activity on breast cancer thanks to a $2.5 million team grant over five years from the Canadian Institutes of Health Research (CIHR).

Courneya's team is one of just four across Canada to be awarded a CIHR team grant, and the only team from the University of Alberta to do so.

A Canada Research Chair in Physical Activity and Cancer since 2004, Courneya has been making breakthroughs in the field of physical activity and cancer field for over a decade. This grant gives his team the opportunity to take their work down new paths and using different approaches thanks to a large, diverse research cohort. Courneya will be working in concert with researchers from the U of A, University of Calgary, Athabasca University and Alberta Health Services whose expertise spans behavioural medicine, psychology, epidemiology, endocrinology, medical oncology, exercise physiology, physiotherapy and bio-statistics.

"The really novel aspect of this study is the link between physical activity and fitness, and disease outcomes. There has been limited research examining those outcomes. Women who survive breast cancer are at greater risk for breast cancer recurrence, second cancers, cardiac dysfunction, weight gain, bone loss, lymphedema, joint pain; they complain of cognitive dysfunction, menopausal symptoms, fatigue; some report psychosocial distress.

The five research projects will focus on the potential role of physical activity and health-related fitness in facilitating treatment completion, alleviating treatment side effects, hastening recovery after treatments, improving long term quality of life and reducing the risks of disease recurrence, other chronic diseases, and premature death.

"Our team will look at breast cancer recurrence, death from breast cancer as well as overall survival and whether physical activity and health-related fitness - cardio-respiratory fitness, muscular strength, body composition - are independent predictors of recurrence of the disease and survival," says Courneya.

For the five-year study, researchers will be recruiting 1500 women newly-diagnosed with breast cancer through the Tom Baker Cancer Centre in Calgary and the Cross Cancer Institute in Edmonton, and the study is set to begin early in 2011. "We have a system set up with the medical oncologists at these centres and all women eligible for the study, up to age 75, will be approached by them, to see if they want to participate," he says.

Besides the major studies, Courneya says, there are opportunities for sub-group analysis, with a large research cohort. "These analyses might include looking at the link between fitness and disease outcomes based on disease stage, or we could look at some of the molecular markers in the cancer cells such as estrogen receptor positive or estrogen receptor negative cancer, for example.

"We may find that fitness is a strong predictor but only for people who have estrogen receptor positive breast cancer. In the sub-groups we can examine if it's the same across all patients or if there are certain medical and demographic factors that make exercise a strong link for some groups and potentially no link for other groups, like estrogen-receptor negative breast cancer. Maybe we'll find that exercise doesn't reduce the risk of recurrence with that type of cancer," says Courneya.

"We can look at and determine what role exercise is playing depending on other medical co-morbidities or depending on your fitness level at the time of diagnosis and those types of things. Then you can give more targeted recommendation about what the best bang for the buck might be in terms of an exercise prescription."

Courneya says the true value of the team grant is the legacy of research projects it will spawn.

"The real goal of our CIHR team grant is to build this cohort so we have a beautiful resource, a living laboratory, 1500 women with all the gold standard assessments of exercise and health-related fitness tracked over many years and followed for all these disease outcomes.

"And once you establish that, there are an endless number of questions future students and academics could potentially look at."