An oncologist and an exercise physiologist walk into a cocktail party . . .
And when they walk out, they have a novel idea for an experiment to find out how exercise can help women recover from breast cancer chemotherapy.
UGA Provost Pamela Whitten hosted the Athens party at which Kevin McCully, a kinesiology professor who runs an exercise science lab, fell into conversation with Petros George Nikolinakos, a medical oncologist who conducts clinical trials at the University Cancer & Blood Center in Athens.
The physiologist and the physician hit on the idea that exercise might speed the recovery of specific cellular functions that are damaged by cancer treatments. The two designed a clinical trial to test this idea.
“Chemotherapy is as close as you can get to killing a person. It destroys the healthy cells as well. It crushes your mitochondria – the powerhouses of cells – destroys your muscle, and you’re tired,” said McCully, director of the Exercise Muscle Physiology Laboratory, where the trial is being conducted.
As a laboratory scientist, McCully thinks about what’s going on inside cells. “Exercise improves your mitochondrial capacity, improves how you feel, and you’re back to where you are. That’s our theory,” said McCully. “The importance of mitochondria is our hypothesis.”
As a practicing doctor, Nikolinakos thinks about the whole patient. “In general, people who stay physically active always do better. The problem with recommending exercise for cancer survivors is that the regimen is not supervised,” he said. “We can’t quantify the intensity and frequency. So we are looking for ways to structure the activity, measure and quantify it, and determine the impact scientifically.”
Together, the UGA team and University Cancer & Blood Center are breaking new ground.
“This trial will be an exciting addition to the current cancer literature,’’ said Hannah Bossie, a graduate research assistant in McCully’s lab. “We already have big population studies showing that people who exercise have less fatigue after treatment, less chance of recurrence, and lower mortality. But the actual biological mechanisms that mediate the relationship between physical activity and cancer and treatment-related fatigue has not been identified.”
Recruitment for the trial will be contingent upon obtaining funding through the National Institutes of Health. It’s open to women diagnosed with stage 1 and 2 breast cancer that has not metastasized, and whose treatment included both radiation and one of two common chemotherapy regimens: Taxotere and Cytoxan (TC) or Adriamycin, Cytoxan, and Taxol (AC-T).
For three months, participants will perform structured exercise at UGA’s Exercise Physiology Laboratory. Researchers will use a safe, noninvasive imaging technology to measure blood flow, blood volume, oxygen consumption, re-oxygenation rates and recovery time in muscle. They’ve been using this technique, called Near-Infrared Spectroscopy, since 2012.
The University Blood & Cancer Center and the Loran Smith Center for Cancer Support at Athens Regional Medical Center will be the recruitment sites for the trial.
Rosemary Wood, a breast cancer survivor, learned about the study while participating in a support group at Loran Smith. She wasn’t eligible, however, because chemotherapy had not been part of her treatment.
But she wanted to exercise. McCully encouraged her to join a preventive health and exercise class for people whose physical activity has been affected by cancer or by various other conditions such as Parkinson’s disease, stroke, cerebral palsy and vision loss.
Wood loves it.
“I do the treadmill, and then the elliptical, and an assorted number of lifting the bars. I got up to 20 minutes on treadmill and 9 laps on elliptical today. When I started out, I could only get up to three laps on the elliptical,” said Wood, a former weekend editor for the Athens Banner-Herald. “I’ve been in this class for three months now. Since then, I’ve noticed that my sleep’s been better. Even walking to my car and back has been a little easier.”
“I’m getting the exercise I need with people who have the knowledge to help me,” she said.
McCully and Nikolinakos say one of their long-term goals is to make physical activity a standard part of post-chemotherapy recovery.
“We want to transform the way a cancer survivor is treated,” said McCully. “We want to be able to say to them that you’ve finished chemotherapy, and now it’s your time to bounce back, join your life, get going.”
Dr. Supriya Venigalla, a medical doctor, is a second-year student in the Master of Public Health program at UGA, in the Health Policy & Management concentration. She is also taking the Graduate Newsroom course at Grady College of Journalism, and works at UGA Cooperative Extension, in the Walk Georgia program.