Grant: Banting Postdoctoral Fellowship Program

Anthracyclines are chemotherapy agents that are commonly used to treat breast cancer. Although these treatments work well against the tumor, they are known to cause damage to the heart muscle cells and may also damage the blood vessels and skeletal muscles. These anthracycline side effects likely contribute to the increased risk of cardiovascular disease in women who have had breast cancer, as well as the reduced exercise capacity, quality of life and cancer-related fatigue reported in this population. In animal studies, both exercise and a reduction in calorie intake can reduce the detrimental effects of anthracyclines on the heart, and may also reduce cancer progression. Maintaining regular exercise training and a strict diet during chemotherapy treatment is challenging for many women with breast cancer due to treatment symptoms. This study will determine whether short-term application of these interventions shortly prior to the receipt of each treatment can prevent the negative effects of anthracycline treatment on the heart, aorta, and skeletal muscle, improve treatment symptoms and quality of life and reduce tumor size. Fifty-six early women with stage breast cancer who will receive anthracycline treatment will be randomly assigned to 1 of 3 groups who will: 1) perform a single 30-minute aerobic exercise session 24 hours prior to each treatment; 2) eat a diet consisting of 50% less calories for 48 hours prior to each treatment; or 3) receive usual cancer care. Magnetic resonance imaging (MRI) will be used to precisely measure the function of the heart, aorta, and the lower leg skeletal muscle at rest, and again during exercise to allow detection of more subtle signs of damage. These low-cost and accessible interventions may be a drug-free way to protect the heart, aorta, and skeletal muscle from anthracycline treatment, and thereby result in short and long-term improvements in cardiovascular health in women diagnosed with breast cancer.