Exercise for improving chemoradiotherapy efficacy in patients diagnosed with rectal cancer
Emerging evidence from preclinical and clinical studies shows that exercise during chemo-radiotherapy cycles has the potential to improve cancer treatment efficacy. Purported mechanisms include enhanced targeting of chemo-radiotherapy treatments via exercise-induced modulation of the tumour microenvironment. This PhD project will establish how exercise can be embedded within the cancer care pathways for rectal cancer patients undergoing neoadjuvant chemoradiotherapy. The effects of exercise on treatment efficacy will be assessed by comparison of radiological and biological tumour response rates between patients randomised to exercise in addition to standard care versus standard care alone.
Exercise for ameliorating the cardiotoxic side-effects of chemo-radiotherapy in patients diagnosed with breast cancer
This PhD project will investigate the role of exercise as an adjunct treatment for attenuating the cardiotoxic side-effects of chemo-radiotherapy in breast cancer patients. Experimental work in the clinical setting will involve assessing cardiotoxicity biomarkers in patients undergoing treatment. Cardiac/haemodynamic function and blood-borne biomarkers of cardiotoxicity at baseline (pre-treatment) and follow-up (post- treatment) will be compared between patients randomised to exercise plus standard care or standard care alone. This study will demonstrate the feasibility of collecting cardiotoxicity outcomes and will yield preliminary mechanistic data to provide new insights into how exercise ameliorates the cardiotoxic effects of adjuvant treatments.
Exercise for attenuating the myotoxic side-effects of chemotherapy
This PhD project aims to provide novel data on the cellular mechanisms involved in the myotoxic effects of chemotherapy, which include atrophy and senescence via increased proteolysis and autophagy and decreased protein synthesis. Platelet releasate contains growth factors which have potent mitogenic and angiogenic effects on muscle. This project will induce senescence in muscle cell lines (in vitro) by doxorubicin treatment and determine whether platelet releasate inhibits senescence, and whether the response is influenced by exercise. Clinical work with oesophagogastric and colorectal cancer patients will involve assessing myopenia/sarcopenia between patients randomised to exercise plus standard care or standard care alone.
Patient and health professional perceptions of embedding exercise into the cancer chemo-radiotherapy treatment pathways: a qualitative study
If exercise during cancer treatment is to become normal practice, we need to understand from the perspectives of patients, carers, healthcare professionals (e.g. doctors, nurses, clinical exercise physiologists and physiotherapists) and policymakers the psychological, social, cultural, political and resource challenges that need to be addressed. In this PhD project, the student will undertake a qualitative study (via survey, focus groups and interviews) to identify barriers and levers to embedding exercise into the adjuvant cancer treatment pathways from the perspectives of patients, carers and other key stakeholders. This research will underpin the development of good practice implementation guidelines and an intervention to support patients and healthcare professionals.