University of Vermont

Peel Coauthors Article on Cardiorespiratory Fitness in Breast Cancer Patients

Amanda Peel, Class of 2015.
Amanda Peel, Class of 2015. (Photo by Raj Chawla, UVM Medical Photography)

University of Vermont College of Medicine student Amanda Peel is first author on a January 13, 2014 Journal of the American Heart Association article that found that cardiorespiratory fitness was significantly lower in recently-treated breast cancer patients, potentially making them more susceptible to cardiovascular risk.

Working with Susan Lakoski, M.D., M.S., UVM assistant professor medicine and director of the Cardiovascular Prevention Program for Cancer Patients, Peel and colleagues reviewed results of clinical trials and observational studies measuring VO2max – the gold standard for cardiorespiratory fitness (CRF) – in the pre– and post–adjuvant treatment setting for breast cancer. Their research sought to determine the impact of fitness on longevity in breast cancer patients.

“Exercising and being fit is an important factor for health and longevity,” says Peel, who is a member of the UVM College of Medicine's Class of 2015. In her, Lakoski and colleagues’ review of 1856 women, “we found that breast cancer patients have much lower fitness than women of similar age without breast cancer.”

According to Peel, Lakoski and the study’s authors, growing evidence indicates that adjuvant breast cancer treatments, including chemotherapy and radiation, have a negative impact on cardiorespiratory fitness (CRF), which is an important predictor of risk for cardiovascular disease. However, determining what CRF level was expected in this patient population had not been widely studied.

“Fitness was impacted by the treatments that women with breast cancer are exposed to,” says Peel. “Given these findings, we propose – and have in place at UVM and Fletcher Allen – an oncology rehabilitation program called Steps to Wellness that is designed to mitigate loss of fitness during and after breast cancer treatment, with the hope that this will lead to a healthier and longer life for breast cancer patients.”

In their study, the researchers conclude that standardizing VO2max (CRF) data may allow healthcare providers to predict patients at risk for cardiotoxicity that might benefit from exercise interventions.

In addition to Peel and Lakoski, coauthors on the study include Kim Dittus, M.D., Ph.D., assistant professor of medicine, UVM Vermont College of Medicine and Vermont Cancer Center; and Samantha M. Thomas, M.B., and Lee W. Jones from Duke Cancer Institute.