Cancer, Chemotherapy and Exercise

Cancer, Chemotherapy and Exercise

Basic science research at Creighton explores the benefits of physical activity, creatine

By Rick Davis, BA’88

Eric Bredahl, PhD, assistant professor of exercise science and pre-health professions, and a team of undergraduate researchers are adding to the growing — but relatively new — body of evidence pointing to the benefits of exercise for cancer patients undergoing chemotherapy.

Bredahl became fascinated with this line of study as a graduate research assistant working at the Rocky Mountain Cancer Rehabilitation Institute (now the Cancer Rehabilitation Institute) at the University of Northern Colorado, where he earned his PhD in sports and exercise science in 2015.

“Some of the work we did conclusively showed that if you had a cancer patient undergoing chemotherapy and they were able to perform low-intensity exercise, their prognosis was greatly improved,” says Bredahl, who has continued that line of research at Creighton for the past four years.

“Your body is meant to move,” he says. “Even if you’re sick or you’re going through chemo, the outcome is markedly better just by moving.”

Chemotherapy agents, he explains, can have cardiotoxic effects — meaning they cause damage to the heart. With chemotherapy, the heart muscle gets smaller, while the inside chamber enlarges, thinning the walls of the heart.

“But if you exercise, that loss of cardiac muscle is reduced,” he says. “So, you have cancer patients who are able to tolerate chemotherapy longer, which means there is a better chance of the cancer being killed and they can maintain a better quality of life. In other words, they have more energy to perform day-to-day tasks.”

Bredahl and his students conduct basic science research, working with various research models. They have found that low-intensity exercise slows tumor growth, and when chemotherapy is introduced, exercise reduces heart damage and maintains muscle function.

A review of recent research literature, he says, shows that exercise can be beneficial in all stages of the treatment process — before someone begins chemotherapy, during treatments and then afterward as part of recovery.

Bredahl is also collaborating with the School of Medicine to look at low-cost interventions that can improve outcomes during chemotherapy. Specifically, he and his students are looking at creatine, a compound produced naturally in the body that is also widely used as a supplement.

“When you hear of creatine, you think of gym guys,” says Bredahl, himself an avid weightlifter. However, its benefits have been found to extend beyond the gym.

In his lab, undergraduate exercise science and pre-health profession students have cultured skeletal muscle cells — treating one group with chemotherapy and another with chemotherapy and creatine.

“What we find is that creatine is cytoprotective — it preserves cell health and cell viability,” Bredahl says.

This could be very beneficial for cancer patients undergoing chemotherapy who, for other health reasons, are not able to exercise to the extent needed for outcome benefits.

“What if we were able to give them a supplement — or nutraceutical, if you will — that’s available in just about every store, it’s low cost to produce and it’s a high yield,” says Bredahl, speaking of creatine.

“There are still a lot of questions that need to be answered before you make clinical recommendations. There’s still a word of caution to it, but we’re starting this line and the initial results are very promising.”

Bredahl says that exercise for cancer patients does not necessarily mean hitting the gym every day or running on a treadmill. Simple routines — a few daily walks, some body-resistance exercises or practicing yoga — “can have profound impacts on the health of your body during chemotherapy,” he says. A little bit of exercise can also stimulate appetite, especially important for those cancer patients who experience weight loss, particularly prominent in those suffering from cancer cachexia.

Bredahl is particularly excited to have undergraduate students involved in the research, which at other institutions would primarily be reserved for graduate students.

“What we do is very much graduate-level research,” Bredahl says. “It’s a testament to Creighton undergrads that I can bring these students in, and in three or four months they’re self-sufficient researchers.”

Wisam Najdawi, a senior exercise science major from Sioux City, Iowa, has been working in Bredahl’s lab since his sophomore year.

“Dr. Bredahl has given me a lot of opportunities, responsibilities and independence in the lab to really grow as a researcher,” says Najdawi, who has shared findings at national and international conferences, and plans to attend medical school next year to pursue an MD/PhD dual degree.

Ashton Legenza, a senior exercise science major from Elkhorn, Nebraska, who also plans to attend medical school after graduation, adds that the students’ work in the lab is “very hands-on” and that Bredahl takes “the time to teach us and coach us through the process.”

Both are keenly aware of the importance of the lab’s work.

“Cancer is something that most, if not all, people will deal with during their lifetime,” Najdawi says. “The idea that we can potentially help reduce the adverse effects of both cancer and chemotherapy for so many people is something very special to me.”