Efficacy of Cardio-Oncology Rehabilitation Exercise for Women With Breast Cancer and Treatment Related Cardiotoxicity (CORE)
Breast Cancer, Left Ventricular Dysfunction, Heart Failure, Systolic
About this trial
This is an interventional treatment trial for Breast Cancer focused on measuring Exercise, Cardiac Rehabilitation, Breast Caner, Left Ventricular Dysfunction, Trastuzumab, Anthracyclines
Eligibility Criteria
Inclusion Criteria:
- Women with breast cancer (receptor status: human epidermal growth factor receptor (HER2+/-), Progesterone receptor, (PR+/-), estrogen receptor (ER+/-); Stage I-III)
- Are 18 yrs. of age or older
- A diagnosis of cardiac toxicity that occurred during treatment will be defined as a decrease from baseline in the left ventricular ejection fraction of >10 percentage points, to a value < 53% by 2D-echocardiography upon repeated measures or a diagnosis of heart failure which will be confirmed by the cardiologist upon cardiac evaluation
- Currently undergoing known cardiotoxic agents including the HER2-antagonist trastuzumab and/or chemotherapy agents including doxorubicin and epirubicin
Exclusion Criteria:
- Women who are pregnant
- Treated with a left ventricular assistant device or a pacemaker.
- Have metastatic disease
- Previous exposure to anthracyclines, cytotoxic treatments or radiation preceding their breast cancer diagnosis
- Unable to confirm a diagnosis of heart failure due to treatment for breast cancer upon cardiac evaluation by their Cardiologist
- Myocardial infarction, complex arrhythmias, or unstable cardiac symptoms in the previous six weeks prior to study enrolment
- Significant co-morbidities that limit their ability to perform exercise (i.e., severe peripheral artery disease, severe chronic obstructive pulmonary disease, musculoskeletal injury or stroke)
- Contraindications to exercise training identified on their first cardiopulmonary assessment that do not subside prior to beginning the program including angina pectoris symptoms, light-headedness or dizziness with exercise, and resting blood pressure > 200mmHg systolic or >120mmHg diastolic blood pressure.
- Contraindications to resistance training including increased eye pressures (> 20mmHg), untreated hernias, limitations due to surgery (lumpectomy/mastectomy) and potential musculoskeletal injuries
Sites / Locations
- Toronto Rehabilitation Institute
Arms of the Study
Arm 1
Arm 2
Experimental
No Intervention
Exercise Rehabilitation
Usual Care
The intervention group will participate in the exercise rehabilitation program for a total of 12 weeks. This includes performing aerobic training five times per week and resistance training two to three times per week. Participants will also be expected to attend the education sessions following their supervised exercise rehabilitation sessions each week.
Participants in the control group will be encouraged to continue with their regular physical activity routine and will receive regular standard of care by their Cardiologist and Oncologist.