Cabrini Cancer Institute trial studies long-term side effects on cancer patients in remission

A tailor-made exercise program for patients recovering from cancer hopes to shed light on a common and debilitating issue facing survivors.

A tailor-made exercise program for patients recovering from cancer hopes to shed light on a common and debilitating – but often unspoken issue – facing survivors.

Cabrini Cancer Institute is leading the Melbourne arm of an international trial that will test whether a 12-week, individualised program for patients in remission can tackle long-term side effects, including fatigue and nerve damage.

The institute’s cancer exercise laboratory head Associate Professor Eva Zopf said patients in remission faced “really debilitating” cancer and treatment side effects at the same time support tends to drop off.

Cabrini Cancer Institute exercise physiologist Associate Professor Eva Zopf hopes to see exercise become a routine part of cancer care. Picture: Supplied

“There’s a lot of focus on helping patients get through their treatment, and then we sort of sometimes forget that post-treatment phase where a lot of individuals still struggle,” the exercise physiologist said.

“Patients are then in this position where they’re no longer getting clinical care.

“These side effects can actually last for quite some time after completing treatment.

“This really impacts their quality of life.”

But she hopes their 12-week trial, which is still recruiting both public and private Victorian patients, can shift the dial.

Dr Zopf said in person sessions, while effective, were inaccessible to many patients because of distance or time barriers, and they hope to show a virtual program alleviates symptoms too.

The study is focused four common side effects: fatigue, chemotherapy induced peripheral neuropathy, low daily functioning and anxiety or depressive symptoms.

Mirana Ramialison with her family during her first Christmas while in treatment for breast cancer in 2023. Picture: supplied

Patients complete three exercise sessions supervised over telehealth a week, completing a mix of aerobic exercise, resistance training and sessions targeted for their specific symptoms.

Dr Zopf said researchers don’t “fully understand yet all the mechanisms behind how exercise improves cancer related side effects”, but it has been “proven to be an effective strategy”.

“It seems counterintuitive, but exercise is actually the best intervention to counteract fatigue,” she said.

She said “very specific exercises, such as balance and sensory motor exercises” were “very beneficial” for CIPN, a nerve damage condition that leads to pain, numbness and tingling.

Melbourne mum Associate Professor Mirana Ramialison was diagnosed with breast cancer in2023 and said the program was “incredible” for her fatigue.

“I could go back on conferences, travel internationally, and be there more for the kids as well,” she said.

“I knew exercise was good in theory, but even as a scientists I didn’t realise how important it was going to be. It was as important as my treatment for the cancer.”

She said there was an “expectation” that everything “goes back to normal” after the main treatment course was finished, but that wasn’t the case.

“I wanted life to go back to as normal as possible,” she said.

“But I wasn’t. I was still tired.

Mirana Ramialison completed the Cabrini Cancer Institute's virtual exercise trial while recovering from breast cancer and said it was amazing. Picture: supplied

“There’s all these expectations, ‘I’ve finished chemo, my hair is growing’ and it looks like ‘that’s it, it’s over”.

“Because you start to look normal, people forget what you just went through.”

She said this was actually when “things start to be the hardest psychologically.”

“When you’re doing treatment, everyone’s strong and we have to get through this.

“But when things start to get better, that’s when we look back and realise what we went through.

“There’s a period of shock.

“It’s an invisible cost.”

She said it wasn’t until she did the exercise program that she realised just how much her fatigue was affecting her daily life at home and work.

“I’m a mum, I have two kids, it was hard for me to help out with their homework,” she said.

“Sometimes, unpacking the dishwasher, it was hard for me.”

Dr Zopf said her dream was to see exercise become part of “routine cancer care”.

“In the ideal world, for me, every person that’s diagnosed with cancer would be referred to an exercise specialist as soon as possible,” she said.

Originally published as Cabrini Cancer Institute trial studies long-term side effects on cancer patients in remission