More than Fitness, Hope

Dieli-Conwright

Left: Dr. Christina Dieli-Conwright, Director of the Women’s Health and Exercise Laboratory, runs a study at USC examining how exercise can keep breast cancer survivors from developing chronic diseases.

BY JAMIE WETHERBE MA ’04

Each year, more than 220,000 women are diagnosed with breast cancer. In 2013, Carrie Ravichandran was one of them.

After a routine mammogram revealed a small lump, Ravichandran went in for further testing before being diagnosed with Stage 1 breast cancer.

There are four stages of breast cancer. Stage 1 cancers are relatively small and have not yet spread, making them responsive to treatments such as the surgical removal of the abnormal cell growth (lumpectomy) or mastectomy, radiation therapy, hormone therapy or any combination thereof.

Ravichandran underwent a lumpectomy followed by rounds of chemotherapy and radiation. While the treatments were successful, Ravichandran—who already suffered from back problems stemming from 20 years as a nurse—was left with severe pain in her hip.

“The pain was horrible,” she says. “I was just laying around feeling sorry for myself because I didn’t think I could do anything else.”

With help from her physician, Ravichandran enrolled in a new exercise study at USC targeting breast cancer survivors.

Funded by the National Cancer Institute, the Women’s Health and Exercise Laboratory examines how exercise can keep cancer survivors from developing chronic diseases, often from weight gain caused by chemotherapy.

“People often associate chemotherapy … with losing a lot of weight, and that’s true in some cancers,” says program director Christina Dieli-Conwright, who earned her Ph.D. in biokinesiology at USC in 2009. “In breast cancer we actually see the opposite in some cases.”

Dieli-Conwright says that research shows patients who undergo chemo gain about 10 to 12 pounds over the course of three to six months.

“So that can be significant to many individuals,” she adds.

The added weight puts cancer survivors at risk of developing co-morbidities, or chronic diseases like diabetes or cardiovascular disease.

“They go through chemo, gain some weight, lifestyle habits change,” Dieli-Conwright says. “They’ve survived cancer but now they might be metabolically unhealthy. We can employ an exercise program specifically to target metabolic dysregulation.”

Two years into the five-year trial, the program has put 40 participants—with plans to recruit 60 more—through a 16-week exercise regimen at USC’s exercise center.

Nearly 85 percent of participants are Latina, many Spanish-speaking, and most were treated at USC Norris Comprehensive Cancer Center or Los Angeles County+USC Medical Center.

The average age of participants is 51, while the youngest member is 28.

All participants come in sedentary, or having exercised less than one hour a week.

“Some have never exercised in their lives,” Dieli-Conwright says.

The program consists of a thrice-weekly exercise regimen that’s timed around patients’ schedules and any limitations related to cancer treatment, including post-surgical swelling and radiation burns.

Under a trainer’s watchful eye, the hour-long routine includes a series of circuit-training resistance exercises that alternate between upper and lower body movements, followed by 20 to 40 minutes of aerobic exercise, such as walking, jogging or cycling.

Patients increase weight, reps and aerobic intensity as they progress through the trial. Outcomes are then compared to a control group who don’t exercise.

Dieli-Conwright says so far she’s seen “great results” in the test group, including reductions of triglycerides, as well as lower cholesterol and glucose levels.

She adds that most participants have lost about 10 pounds by the end of the program, even without changing their diets, “which is good because people are motivated by weight loss.”

Patients also maintain the benefits three months after the study, even without exercising as rigorously.

More than just healthy bodies, members leave with wellness on their minds.

“We instill in them that they do have time to exercise,” Dieli-Conwright says. “And if they decide to continue to exercise, they’re comfortable and know what to do.”

Dieli-Conwright says an added bonus is seeing the boost in patients’ confidence.

“They often come in a little depressed after finishing treatment,” she says. “We give them something to be a part of.”

Ravichandran, who still suffers from chronic pain and uses a walker, says more than a chance at fitness, the study has given her hope.

“Every single person has been so kind and so positive, I couldn’t help but have a life-changing thing happen to me,” she says, getting a little choked up. “I wish every person who has to go through cancer could go through this program.”

For more information on the Women’s Health and Exercise Laboratory, go to pt.usc.edu/labs/whel/