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GHS Cancer Institute, USC School of Medicine partner
November 22, 2013
The Greenville Health System’s Human Performance Laboratory, expected to open January, is the first HPL in the nation to be fully embedded into a cancer research and treatment program.
The HPL, which already is working with patients on a pilot basis, is a collaborative effort between GHS and the University of South Carolina School of Medicine Greenville. While its initial focus is on cancer survivor patients in the GHS Cancer Institute, the lab will ultimately serve all GHS clinical populations.
Human performance labs traditionally have been the province of elite athletes who use the state-of-the-art analysis to improve performance. This the first time that an HPL will be used by a cancer institute to measure the changes in post-treatment cancer survivors—from whole body function all the way down to the cellular level—in an effort to improve patient health and outcomes. The lab, based at the GHS Cancer Institute, will measure cardiorespiratory fitness, muscular strength, body composition and metabolic fitness down to the mitochondrial level.
“By determining how exercise affects survivor’s health and outcomes, we can develop new cancer management techniques that will help patients overcome the crippling fatigue that too often accompanies cancer treatment,” said Larry Gluck, M.D., the institute’s medical director.
If achieved, this patient-recovery milestone would be on par with how chemotherapy-induced nausea was significantly reduced by harnessing better-targeted medications, said Gluck.
As many as 200 to 300 patients could take part in the Human Performance Lab in its first year.
Gluck started the GHS “Moving On” oncology-rehabilitation program in 1992 with a dozen breast cancer survivors. It was the first such program in the nation. The current Moving On program now is housed within GHS’ Center for Integrative Oncology and Survivorship.
Last year, the American Cancer Society announced the scientific evidence shows regular physical activity not only helps prevent cancer, but that physical activity after cancer diagnosis may reduce risk of recurrence and improve overall mortality among multiple cancer survivor groups.
Exercise may decrease the risk of colon cancer by 60%, and recurrence of breast cancer may decrease as much as 50%, according to current research.
“Exercise is the very thing that cancer survivors need to do to decrease their chances of recurrence or second cancers independent of the first,” said Jennifer Trilk, Ph.D., lab director and clinical assistant professor at the USC School of Medicine Greenville. “In addition, preliminary research demonstrates that exercise may protect against, as well as reverse, some of the muscle wasting that occurs as a result of cancer therapy.”
“Our team believes that cancer survivors who exercise during and after cancer treatment have better physiological health, functional health, cognitive health and quality of life than cancer survivors who don’t exercise,” said Trilk.
Using the lab, the group will be able to objectively measure changes after the 12-week nurse-supervised Moving On exercise program in areas such as cardiorespiratory fitness, associated with decreased cancer risk and greater longevity, and metabolic fitness, associated with muscle quality and function. Using dual x-ray absorptiometry, researchers also will measure cancer survivors’ body composition, which gives a detailed assessment of the body’s muscle and fat content and location.
Gluck has long suspected that chemotherapy and radiation therapy might damage mitochondrial function and help explain cancer patients’ feeling of fatigue. And while chemotherapy doesn’t enter the brain proper, it does produce elements that do, and researching this may lead investigators to a better understanding of the phenomena.
Trilk will use near-infrared spectroscopy (NIRS), a non-invasive instrument that measures muscle health and function at the cellular level, to study mitochondria. This is the first time this technology will be used to investigate mitochondrial function in cancer patients.
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