Breast Cancer Research and Treatment

, Volume 167, Issue 3, pp 719–729 | Cite as

The effect of an aerobic exercise bout 24 h prior to each doxorubicin treatment for breast cancer on markers of cardiotoxicity and treatment symptoms: a RCT

  • Amy A. Kirkham
  • Neil D. Eves
  • Rob E. Shave
  • Kelcey A. Bland
  • Joshua Bovard
  • Karen A. Gelmon
  • Sean A. Virani
  • Don C. McKenzie
  • Eric J. Stöhr
  • Darren E. R. Waburton
  • Kristin L. CampbellEmail author
Clinical trial



In rodents, a single exercise bout performed 24 h prior to a single doxorubicin treatment provides cardio-protection. This study investigated whether performing this intervention prior to every doxorubicin treatment for breast cancer reduced subclinical cardiotoxicity and treatment symptoms.


Twenty-four women with early stage breast cancer were randomly assigned to perform a 30-min, vigorous-intensity treadmill bout 24 h prior to each of four doxorubicin-containing chemotherapy treatments or to usual care. Established echocardiographic and circulating biomarkers of subclinical cardiotoxicity, as well as blood pressure and body weight were measured before the first and 7–14 days after the last treatment. The Rotterdam symptom checklist was used to assess patient-reported symptoms.


The exercise and usual care groups did not differ in the doxorubicin-related change in longitudinal strain, twist, or cardiac troponin. However, the four total exercise bouts prevented changes in hemodynamics (increased cardiac output, resting heart rate, decreased systemic vascular resistance, p < 0.01) and reduced body weight gain, prevalence of depressed mood, sore muscles, and low back pain after the last treatment (p < 0.05) relative to the usual care group. No adverse events occurred.


An exercise bout performed 24 h prior to every doxorubicin treatment did not have an effect on markers of subclinical cardiotoxicity, but had a positive systemic effect on hemodynamics, musculoskeletal symptoms, mood, and body weight in women with breast cancer. A single exercise bout prior to chemotherapy treatments may be a simple clinical modality to reduce symptoms and weight gain among women with breast cancer.


Doxorubicin Breast cancer Cardiotoxicity Exercise Treatment symptoms 


Financial support

This work was supported by an Anita Cochrane Memorial Fund Award from the British Columbia Cancer Foundation. AK was supported by the Canadian Institutes of Health Research. We also acknowledge the support of GE Healthcare.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Amy A. Kirkham
    • 1
  • Neil D. Eves
    • 2
  • Rob E. Shave
    • 3
  • Kelcey A. Bland
    • 4
  • Joshua Bovard
    • 5
  • Karen A. Gelmon
    • 6
  • Sean A. Virani
    • 7
  • Don C. McKenzie
    • 5
  • Eric J. Stöhr
    • 2
    • 8
  • Darren E. R. Waburton
    • 5
  • Kristin L. Campbell
    • 9
    Email author
  1. 1.Department of Biomedical EngineeringUniversity of AlbertaEdmontonCanada
  2. 2.Centre for Heart, Lung and Vascular HealthUniversity of British ColumbiaKelownaCanada
  3. 3.Cardiff Centre for Exercise and HealthCardiff Metropolitan UniversityCardiffUK
  4. 4.Rehabilitation SciencesUniversity of British ColumbiaVancouverCanada
  5. 5.School of KinesiologyUniversity of British ColumbiaVancouverCanada
  6. 6.Medical Oncology, British Columbia Cancer AgencyVancouverCanada
  7. 7.Department of Medicine, Gordon & Leslie Diamond Health Care Centre 9th FloorUniversity of British ColumbiaVancouverCanada
  8. 8.Columbia University Medical CenterNew YorkUSA
  9. 9.Department of Physical TherapyUniversity of British ColumbiaVancouverCanada

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