Sara Hassing Johansen is a PhD candidate at the Department of Physical Performance. On May 20, 2025, 10:00—16:00 she will defend her thesis From Cardiorespiratory Limitations through the Cancer Journey to Benefits of Cardio Training in Cancer Survivors: The Effect of Exercise Among Breast Cancer Survivors at the Norwegian School of Sport Sciences, Auditorium Innsikt.
About the study
Many people know that cancer treatment can be tough, but fewer are aware that the effects can last for years. Regarding the tough course of cancer treatment that can also affect the healthy cells in the body, cancer survivors remain susceptible to late effects following therapy, including physical, psychological, and social challenges.
One major issue is reduced cardiorespiratory fitness – how well the heart, lungs, and muscles work together. Lower cardiorespiratory fitness is linked to a higher symptom burden, increased cardiovascular risk, and early mortality. However, we still don’t fully understand how much cancer treatment affects CRF in both the short and long term. At the same time, exercise is often recommended to improve CRF, but studies suggest that breast cancer survivors may not respond to training as well as those without a cancer history.
As the population of cancer survivors continues to grow, safe and effective interventions are crucial to sustain good health for cancer survivors. Therefore, the big question is: How much does cancer treatment impact cardiorespiratory fitness, and can exercise still make a difference in the long run?
Implication
This thesis provides compelling evidence of the substantial cardiorespiratory fitness decline occurring during and after systemic anticancer treatment, emphasizing the critical role of interventions to counteract these changes, such as exercise therapy.
As the population of cancer survivors continues to grow, addressing late effects has become a critical component of post-cancer care.
Exercise therapy has emerged as one of the most effective non-pharmacological interventions, with far-reaching implications for the overall health of cancer survivors.
However, the blunted exercise response observed among long-term BCSs in this thesis highlights the long-term physiological burden of cancer treatment.
This implies that BCSs may require more tailored and prolonged rehabilitation strategies to counter the lasting consequences of treatment. Furthermore, the clinically meaningful improvements observed in fatigue and HRQoL among BCSs with the highest symptom burden highlight the therapeutic potential of exercise therapy.
Hence, exercise therapy should be recognized as a crucial rehabilitation strategy to mitigate symptoms and the risk of severe disease during survivorship. Importantly, the heterogeneity observed among this population, particularly in CRF, fatigue, and HRQoL levels, reinforces the importance of individualized prescriptions to optimize both physical and psychological health.
Compared to generalized exercise guidelines for the broader population, tailored approaches can provide effective and safe rehabilitation by addressing the specific challenges faced by each survivor. For example, integrating the importance of exercise therapy into survivorship care may enable some survivors to manage independently with minimal follow-up.
Others might benefit from more structured guidance, such as conversations or participation in community-based exercise groups. For those experiencing greater challenges, more intensive and closely supervised interventions may be necessary to facilitate effective rehabilitation.
Lastly, while this thesis highlights the critical importance of research in long-term cancer survivors, further research is essential to establish exercise therapy as a cornerstone of cancer rehabilitation. The blunted exercise response observed in BCSs necessitates the need to unravel the mechanisms underlying these impairments, which likely stem from complex treatment-related physiological impairments.
Hopefully, by building on our findings, exercise therapy will become an integral part of standard cancer treatment and survivorship care, improving overall health throughout the cancer survivorship continuum. This may not only benefit cancer survivors, but also provide economic benefits, including reduced healthcare costs, lower disability rates, and improved workability in society.
Read the thesis here
Committee
Chair
- Professor Trine Stensrud, Norwegian School of Sport Sciences
Opponents
- Associate Professor Morten Quist, Department of Clinical Medicine, Copenhagen University
- Professor Susanne Oksbjerg Dalton, Danish Research Center for Equality in Cancer, Department of Clinical Oncology
Supervisors
- Main Supervisor: Tormod Skogstad Nilsen, Associate Professor, Norwegian School of Sport Sciences
- Co-Advisor: Elisabeth Edvardsen, Researcher, Norwegian School of Sport Sciences
- Co-Advisor: Lene Thorsen, Senior Researcher, Unit for Late Effects After Cancer Treatment, Oslo University Hospital.
Program
- 10.15-11.00: Trial lecture: “Sosioøkonomiske forskjeller i livsstil – implikasjoner for folkehelse generelt og kreft spesifikt”
- 11.00-16.00: Public defense of the thesis: From Cardiorespiratory Limitations through the Cancer Journey to Benefits of Cardio Training in Cancer Survivors: The Effect of Exercise Among Breast Cancer Survivors
Practical info
The defense will be chaired by Rector Lars Tore Ronglan
The defense is open to everyone and will be streamed on NIH’s YouTube channel.
