Behavioural Medicine Laboratory

The Behavioural Medicine Laboratory is focused on generating new knowledge on how physical activity can help cancer patients prepare for treatments (prehabilitation), cope with treatments, recover after treatments (rehabilitation), and improve long term quality of life and survival.

Our research seeks to advance the scientific understanding of the interrelationships among the behavioural, biological and psychosocial aspects of physical activity and cancer.

Who We Are

The laboratory is overseen by Dr. Kerry S. Courneya, Director of the Behavioural Medicine Laboratory, Canada Research Chair in Physical Activity and Cancer, and a Professor in the Faculty of Kinesiology, Sport, and Recreation.

The Behavioural Medicine Fitness Centre works closely with the Cross Cancer Institute in Edmonton. The Institute's experts assist us in our work at the Centre.

Graduate Student Opportunities

Dr. Courneya typically supervises 4-8 graduate students and post-doctoral fellows in the Behavioural Medicine Laboratory (BML) and opportunities are available regularly.

- Most students in the BML hold external scholarships or receive full research assistanships (RAs) as part of their training
- Students work 12 hours per week in the BML

Prior to applying for either graduate studies or a post-doctoral fellowship, those interested should contact Dr. Courneya to determine if their research interests fit with those of the BML, and also what opportunities are available for supervision. Contact Dr. Kerry Courneya at kerry.courneya@ualberta.ca or at 780.492.1031

About the Laboratory

  • Behavioural Medicine Fitness Centre

    Fitness equipment in the BMFCExercise intervention studies take place at the Behavioural Medicine Fitness Centre (BMFC).

    The primary research participants are:

    - cancer patients from the Cross Cancer Institute (CCI)
    - cancer survivors from the Edmonton and surrounding Community
    - persons from the community at high risk for cancer

    The BMFC is located in the Research Transition Facility and is fully equipped with the latest exercise equipment. The Centre is equipped with:

    - Life Fitness treadmills,
    - Life Fitness recumbent and upright cycle ergometers,
    - Life Fitness elliptical cross trainers,
    - APEX selectorized resistance machines.
    - Other equipment also includes hand weights, exercise balls, and a stretching area.

    The BMFC operates primarily by appointment.

    Parking
    Complimentary parking is available at the BMFC. Our parking spots are on the west side of the building, in the EDC parking lot.

    - Once you have joined a study, you will be issued a parking pass to use during the duration of your participation
    - Please place your parking pass on your car's dashboard
    - If parking stalls are full, please purchase a ticket at the ticket booth and we will reimburse you.
    - Cost is $1.25 per 30 minutes and correct change is required

    How to get to the Behavioural Medicine Fitness Centre

    The Behavioural Medicine Fitness Centre is located at the University of Alberta, west of the Health Sciences LRT Station, in the Research Transition Facility, 8308-114 Street.

    - From 87 Avenue, turn south next to the Jubilee Theatre
    - Our parking lot is located just south of the Jubilee building (not the parkade)
    - Pay stalls are located at the entrance of the outdoor parking lot

    The BMFC is located at the northwest corner and the only access to the BMFC is through the northwest door.

  • Body Composition Testing
    Study participants' body composition will be assessed using a non-invasive technique known as dual energy x-ray absorbitometry (DXA).

    DXA measures bone density (AP spine and femur), lean tissue mass, and total and regional body fat (i.e., abdominal body fat). This body composition measure requires you to wear a hospital gown and lie quietly on the apparatus for approximately five minutes while an external scan of the entire body is performed.

    Participant Information for DXA Scan
    The test takes place at the Cross Cancer Institute.
  • Exercise Testing Room

    Study participants complete various physiological tests such as a graded exercise test in one of our Exercise Testing Rooms. The first is located in the basement of the Cross Cancer Institute and the second is located at the Behavioral Medicine Fitness Centre.

    The Exercise Testing Room are equipped with an:

    - Ergoline Electronically Braked Bike and Woodway Treadmill for the aerobic exercise tests
    - Metabolic measurements are determined with the Parvo Medics TrueOne® 2400 Metabolic Measurement System

  • Laboratory Operations

    We conduct multidisciplinary, biopsychosocial research in three broad areas:

    - The effects of exercise on cancer control outcomes such as prevention, coping, rehabilitation, health promotion, palliation, and survival,
    - the determinants of exercise for cancer control, and
    - the effectiveness of interventions designed to promote exercise for cancer control.

    The Behavioural Medicine laboratory is involved in many large scale case-control and cohort studies as well as single-site and multi-centre randomized controlled trials, with a variety of cancer sites being represented, including colorectal, prostate, testicular, hematologic, gynecologic, and breast cancer.

Research Studies

Here is a sample of some of the studies that are in progress

  • Alberta Moving Beyond Breast Cancer Cohort Study

    CIHR Team in Physical Activity and Breast Cancer Survivorship: The Alberta Moving Beyond Breast Cancer (AMBER) Cohort Study

    Research Description

    The objective of our research team is to study physical activity (PA) and health-related fitness (HRF) to improve breast cancer survivorship from the time of diagnosis and for the balance of life. We propose to achieve this objective by establishing a large cohort of breast cancer survivors with a comprehensive assessment of subjective and objective measures of physical activity and health-related fitness (e.g., physical fitness, physical functioning, body composition). This cohort will allow us to address important questions related to physical activity and health-related fitness including: (a) examining associations with important outcomes such as disease outcomes, symptoms, late effects, psychosocial outcomes, and quality of life, (b) examining determinants such as medical, social cognitive, and environmental, and (c) examining mechanisms and moderators of observed associations. These data will help inform strategies to promote physical activity and health-related fitness to improve breast cancer survivorship.

    Our study will include:

    - a comprehensive self-report measure of PA developed by our team that measures the type, frequency, intensity, and duration of PA at work, at home, and for recreation and transportation
    - a self-report assessment of sedentary behavior (e.g., television viewing, sitting time) that has emerged as an important independent predictor of disease outcomes in other populations including the risk of developing ovarian cancer
    - state-of-the-science objective measures of PA and sedentary behavior (i.e., accelerometers)
    - a comprehensive assessment of HRF including standardized and validated measures of cardiorespiratory fitness, musculoskeletal fitness, and body composition
    - a full assessment of biomarkers purported to mediate possible associations between PA, HRF, and breast cancer outcomes
    - a comprehensive assessment of PROs including quality of life, fatigue, and cognitive function using standardized and validated measures
    - a complete assessment of potential determinants of PA and HRF based on a social ecological model that includes social cognitive and environmental correlates.

    The cohort study will provide the most comprehensive inquiry into the role of PA and HRF in breast cancer survivorship to date. The data generated will allow us to answer key questions related to PA and HRF in breast cancer survivors including:

    - the independent and interactive associations of PA and HRF with important health outcomes in breast cancer survivors including disease outcomes (e.g., recurrence, breast cancer-specific mortality, overall survival), treatment completion rates, symptoms and side effects (e.g., pain, lymphedema, fatigue, cognitive dysfunction), and PROS (e.g., QoL, anxiety, depression, self-esteem, happiness)
    - the determinants of PA and HRF including demographic, medical, social cognitive, and environmental variables
    - the mediators of any observed associations between PA, HRF, and health outcomes including biological, functional, and psychosocial outcomes
    - the moderators of any observed associations including demographic, medical, and biological factors.

    The AMBER cohort will serve as the basis for five initial research projects proposed within our CIHR Team Grant. The overall aim is to establish a cohort of breast cancer survivors in whom the role of PA, HRF in breast cancer outcomes can be examined. Specific objectives have been established for the five initial projects that will use this cohort. This large cohort will be built in Alberta over approximately a 4 year period with assessments at multiple time points using subjective and objective measures of PA, HRF, and health.

    Overview of Study Design and Methods

    A prospective cohort study is proposed that will recruit 1500 survivors of incident, histologically-confirmed, primary breast cancer from Edmonton (i.e., Cross Cancer Institute) and Calgary (i.e., Tom Baker Cancer Centre) who will be followed for a minimum of five years postbaseline assessment. A rapid case ascertainment method using the Alberta Cancer Registry (ACR) will be used to identify cases prior to surgery and to enrol them into this study. Assessments will be made at baseline (within 2 months of surgery and generally prior to the initiation of adjuvant therapy), and at 1 and 3 years follow-up of their PA, HRF, PROs, determinants of PA, and lymphedema through a combination of objective and self-reported measurements. PA, PROs and determinants of PA will be followed up at 5 years. Blood samples will also be taken at baseline, 1 and 3 years follow-up. The cohort members will be followed up by regular vital status linkages and through chart abstractions to identify progressions, recurrences, and new primaries that occur in this cohort. Five projects are initially proposed that will use this cohort to examine separate scientific questions regarding the associations between PA, HRF and breast cancer outcomes.

    Additional information about the AMBER Trial at www.amberstudy.com or email amberstudy@ualberta.ca

  • Colon Health and Life-Long Exercise Change

    Background

    Observational studies indicate that physical activity (PA) is strongly associated with improved disease outcomes in colon cancer survivors, but a randomized controlled trial is needed to determine whether the association is causal and whether new policies to promote exercise are justified.

    Purpose

    The CO.21 Colon Health and Life-Long Exercise Change (CHALLENGE) trial undertaken by the National Cancer Institute of Canada Clinical Trials Group (NCIC CTG) is designed to determine the effects of a structured PA intervention on outcomes for survivors of high-risk stage II or III colon cancer who have completed adjuvant therapy within the previous 2-6 months.

    Methods

    Trial participants (n = 962) will be stratified by centre, disease stage, body mass index, and performance status, and will be randomly assigned to a structured PA intervention or to general health education materials. The PA intervention will consist of a behavioural support program and supervised PA sessions delivered over a 3-year period, beginning with regular face-to-face sessions and tapering to less frequent face-to-face or telephone sessions. The primary endpoint is disease-free survival. Important secondary endpoints include multiple patient-reported outcomes, objective physical functioning, biologic correlative markers, and an economic analysis.

    Summary

    Cancer survivors and cancer care professionals are interested in the potential role of PA to improve multiple disease-related outcomes, but a randomized controlled trial is needed to provide compelling evidence to justify changes in health care policies and practice.

  • Intense Exercise for Survival among Men with Metastatic Castrate-Resistant Prostate Cancer

    Exercise is known to be safe and result in improved physical function and quality of life for most individuals with cancer. However, we know very little about whether exercise can increase overall survival and reduce disease progression, skeletal-related events and pain in patients with metastatic castrate-resistant prostate cancer.

    There are 2 arms which patients can be randomized onto on the INTERVAL Trial. Participants on both arms will receive usual care from their doctor, newsletters, questionnaires and periodic fitness testing. Those on the intervention arm will also perform 2 years of supervised exercise sessions made up of high intensity aerobic training and resistance training. The trial is worldwide multi-site trial looking to have 866 people join the trial - 45 of those will be from Edmonton.

    The INTERVAL Trial will help us determine if high intensity aerobic and resistance training plus psychosocial support increases overall survival compared to psychosocial support alone in prostate cancer patients. The INTERVAL Trial is proposing the use of exercise as medicine, concomitant with other therapies, to improve quality of life, improve drug efficacy, change tumor biology, and ultimately increase and prolong survival in metastatic castrate-resistant prostate cancer patients.

Student and Staff-Lead Studies

  • ERASE Trial Abstract

    Prostate cancer is the most common cancer in Canadian men. Most prostate cancer patients immediately receive expensive treatments including surgery, radiation therapy, and hormonal therapy that may cause serious side effects such as urinary or sexual dysfunction. To avoid these negative impacts, a clinical practice called “active surveillance” has been introduced for low-risk prostate cancer patients. In active surveillance, men do not receive any treatments unless or until their prostate cancer becomes clinically significant. Unfortunately, about a half of men eventually do need medical treatments due to tumour progression and/or fear of cancer progression.

    Interventions designed to slow tumour growth and reduce fear of cancer progression would represent a major advance in the care of these men. Exercise has been shown to delay the progression of prostate tumours in animal models by increasing immune function, however, no studies have been done in men with prostate cancer. Moreover, exercise can help manage some symptoms in prostate cancer patients but no study has examined fear of cancer progression. Right now, prostate cancer patients on active surveillance receive limited advice concerning exercise.

    The aims of this study are to provide evidence on the effects of exercise on (1) cardiorespiratory fitness, (2) biochemical progression of prostate cancer and cancer-related biomarkers, and (3) patient-reported outcomes including anxiety, fear of cancer progression, quality of life, and symptoms in prostate cancer patients undergoing active surveillance.

    Active surveillance is the preferred way of managing men with low-risk prostate cancer but many men still eventually need treatments. Exercise could be an effective intervention that can help men with prostate cancer remain on active surveillance longer by delaying tumour progression and reducing their fear of cancer progression. Ultimately, exercise may play an important role in improving long-term clinical outcomes and save significant medical costs related to prostate cancer treatment.

    For more information, click on this link www.ERASEstudy.com

  • BRAVE Trial Abstract

    Bladder cancer is the fifth most common cancer in Canada and has the eighth highest cancer mortality rate. The treatment for the most frequent type of bladder cancer is surgically removing the tumour followed by six weeks of medication placed within the bladder (intravesical therapy).

    There are physical and psychosocial challenges from bladder cancer and its treatment that may affect how patients feel and function, and consequently their quality of life. Moreover, bladder cancer patients are at a high risk of their bladder cancer recurrence and progression. Exercise is a low-cost intervention that may help patients feel better, manage side effects related to treatment, and improve quality of life. To date, however, no study has examined if it is safe or even possible for bladder cancer patients to exercise during intravesical therapy.

    The Bladder cancer and exeRcise trAining during intraVesical thErapy (BRAVE) Trial will be the first study to test the safety and feasibility of exercise in bladder cancer patients during this drug therapy. We will ask some patients to do a supervised exercise program during their drug treatment while other patients will be asked not to exercise. We will compare the 2 groups on how they fare with their bladder cancer treatment. The BRAVE study will provide information on whether exercise may help patients feel better, function better, and possibly even lower their chances of the disease coming back or getting worse. www.bravestudy.ca 

  • LIFTING Trial Abstract

    Despite improvements in treatments, head and neck cancer survivors (HNCS) still endure numerous acute and chronic side effects. Strength training has been shown to manage some of these side effects but most interventions have involved light-to-moderate resistance training programs. Heavy lifting strength training (HLST) may produce better outcomes but it is unknown if such a weight training program is feasible and safe for HNCS.

    The primary aim of this proposed study is to examine the feasibility and safety of a HLST program in HNCS at least 1 year post-surgical neck dissection.

    This single arm feasibility study will recruit 15-20 HNCS to complete the HLST program 2 times per week. Eligibility criteria are: 1) previously diagnosed with any subtype and stage of HNC; 2) at least 1 year post-neck dissection for HNC and showing full shoulder range of motion or recovery of the SAN as deemed adequate by neurological evaluation; 3) adults ages 18 and up; 4) no unmanaged medical conditions, alcohol, or drug abuse; 5) approved for a HLST program by the treating surgeon and a certified exercise physiologist; 6) ability to understand and communicate in English.

    The primary feasibility outcomes will include the eligibility rate (with reasons for ineligibility), recruitment rate (with reasons for refusal), 1RM testing rate (with reasons for not completing the test), program adherence (including attendance, dose modifications, and progression), and follow-up assessment rate (with reasons for drop out). The primary efficacy outcome will be strength gains from baseline. Secondary efficacy outcomes will include physical functioning, quality of life, post traumatic growth, fear of cancer recurrence, pain, body composition, anxiety, fatigue, stress, shoulder mobility, self-esteem, sleep, and motivation to engage in a heavy lifting strength training program.

    Weight training is an effective intervention in HNCS but the optimal weight training prescription is unknown. Heavy weight training has never before been explored in this cancer population; making the LIFTING trial the first of its kind. The development of this research idea stems from my 3 HNC experiences, and benefits from the sport of powerlifting. If HLST is deemed safe and feasible in HNCS, it can be compared to light-to-moderate load weight training to determine if it is a better prescription for improving outcomes that are important to HNCS. Additionally, future research may consider exploring this training style in other cancer types.

For Cancer Survivors

Our laboratory has a number of resources that may be helpful if you are a cancer survivor, or are caring for someone who is. Our focus is on the benefits of physical activity and our resources will help you to incorporate this all-important facet of your treatment into your wellness regimen.

All of these resources have been compiled from the numerous studies we have conducted in the Behavioural Medicine Laboratory.

You may download any of the resources in PDF format. Though these are copyrighted texts they are provided here for you to use as you journey to wellness, or support another in theirs.

Exercise for Health Guidebook. Download Exercise for Health: An Exercise Guide for Breast Cancer Survivors© in PDF format or open the guide (below). This guide book is designed to help breast cancer survivors increase their physical activity. View the guide here.