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THRIVEing and surviving: UMass Boston, Dana Farber team studies how exercise helps Black and Hispanic patients recover from chemo

Dr. Huimin Yan Image by: Gray Milkowski
Dr. Huimin Yan. Image by: Gray Milkowski

More than 650,000 people undergo chemotherapy treatments each year, and for anyone who has experienced it 鈥 or knows someone who has 鈥 the procedure takes a toll.

One of the serious side effects is a weakened cardiovascular system, something that scientists have spent years researching how to help patients recover from. Though they have had a great deal of success, the studies have had one problem 鈥 participants are overwhelmingly white.

鈥淏lack and Hispanic patients only make up six to eight percent of whole participants who are enrolled in those research studies,鈥 says , an assistant professor of exercise and health sciences. The outcome is that the results cannot be generalized for everyone, which is a barrier for people of color who need care.

It鈥檚 a problem that researchers from UMass Boston鈥檚 Manning College of Nursing and Health Sciences and the Dana Farber/Harvard Cancer Center (DF/HCC) are set on solving as part of a three-year, nearly $1 million study being funded by a  from the National Institutes of Health. Known as the THRIVE study, Yan is working with Professor of Nursing  and Dr. Christina Dieli-Conwright of DF/HCC to measure how home-based exercise improves participation and the cardiovascular health of Black and Hispanic patients receiving chemotherapy for breast, colorectal, and prostate cancer.

Dr. Laura Hayman
Dr. Laura Hayman鈥嬧嬧嬧

It鈥檚 research that is groundbreaking for two reasons: the team is exclusively working with Black and Hispanic cancer patients, and they are using next-generation technology and inclusive methods.

The research uses blood pressure as a key indicator of the subject鈥檚 cardiovascular health, but measuring it is a little different from the cuff you put on in a doctor鈥檚 office. Yan and her team use a machine to noninvasively measure aortic arterial pressure, which is a better predictor of future diseases.

Yan says the device 鈥渟enses the pressure at its highest, but then also all the way through.鈥 The generated pressure waveforms tell researchers how stiff the patient鈥檚 arteries are.

鈥淭he techniques Dr. Yan is using are really innovative technologies that are designed to be more predictive of those at risk for hypertension and other cardiovascular risks in oncology patients,鈥 said Hayman, an expert in cardiovascular disease risk factors and health disparities.

The study then asks patients to undergo an exercise regimen and track improvement, something that those in the medical field wouldn鈥檛 have dreamed of until recently.

鈥淚n the past people thought that if you're receiving chemotherapy, you're too tired or too fragile to exercise,鈥 says Yan. 鈥淏ut there is emerging evidence that suggests it鈥檚 feasible, and that's beneficial.鈥

One of the challenges that the study faces is overcoming mistrust of medical research in the Black and Hispanic communities, bred by a long history of malpractice and unethical treatment. It makes it difficult to recruit participants, but the study is built to get past this by meeting participants where they are. 

鈥淲e go to the community more, we talk to potential participants, and we explain what we鈥檒l be doing to them, and that鈥檚 really helped with recruitment,鈥 says Yan.

Recruiting student researchers who can have those conversations with participants has also helped.

鈥淚 welcome students with diverse backgrounds into my lab, because when they go out and talk to people to try and recruit them for research studies, they can relate more and can communicate better 鈥 there鈥檚 more trust,鈥 says Yan.

Dr. Yan and her team of students demonstrate how they would measure a patient's artery pliability.
Dr. Yan and her team of students demonstrate how they would measure a patient's artery pliability. 

The study also puts money and resources into inclusivity. Typical studies might ask for participants to travel to a lab to do their exercise, meaning that participation was much more difficult for people using public transit, who need to find childcare, or even pay for parking.

But Yan and her colleagues instead ask people to stay home. They send exercise equipment, iPads, Fitbits, and Wi-Fi hotspots to each participant, and by doing so, each person can have reliable internet, video call with researchers, and track their exercise without being impeded by travel or money. 

鈥淲e鈥檙e trying to make the intervention targeted to lower the barriers for our target population to exercise,鈥 says Yan.