Digital Surgery Lab

Our Clinical studies examine the potential of physical exercise as a concurrent therapy along with standard care to counteract the overall side effect burden of breast cancer treatment resulting from fatigue, cardiotoxicity, neuropathies, and sleep disturbances. Examples of our clinical research include a 4 to 6 month randomized controlled trial that is examining the impact of supervised exercise on Ki67 among breast cancer patients undergoing neoadjuvant treatment (The Neoadjuvant Exercise Oncology Program – NEO -Program). We have other clinical trials in preparation to 1) examine whether resistance exercise can improve tolerability to cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) with endocrine therapy in estrogen receptor-positive (ER+)/Human Epidermal Receptor 2-negative (HER2-) breast cancers and 2) to determine whether physical exercise can improve sleep patterns during adjuvant hormone therapy in hormone-dependent (HR+) breast cancer.

Epidemiological studies use already existent data resources to expand our understanding of the role of physical activity and sleep in the etiology of cancer. Epidemiological studies are important to determine the distribution of risk factors for cancer such as physical inactivity or poor sleep in the population and quantify dose-response relationships between physical activity, sleep, and cancer risk and cancer survivorship. Examples of ongoing studies include our 1) examinations of the distribution of activity levels in the Portuguese population (n=8000 adults) using wearable measures of step counts and stepping intensity, and 2) examinations of associations between wearable-based sleep patterns and risk of mortality among adults (n=5000 adults).

Digital Health studies in our lab are examining the clinical value of wearable technology in oncology for the timely identification and monitorization of cancer treatment side effects including fatigue. These studies will allow for more individualized and proactive cancer treatments. We are particularly interested in identifying digital biomarkers of cancer outcomes using physical activity, exposure to light, and sleep measures, extracted from consumer and research-grade wearables. One example of a digital health study that we conducted recently includes the characterization of sleep patterns using a contactless sleep device among 25 women undergoing neoadjuvant chemotherapy and whose sleep patterns were monitored for 4 consecutive months throughout the entire duration of their treatment.