Introduction Non-muscle invasive bladder cancer (NMIBC) accounts for about 75% of newly diagnosed bladder cancers. The treatment for NMIBC involves surgical removal of the tumour followed by 6 weekly instillations of immunotherapy or chemotherapy directly into the bladder (ie, intravesical therapy). NMIBC has a high rate of recurrence (31%–78%) and progression (15%). Moreover, bladder cancer and its treatment may affect patient functioning and quality of life. Exercise is a safe and effective intervention for many patient with cancer groups, however, no studies have examined exercise during intravesical therapy for NMIBC. The primary objective of the Bladder cancer and exeRcise trAining during intraVesical thErapy (BRAVE) trial is to examine the safety and feasibility of an exercise intervention in patients with bladder cancer undergoing intravesical therapy. The secondary objectives are to investigate the preliminary efficacy of exercise on health-related fitness and patient-reported outcomes; examine the social cognitive predictors of exercise adherence; and explore the potential effects of exercise on tumour recurrence and progression. Methods and analysis BRAVE is a phase II randomised controlled trial that aims to include 66 patients with NMIBC scheduled to receive intravesical therapy. Participants will be randomly assigned to the exercise intervention or usual care. The intervention consists of three supervised, high-intensity interval training sessions per week for 12 weeks. Feasibility will be evaluated by eligibility, recruitment, adherence and attrition rates. Preliminary efficacy will focus on changes in cardiorespiratory fitness and patient-reported outcomes from baseline (prior to intravesical therapy) to pre-cystoscopy (3 months). Cancer outcomes will be tracked at 3 months, and 1-year follow-up by cystoscopy. Analysis of covariance will compare between-group differences at post-intervention (pre-cystoscopy) for all health-related fitness and patient-reported outcomes. Ethics and dissemination The study was approved by the Health Research Ethics Board of Alberta-Cancer Committee (#20–0184). Dissemination will include publication and presentations at scientific conferences and public channels. Trial registration number NCT04593862; Pre-results.

Background/Objectives: Early-stage breast cancer treatments adversely affect components of health-related fitness (HRF) important for treatment tolerability, recovery, and long-term outcomes. Few studies have examined cancer treatment modality-specific effects on HRF. We examined associations of breast cancer treatment modalities, regimens, and combinations with one-year changes in HRF. Methods: Newly diagnosed early-stage breast cancer patients were recruited between 2012 and 2019 for the Alberta Moving Beyond Breast Cancer (AMBER) cohort study. HRF assessments were completed within 90 days of diagnosis and at one year, including cardiorespiratory fitness, muscle strength and endurance, and body composition. Analysis of covariance was used to test whether HRF changes differed between treatment modalities, regimens, and combinations. All tests were 2-sided. Results: A total of 1350 participants (mean [SD] age, 55.6 [10.7] years) were included. Women who received chemotherapy (n = 797; 59%) experienced statistically significant smaller increases in upper body strength (−1.7 kg, 95% confidence interval [CI]: −3.0 to −0.5), greater declines in lower body endurance (−118.0 kg, 95%CI: −216.6 to −19.3), and greater declines in total lean mass (−0.7 kg, 95%CI: −1.1 to −0.3), bone mineral density (−0.01 g/cm², 95%CI: −0.02 to 0.00), and bone mineral content (0.04 kg, 95%CI: −0.06 to −0.02). Other treatment modalities were modestly and inconsistently associated with HRF changes. Treatment combinations that included chemotherapy had the most negative impact on cardiorespiratory fitness and body composition. Conclusions: Chemotherapy—either alone or in combination with other treatments—had the largest and broadest negative impact on HRF recovery in early-stage breast cancer at one-year follow-up.

Background: Colon Health and Life-Long Exercise Change (CHALLENGE) was the first phase 3 trial to examine the effects of exercise on cancer-related survival and, therefore, required a substantial and sustained increase in moderate-to-vigorous physical activity (MVPA) that had not been achieved in previous trials. Here, we report the effects of the intervention on the social cognitive beliefs that were targeted to achieve long-term exercise behavior change. Methods: Patients with resected colon cancer who had completed chemotherapy were randomized to health education materials (HEM) or a structured exercise program (SEP) consisting of 48 behavioral support sessions delivered over a 3-year period. Social cognitive constructs from the Theory of Planned Behavior were assessed by single items using 5-point scales at baseline and every 6 months during the 3-year intervention. Regression models for repeated measurements were used to estimate the least square means and robust standard errors (SEs) for each randomized group at each time point. Results: Between 2009 and 2024, 889 patients were randomized to SEP (n = 445) or HEM (n = 444). SEP compared to HEM reported significantly more favorable social cognitive beliefs about exercise at almost all time points. Average intervention effects (AIE) across the 3-year intervention favored SEP for perceived benefit (AIE = 0.29; P < .001), enjoyment (AIE = 0.40; P < .001), difficulty (AIE = −0.18; P = .003), confidence (AIE = 0.28; P < .001), support (AIE = 0.59; P < .001), motivation (AIE = 0.47; P < .001), opportunity (AIE = 0.31; P < .001), and planning (AIE = 0.82; P < .001). All social cognitive variables were significantly associated with self-reported MVPA at all time points. Conclusions: The SEP intervention in the CHALLENGE trial successfully targeted the social cognitive beliefs that were associated with sustained MVPA. NCT00819208.