Titles and Affiliations
Professor of Hematology Oncology
Department of Medicine
Research Area
Determining how much supervised exercise support is needed to improve health outcomes for breast cancer patients in order to make exercise a routine part of breast cancer care.
Impact
Regular physical activity during breast cancer treatment can reduce side effects, improve strength and quality of life, and support long-term recovery, which is why leading medical organizations now recommend exercise as part of standard care. Yet most patients never receive an exercise referral, largely because exercise programs are rarely covered by insurance. Dr. Schmitz’s research builds on earlier findings showing that supervised exercise during treatment reduced costly, unplanned medical care by more than the program cost, a compelling economic case for coverage. What remains unclear is how much supervision is actually needed to achieve these benefits, a critical question for patients, health systems, and insurers alike.
What’s Next
Dr. Schmitz’s RISE study will enroll women with early-stage breast cancer in a telehealth-based, home exercise program and compare three levels of coaching support: no supervised sessions, twelve sessions, or twenty-four sessions, all delivered virtually. The team will track participants’ medical care use and costs through health records, alongside their physical function, symptoms, and quality of life, while also capturing what level of coaching support patients themselves prefer during treatment. By identifying the most effective and efficient level of support, this research aims to make the economic case that insurers need to begin covering exercise programs, helping move exercise oncology out of the research setting and into standard, accessible care for more patients facing a breast cancer diagnosis.
Biography
Kathryn H. Schmitz, PhD, MPH is a tenured Professor at the University of Pittsburgh School of Medicine, Deputy Director and Associate Director of Population Sciences for the UPMC Hillman Cancer Center. Her training is in exercise physiology, epidemiology, and oncology. Through her work with outstanding collaborators, she has developed an international reputation as a leading voice in exercise oncology research, policy, and implementation. Her seminal work on exercise and breast cancer related lymphedema, published in JAMA and NEJM, led to clinical practice changes and altered guidelines from the National Cancer Institute, the Susan G. Komen Foundation, and the American Cancer Society. Prior to the PAL trial, all of these organizations guided breast cancer survivors to avoid lifting anything heavier than 5-15 pounds, ever again. Based on the results, guidelines from these major organizations have shifted to recommend slowly progressive strength training for all breast cancer survivors. The program is now commercially available and called Strength After Breast Cancer. Leadership of two ACSM Roundtables on exercise and cancer has led to additional advocacy work, including development of exercise related standards for both the National Accreditation Program for Breast Cancer (NAPBC) and the American College of Surgeons Commission on Cancer (ACOS COC) (forthcoming). Economic analyses she co-led has resulted in UPMC becoming the first U.S. based payer to provide exercise oncology as a covered benefit. She has enjoyed more than $60 million in continuous NIH research funding since 2001, with an H-index of 95 and over 56,000 citations of her work. A unique aspect of her current and previous exercise oncology clinical trials includes a blended focus on physical function improvements, assessment of biological parameters (inflammation, adipokines, telomeres), and assessment of implementation barriers and facilitators. She has also served on multiple NIH study sections, and as an editor for Exercise and Sports Science Reviews. She is the vice-chair of the Accreditations Committee for NAPBC and member of the Standards Committee for the ACOS COC. She currently lead or co-lead four NCI funded trials: THRIVE-65, Nurse AMIE, PA Moves, and DEFEND. These contributions culminated in an American College of Sports Medicine Citation Award, honorary fellowship in the Faculty of Sports and Exercise Medicine in Royal College of Surgeons, a Lifetime Achievement Award from the President’s Council on Fitness, among other awards.
