Elia Rishis has always had a passion for physical activity. She grew up swimming competitively and feels grateful that swimming, and sports in general, have allowed her to reap the physical, mental and social benefits of physical activity.
These experiences in sport inspired her to pursue a bachelor of science in kinesiology and health sciences at York University, where she completed an undergraduate thesis in sport psychology with Joseph (Joe) Baker, now a professor of sport science at the University of Toronto Faculty of Kinesiology and Physical Education (KPE) and chair in sport science, data modelling and sports analytics at the Tanenbaum Institute for Science in Sport (TISS).
“I truly enjoyed the multidisciplinary nature of kinesiology, ranging from physiology and anatomy to the sociocultural perspectives and was eager to use my lifelong passion for research to investigate the benefits of physical activity with a master of science in kinesiology at U of T,” says Rishis, who graduated from KPE this spring.
Having lost close family members to heart failure and cancer, Rishis was particularly drawn to the study of cardio-oncology, an area of research spearheaded by Assistant Professor Amy Kirkham at KPE.
Members of Amy Kirkham's lab, with Kirkham in the middle wearing a black shirt and Elia Rishis to the right of her in a striped beige sweater
“My personal experiences, but also the novelty of this field, made me want to learn more about the disease that affected my family and millions of other Canadians,” says Rishis. “I was particularly drawn to U of T given its affiliation with some of the leading teaching and research hospitals across Canada which provided students like myself with access to incredible mentors and clinical opportunities that shaped my learning experience.”
Under the supervision of Kirkham, who also holds an affiliate scientist status at the Toronto Rehabilitation Institute (RHI), Rishis investigated the effectiveness of the 16-week Health, Exercise, Active Living and Therapeutic Lifestyle (HEALTh) program, a cardiac rehabilitation program at TRI designed specifically for women with breast cancer, who are at risk of heart disease.
“Breast cancer is the most diagnosed cancer among women in Canada,” says Rishis, “however while breast cancer deaths have dramatically declined since their peak in 1986, this has been accompanied by the recognition that breast cancer survivors are then at a three to six times elevated risk of cardiovascular disease (CVD) death.”
The increased CVD risk, Rishis explains, is attributed to breast cancer therapies that cause heart muscle injury and dysfunction, which are deemed to be ‘cardiotoxic’. Adding to this risk are unhealthy lifestyle behaviours such as physical inactivity and poor diet that persist during and after treatment. Due to this elevated CVD risk, the American Heart Association released a position statement in 2019, recommending the use of multimodal cardiac rehabilitation to reduce CVD risk in cancer survivors.
Rishis’ thesis is the first to prospectively evaluate the effectiveness of a multimodal CR program in reducing CVD risk in women with breast cancer.
“My work found that a cardiac rehabilitation program tailored to women with breast cancer was effective at improving their VO2peak, which is the gold standard measure of cardiorespiratory fitness and one of the most robust measures of health, longevity and CVD risk,” says Rishis. “Women in the program also experienced significant improvement in their diet quality, cancer-related fatigue and physical activity behaviours."
Rishis hopes these results can be applied toward future funding of cardio-oncology rehabilitation programs across Canada so that more women with breast cancer can experience the benefits of these programs to live longer and healthier lives.
“Completing a master’s degree at KPE/UofT was one of the best decisions of my life,” says Rishis. “I experienced an immense amount of academic and personal growth during this time.
“I can attribute much of this to Amy who pushed me outside of my comfort zone and presented me with numerous opportunities that allowed me to challenge myself.”
While working on her master’s thesis, Rishis also worked on other research projects that enabled her to develop a variety of skills. For instance, prior to beginning her thesis, she served as a project manager for the Kirkham lab’s first clinical trial involving 183 women across Ontario taking part in a four-month nutrition intervention.
“This was my first time managing a study of this scale and I quickly learned the value and importance of independence, critical thinking and leadership, as I navigated unforeseen technical and equipment errors, building participant rapport while managing a 10+ person research team,” says Rishis.
Another component Rishis valued during her time as a master’s student at KPE was the inter and cross-faculty collaboration with other students and labs to learn more about their research and how they can build on each other’s work and collaborate.
Rishis especially enjoyed collaborating with students and labs across KPE and beyond. In this picture, Rishis is standing behind Assistant Professor Robert Bentley, who is at the bottom left. Assistant Professor Jenna Gillen is standing on the bottom right, with Associate Professor Dan Moore behind her.
“In fact, as part of our first clinical trial, we developed several sub-studies that enabled collaboration with Assistant Professor Jenna Gillen’s lab, who specialize in glucose metabolism and graciously shared their extensive knowledge on using novel tools/technology,” says Rishis. “To me, experiences like this solidified my appreciation of a team-based approach to science and research and showed me just how much you can learn through collaboration.”
Another academic highlight and experience she’ll cherish from her master’s degree, was the opportunity to present at national and international conferences.
“Seeing your work come to fruition after a lengthy process and finally be able to share it with participants, patients and other experts in the field was exciting,” says Rishis, who is keen to give a shout out to all her lab-mates, especially the first graduate lab members: Stephanie Small, Barbara de Barros Gonze, Alfred Min, Julia Rickard, Alex Dojutrek, Donya Merza and Rebecca Christensen.
“Thank you for the cries, laughs and support,” she says. “I also must acknowledge the staff at the Toronto Rehabilitation Institute and HEALTh program, including the medical director, Dr. Paul Oh, who were all so kind and supportive of research.
“Learning to balance the various roles of a graduate student took some time but with the help of many calendars to stay on top of deadlines and my support system, which included friends and family, I learned to take a deep breath, manage my stress and juggle it all to the best of my ability.”
Those skills will serve her well come September when she starts medical school at U of T’s Temerty Faculty of Medicine – her ultimate goal.
“I knew from a young age that I wanted to become a doctor,” says Rishis. “The experiences and opportunities I was afforded during my master’s degree, working with breast cancer survivors at the Toronto Rehabilitation Institute and Sunnybrook Health Sciences Centre, exposed me to clinical medicine and allowed me to work within a team of interdisciplinary healthcare professionals.
“These experiences solidified how much I enjoyed hearing patient’s stories, the inquisitive nature of research and continuous learning, and reaffirmed my desire to pursue medicine.
Kirkham is not surprised by the path Rishis is pursuing – or her success in getting to this point.
“When I first interviewed Elia about joining my lab, she was clear about her goal of pursuing medical school and wanting to practice medicine and research in the area of women’s cardiovascular health,” says Kirkham. “I am so proud of her accomplishments during her MSc in my lab - it’s extremely satisfying that I could play a small role in helping her to achieve her goals.”
Kirkham, who says she aspires to make her research program a conduit for developing the next generation of scientists and healthcare practitioners who will consider sex and gender as a forethought for every study and every patient, is confident Rishis will be a strong advocate for women’s health in her future career in medicine.
Rishis’ message to students entering the graduate program in the fall is to enjoy it.
“It may seem overwhelming at first and from time to time, but it’s well worth it in the end,” she says. “Time flies, so don’t forget to celebrate the small wins as you work towards your larger goals.
“But also, don’t forget to take care of yourself. Find your people. Find your support system. Find doing things you love. For me, that came in the form of a run, workout and reading - a non-journal article.”
Rishis says she hopes - and expects - the next several years in med. school will challenge her, “but If I’ve learned anything from my master’s, it’s to accept new challenges and opportunities that afford growth and improvement.”
Kirkham approves of that message.
“I often tell my graduate students that if they don’t feel uncomfortable at times then they aren’t learning and growing,” she says. “Elia embraces this sentiment in pursuit of the lofty goals she sets for herself.”