An Open-label Randomized Trial of Exercise ± Creatine Supplementation to Augment the Adaptations of Exercise Training in Cancer Survivors

Inclusion criteria (Breast Cancer Group) * Age 18-75 years of age * Diagnosis of breast cancer requiring chemotherapy * Recent (within 6 months) completion of chemotherapy * Willing to attend 3 virtual-based exercise sessions per week * Able to take oral medications * Participant is willing and able to provide consent to participating in the study * Serum creatinine ≤ 1.5 x ULN or Estimated glomerular filtration rate (eGFR) ≥30 mL/min/1.73 m2 by Chronic Kidney Disease Epidemiology Collaboration equation. Exclusion criteria (Breast Cancer Group) * Physical indications where performing exercise may be limited and/or contraindicated * Poorly controlled hypertension (blood pressure \> 160/95mmHg) * Current tobacco use (within 6 months) * Anabolic steroids use * Pitting edema greater than 2+ * Currently undergoing chemotherapy treatment for cancer * History of moderate-severe heart disease (New York Heart Classification greater than grade II) or pulmonary disease (dyspnea on exertion upon climbing one flight of stairs or less; abnormal breath sounds on auscultation) * Pregnant or plan to become pregnant during the study * Recent (within one month) or anticipated treatment with corticosteroids (except for short term use during the time of chemotherapy), or other appetite stimulants * Serum creatinine \> 1.5 x ULN or Estimated glomerular filtration rate (eGFR) \< 30 mL/min/1.73 m2 by Chronic Kidney Disease Epidemiology Collaboration equation * Currently taking creatine supplements * Lack of availability to a smartphone and/or internet Inclusion Criteria (Healthy Age-matched Control Group) * Age 18-75 years of age * Have never been diagnosed with cancer * Willing to provide consent to participate in this study Exclusion Criteria (Healthy Age-matched Control Group) * Physical indications where performing exercise may be limited and/or contraindicated * Poorly controlled hypertension (blood pressure \> 160/95mmHg) * Current tobacco use (within 6 months) * Anabolic steroids use * Pitting edema greater than 2+ * History of cancer diagnosis * History of moderate-severe heart disease (New York Heart Classification greater than grade II) or pulmonary disease (dyspnea on exertion upon climbing one flight of stairs or less; abnormal breath sounds on auscultation) * Pregnant or currently taking prescribed medication to prepare for pregnancy (i.e. hormonal therapy for IVF) * Recent (within one month) treatment with corticosteroids * Recent (within one month) use of appetite stimulants or appetite suppressants * Serum creatinine \> 1.5 x ULN or Estimated glomerular filtration rate (eGFR) \< 30 mL/min/1.73 m2 by Chronic Kidney Disease Epidemiology Collaboration equation * Diagnosed Bipolar Disorder or MDQ score indicative of bipolar disorder or Neurological disorders * Uncontrolled diabetes (A1c of 6.5% or higher) * Currently taking creatine supplements * Lack of availability to a smartphone and/or internet