Home-based interventions improved elderly cancer survivors' ability to function

November 18, 2008

WASHINGTON, D.C. - Climbing stairs, carrying groceries, taking a shower - these are activities that we take for granted; however, after a cancer diagnosis, many survivors are unable to function as they used to. Home-based diet and exercise interventions may improve physical functioning in older, long-term cancer survivors, according to data presented at the American Association for Cancer Research's Seventh Annual International Conference on Frontiers in Cancer Prevention Research.

Wendy Demark-Wahnefried, Ph.D., professor of behavioral science at the University of Texas M. D. Anderson Cancer Center, focused this study on survivors older than 65 years old. She said this age group often suffers long-term side effects of cancer and its treatment which could threaten the ability to live independently. "Younger cancer patients are usually able to bounce back, but older patients may need a structured program to stop functional decline and retain independence," said Demark-Wahnefried.

Demark-Wahnefried and colleagues identified 20,015 cancer survivors from cancer registries and self-referral sources. Of these cases, 1,208 were screened and 641 participants were enrolled in the trial. To be included, patients had to be older than 65 years, have survived their cancer for at least five years with no evidence of recurrence, have no medical conditions that would preclude unsupervised exercise, and be overweight or obese.

Participants were randomly assigned to an intervention or a wait-list control group. Those in the intervention group received tailored mailed print materials on diet and exercise, a pedometer and exercise bands. For the first three weeks, participants received weekly phone calls, which tapered off to every two weeks and then once a month until the end of the study.

At the end of one year, researchers evaluated physical function, diet quality and physical activity using standard measures. Participants in the intervention group demonstrated significant improvements in their diet and exercise behaviors, and their weight status. What's more, according to the SF-36 physical function test, participants in the intervention group had a 2.5 point decline compared with a 5.3 point decline in the control group. Similar differences were seen in measures of basic lower extremity and advanced lower extremity functioning. Overall, the magnitude of effect was similar to preventing physical function losses comparable to that imposed by ischemic heart disease.

The ability to perform moderate to vigorous physical activity improved as well. In the intervention group, participants increased their ability by 44.9 minutes a week compared with 29.7 minutes per week in the control group.

Body mass index declined by 0.8 in the active group compared with 0.3 in the control group.

Demark-Wahnefried said these findings are important because the number of cancer survivors is skyrocketing, and we're just beginning to see the long-term health effects of the disease and its treatment. Given current economic concerns, such research is particularly relevant.

"Last year alone, we spent $219 billion on cancer care, but only 40 percent of that was spent on treatment," said Demark-Wahnefried. "The majority of costs were due to lost productivity and health problems that surfaced afterwards."

The current study did not directly assess cost-effectiveness, but Demark-Wahnefried said she expects to see cost savings when they conduct further studies.
The mission of the American Association for Cancer Research is to prevent and cure cancer. Founded in 1907, AACR is the world's oldest and largest professional organization dedicated to advancing cancer research. The membership includes more than 28,000 basic, translational and clinical researchers; health care professionals; and cancer survivors and advocates in the United States and 80 other countries. The AACR marshals the full spectrum of expertise from the cancer community to accelerate progress in the prevention, diagnosis and treatment of cancer through high-quality scientific and educational programs. It funds innovative, meritorious research grants. The AACR Annual Meeting attracts more than 17,000 participants who share the latest discoveries and developments in the field. Special conferences throughout the year present novel data across a wide variety of topics in cancer research, treatment and patient care. The AACR publishes five major peer-reviewed journals: Cancer Research; Clinical Cancer Research; Molecular Cancer Therapeutics; Molecular Cancer Research; and Cancer Epidemiology, Biomarkers & Prevention. The AACR's most recent publication and its sixth major journal, Cancer Prevention Research, is dedicated exclusively to cancer prevention, from preclinical research to clinical trials. The AACR also publishes CR, a magazine for cancer survivors and their families, patient advocates, physicians and scientists. CR provides a forum for sharing essential, evidence-based information and perspectives on progress in cancer research, survivorship and advocacy.

American Association for Cancer Research

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