Exercise and Dietary Counseling in Improving Physical Activity, Nutrition, and Quality of Life in Older Long-Term Cancer Survivors Who Are Overweight

OBJECTIVES:

Primary

• Compare the physical function over 1 year of overweight older long-term cancer survivors assigned to immediate vs delayed exercise and dietary counseling.

Secondary

• Compare physical activity, saturated fat and vegetable and fruit intake, body mass index, depression, and general health and well being of experimental arm patients vs control arm patients.
• Evaluate self-efficacy, social support, comorbidity, cancer-type, and gender as factors associated with program efficacy.
• Determine the functional decline over a 2-year period in patients who undergo immediate vs delayed intervention.
• Characterize the mathematical form, over a 2-year period, of physical functioning trajectories among older cancer survivors, including determining if the intervention effects are durable in those who receive the intervention initially and whether "catch-up" is possible in the delayed intervention arm.

OUTLINE: This is a randomized study. Patients are stratified according to cancer type (colorectal vs breast or prostate), sex, age (65-74 years vs 75 years and over), and race (white vs non-white). Patients are randomized to 1 of 2 intervention arms.

• Arm I (immediate intervention): Patients receive a personalized notebook of diet and exercise information, exercise equipment, and logbooks to record food intake and exercise behaviors. Patients undergo 20-minute telephone discussions with a health counselor once weekly for 3 weeks, every 2 weeks for 2 months, and then monthly for up to 1 year for a total of 15 sessions. Patients also undergo a 5-minute telephone survey to assess health every 3 months.
• Arm II (delayed intervention): Patients undergo intervention as in arm I after a 1-year waiting period.

After completion of study intervention, patients are followed periodically for up to 2 years.

PROJECTED ACCRUAL: A total of 640 patients will be accrued for this study.

DISEASE CHARACTERISTICS:

• Diagnosed colorectal, prostate, or female breast cancer

• At least 5 years beyond date of diagnosis with no clinical evidence of progressive disease or second primaries
• Body mass index ≥ 25 kg/m^2 and < 40 kg/m^2
• Currently exercising < 150 minutes/week
• Hormone receptor status not specified

PATIENT CHARACTERISTICS:

• Menopausal status not specified
• No serious intercurrent medical condition or disability that could preclude study treatment, including any of the following:

• Severe orthopedic condition or scheduled hip or knee replacement within the next 6 months
• Paralysis
• End-stage renal disease
• Dementia
• Unstable angina
• Heart attack, congestive heart failure, or pulmonary condition that required oxygen or hospitalization within the past 6 months
• Ability to read, write, and speak English

PRIOR CONCURRENT THERAPY:

• No concurrent warfarin