Can Lifestyle Changes Improve Outcomes in Breast Cancer?
Network - Winter 2012
They’ll kick up their exercise a notch, learn how to shop for and prepare healthy meals, and practice stress reduction techniques.
All under the watchful eye of trained coaches.
Perhaps most important, they’ll do these things with others in the same boat.
“They” will be 120 breast cancer patients recruited from MD Anderson’s Nellie B. Connally Breast Center and Department of Radiation Oncology to test the premise that comprehensive integrative oncology, including certain lifestyle and behavior changes, may strengthen the body’s defenses against cancer.
In an ambitious clinical trial set to begin next summer, researchers from the Integrative Medicine Program and the departments of General Oncology and Behavioral Science will explore whether improving patients’ diet and nutrition, levels of physical activity, stress management and social engagement can help them avoid a recurrence and increase survival.
A control group will receive the standard of care without the lifestyle interventions. Both groups will be monitored regularly for immune function, endocrine function, insulin and glucose metabolism, and more.
A cancer cell doesn’t grow in a vacuum
Though we all have premalignant cells in our bodies, not all of them grow or become malignant.
The tumor microenvironment — the environment surrounding the cells including immune cells, blood vessels, proteins, and other molecules — plays an important part in whether cancer cells survive and multiply, are killed by the system or undergo spontaneous death.
The trial will test whether conscious efforts to strengthen the body’s natural defenses against cancer can make a difference.
Funded by the Servan-Schreiber/Cohen Anticancer Fund, the trial will explore several components as part of the comprehensive, integrative oncology intervention:
- dietary coaching to help reach or maintain a healthy weight and focus on eating an anti-cancer diet,
- supporting daily physical activity,
- practical tools for managing stress, and
- fostering social connection and mindfulness in all aspects of life.
Cohen worked closely with the late David Servan-Schreiber, M.D., Ph.D., to design the trial.
Servan-Schreiber, who died in July 2011 of a brain cancer recurrence, was a physician, neuroscientist and author of the New York Times bestseller "Anticancer: A New Way of Life." He was also an adjunct professor in the section of Integrative Medicine in MD Anderson's Department of General Oncology.
Although the study will be conducted only at MD Anderson, if the results are positive, it may set an example for other cancer centers around the world.
Coaching of new behaviors, peer support
The study is designed to take advantage of patients’ daily visits to the Radiation Treatment Center.
Three times a week, they will attend sessions. A once-a-week group class will teach cooking skills and foster sharing among study members.
“This lifestyle coaching will be incorporated into participants’ radiation therapy treatment,” Cohen says. “It’s a teachable moment, because they’re at MD Anderson every day during this time.”
When radiation therapy ends, participants will have weekly meetings with their coaches over the computer. They’ll continue to be monitored carefully and can keep track of their progress throughout the trial on a web-based portal.
“We want to encourage optimal health and well-being for these patients, based on the evidence on what lifestyle factors should lead to improved outcomes,” Cohen says.