TY - JOUR
T1 - Weight management and physical activity throughout the cancer care continuum
AU - Demark-Wahnefried, Wendy
AU - Schmitz, Kathryn H.
AU - Alfano, Catherine M.
AU - Bail, Jennifer R.
AU - Goodwin, Pamela J.
AU - Thomson, Cynthia A.
AU - Bradley, Don W.
AU - Courneya, Kerry S.
AU - Befort, Christie A.
AU - Denlinger, Crystal S.
AU - Ligibel, Jennifer A.
AU - Dietz, William H.
AU - Stolley, Melinda R.
AU - Irwin, Melinda L.
AU - Bamman, Marcas M.
AU - Apovian, Caroline M.
AU - Pinto, Bernardine M.
AU - Wolin, Kathleen Y.
AU - Ballard, Rachel M.
AU - Dannenberg, Andrew J.
AU - Eakin, Elizabeth G.
AU - Longjohn, Matt M.
AU - Raffa, Susan D.
AU - Adams-Campbell, Lucile L.
AU - Buzaglo, Joanne S.
AU - Nass, Sharyl J.
AU - Massetti, Greta M.
AU - Balogh, Erin P.
AU - Kraft, Elizabeth S.
AU - Parekh, Anand K.
AU - Sanghavi, Darshak M.
AU - Morris, G. Stephen
AU - Basen-Engquist, Karen
N1 - Funding Information:
DISCLOSURES: The National Cancer Policy Forum Workshop was supported by the Centers for Disease Control and Prevention, the National Institutes of Health/National Cancer Institute, the American Association for Cancer Research, the American Cancer Society, the American College of Lifestyle Medicine, the American College of Radiology, the American College of Sports Medicine, the American Council on Exercise, the American Society for Radiation Oncology, the American Society of Clinical Oncology, the American Society of Hematology, the Association of American Cancer Institutes, AstraZeneca, Bristol-Myers Squibb, the Cancer Support Community, the CEO Roundtable on Cancer, Dana-Farber Cancer Institute, Flatiron Health, Helsinn Health care SA, the LIVESTRONG Foundation, the Medical Fitness Association, Merck Research Laboratories, the National Comprehensive Cancer Network, Novartis Oncology, the Oncology Nursing Society, the Penn State Cancer Institute, Pfizer Inc, and The University of Texas M. D. Anderson Cancer Center. Support for individual efforts were as follows: an American Cancer Society Clinical Research Professor Award (CRP-14-111-01-CPPB) and a grant from the National Cancer Institute (P30 CA13148; Wendy Denmark-Wahnefried and Jennifer R. Bail); Breast Cancer Research Foundation and Hold’Em for Life Charities (Pamela J. Goodwin); the National Cancer Institute (grant P30 CA023074; Christie A. Befort); an Australian National Health and Medical Research Council Senior Research Fellowship (APP1041789; Elizabeth G. Eakin); the National Institutes of Health (grant P2CHD086851; Marcas M. Bamman); and the Duncan Family Institute, the Cancer Prevention Research Institute of Texas (PP 130079 and PP170023), and the National Cancer Institute (P30 CA 16672; Karen Basen-Enquist). Kathryn H. Schmitz reports a copyright on Strength After Breast Cancer educational materials, with royalties paid to the University of Pennsylvania. Crystal S. Denlinger reports personal fees and other support from Eli Lilly and Company and Merrimack Pharmaceuticals; personal fees from Merck, EMD Serono, and Carevive; and other support from Bristol-Myers Squibb, MedImmune LLC, Advaxis, Genentech, InCyte Corporation, OncoMed, Astex Pharmaceuticals, and Macrogenics, outside the submitted work. Caroline M. Apovian reports personal fees from Nutrisystem, Zafgen, Sanofi-Aventis, NovoNordisk, Scientific Intake, Merck, and Johnson and Johnson; grants and personal fees from Orexigen, GI Dynamics, Takeda, and Gelesis; grants from Aspire Bariatrics, Myos, the Vela Foundation, the Dr. Robert C. and Veronica Atkins Foundation, Coherence Lab, Energesis, and PCORI; and other support from Science-Smart LLC, outside the submitted work. Kathleen Y. Wolin reports personal fees from Coeus Health and ScaleDown, outside the submitted work; in addition, she has a patent pending for a digital weight management platform. Erin P. Balogh and Sharyl J. Nass report research funding from AstraZeneca, Bristol-Myers Squibb, Flatiron Health, Helsinn Health care SA, the Medical Fitness Association, Merck Research Laboratories, Novartis Oncology, and Pfizer Inc, outside the submitted work. The remaining authors made no disclosures.
Funding Information:
Healthy Living after Cancer (HLaC) is a partnership project among 4 Australian state-based Cancer Councils, which are funded by the Australian National Health and Medical Research Council. It is evaluating the implementation of an evidence-based, 6-month, telephone-delivered lifestyle program, delivered by the Cancer Councils through their national cancer information and support service. HLaC is provided free of charge to cancer survivors with any type cancer after treatment with curative intent. It provides behaviorally based support to achieve internationally agreed recommendations for PA, healthy eating, and healthy weight. In this phase 4 dissemination study (single-group, pre-post design with assessments at baseline and 6 months), primary outcomes relate to program implementation: adoption (referral sources); reach (number of participants) and retention; fidelity of implementation; participant and staff satisfaction; and fixed and recurrent program costs. Secondary outcomes are patient-reported and validated measures of weight, PA, dietary intake/behavior, QOL, cancer-related side effects, and fear of recurrence. To date, 500 patients have enrolled (89% women; mean age [6 standard deviation], 55 6 11 years; average BMI [6 standard deviation], 29 6 6 kg/m2), with a wide range of cancers. The retention (program completion) rate is 57%. Among the first 200 program completers, significant (P < .05) and clinically meaningful improvements have been seen in all secondary, patient-reported outcomes. This collaborative undertaking provides an opportunity for national dissemination of an evidence-based intervention to support healthy living among cancer survivors. Rigorous evaluation of service-level and patient-reported outcomes will provide the practice-based evidence needed to achieve sustained support.
Publisher Copyright:
© 2017 American Cancer Society
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Mounting evidence suggests that weight management and physical activity (PA) improve overall health and well being, and reduce the risk of morbidity and mortality among cancer survivors. Although many opportunities exist to include weight management and PA in routine cancer care, several barriers remain. This review summarizes key topics addressed in a recent National Academies of Science, Engineering, and Medicine workshop entitled, “Incorporating Weight Management and Physical Activity Throughout the Cancer Care Continuum.” Discussions related to body weight and PA among cancer survivors included: 1) current knowledge and gaps related to health outcomes; 2) effective intervention approaches; 3) addressing the needs of diverse populations of cancer survivors; 4) opportunities and challenges of workforce, care coordination, and technologies for program implementation; 5) models of care; and 6) program coverage. While more discoveries are still needed for the provision of optimal weight-management and PA programs for cancer survivors, obesity and inactivity currently jeopardize their overall health and quality of life. Actionable future directions are presented for research; practice and policy changes required to assure the availability of effective, affordable, and feasible weight management; and PA services for all cancer survivors as a part of their routine cancer care. CA Cancer J Clin 2018;68:64-89.
AB - Mounting evidence suggests that weight management and physical activity (PA) improve overall health and well being, and reduce the risk of morbidity and mortality among cancer survivors. Although many opportunities exist to include weight management and PA in routine cancer care, several barriers remain. This review summarizes key topics addressed in a recent National Academies of Science, Engineering, and Medicine workshop entitled, “Incorporating Weight Management and Physical Activity Throughout the Cancer Care Continuum.” Discussions related to body weight and PA among cancer survivors included: 1) current knowledge and gaps related to health outcomes; 2) effective intervention approaches; 3) addressing the needs of diverse populations of cancer survivors; 4) opportunities and challenges of workforce, care coordination, and technologies for program implementation; 5) models of care; and 6) program coverage. While more discoveries are still needed for the provision of optimal weight-management and PA programs for cancer survivors, obesity and inactivity currently jeopardize their overall health and quality of life. Actionable future directions are presented for research; practice and policy changes required to assure the availability of effective, affordable, and feasible weight management; and PA services for all cancer survivors as a part of their routine cancer care. CA Cancer J Clin 2018;68:64-89.
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U2 - 10.3322/caac.21441
DO - 10.3322/caac.21441
M3 - Review article
C2 - 29165798
AN - SCOPUS:85034752047
SN - 0007-9235
VL - 68
SP - 64
EP - 89
JO - Ca-A Cancer Journal for Clinicians
JF - Ca-A Cancer Journal for Clinicians
IS - 1
ER -