Grant Number:	1R03CA282955-01A1 Interpret this number
Primary Investigator:	Preston, Mark
Organization:	Brigham And Women'S Hospital
Project Title:	Informing Lifestyle Recommendations for Kidney Cancer Survival: Investigating the Role of Dietary Patterns and Physical (IN)ACTIVITY
Fiscal Year:	2024

PROJECT SUMMARY Renal cell carcinoma (RCC) accounts for 4.1% of new cancer cases in the United States (US) – 1 out of every 25 diagnoses – and the number of individuals living with the disease has consistently increased over the past five decades. When patients are diagnosed with RCC, they often ask: “What can I do to improve my chance of survival?” A cancer diagnosis is a “teachable moment,” a time when an individual may be open to behavior change. But what behaviors should be endorsed? As yet, sufficient data are unavailable to give evidence-based, disease-specific lifestyle recommendations. Few studies have considered modifiable behaviors that might improve survival. Such studies are imperative given that 14,000 individuals die from RCC in the US each year. As such, we seek to comprehensively study the associations of dietary patterns and physical activity with RCC survival using data from three large, prospective cohorts: the Health Professionals Follow-up Study, Nurses’ Health Study, and Nurses’ Health Study 2. These cohorts are unique in their collection of repeated food frequency questionnaires (FFQs), physical activity assessments, and extensive covariable data, both before and after diagnosis. They also include more than 1000 confirmed cases of RCC, among whom roughly 300 have died from disease. In Aim 1, we will use FFQs to compute pre- and post- diagnostic adherence to the alternative healthy eating index (AHEI) and Dietary Approaches to Stop Hypertension (DASH), type 2 diabetes prevention, inflammatory, and insulinemic diets. We will then evaluate RCC-specific and overall mortality among RCC patients in relation to adherence to each pattern post-diagnosis and change in adherence to each pattern from pre- to post-diagnosis. Due to its impact on hypertension, we hypothesize that adherence to the DASH diet will be most strongly protective against RCC-specific mortality, even relative to an otherwise healthy diet (AHEI). In Aim 2, we will evaluate RCC-specific and overall survival among RCC patients in relation to post-diagnostic physical activity (including by volume, type, and intensity), post-diagnostic sedentary behavior, and pre- to post-diagnosis change in physical (in)activity levels. We hypothesize that increasing physical activity will be associated with a reduced risk of RCC-specific mortality and that increasing sedentary behavior will be associated with a greater risk of RCC-specific mortality. Results will offer first ever insights into dietary choices that improve RCC survival, and results regarding physical (in)activity will be borne from analyses including over five times the number of outcomes as had the prior pertinent study. Our research will thus yield a foundation for developing evidence-based lifestyle recommendations for RCC survivors. Only equipped with data from rigorous and well powered research can we offer RCC patients some self-determined control over their outcomes.





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