Grant Number:	5R21CA092468-02 Interpret this number
Primary Investigator:	Demark-Wahnefried, Wendy
Organization:	Duke University
Project Title:	Strength-Survivor Training for Enhancing Total Health
Fiscal Year:	2002

DESCRIPTION (provided by applicant): Weight gain is a common side effect that accompanies adjuvant chemotherapy for breast cancer. While the phenomenon of weight gain is consistent, the magnitude is greater among patients who receive multi-agent, high dose regimens and among those who are younger (25 percent of premenopausal patients gain over 11 kg during treatment). Patients report weight gain as "distressing" There also is evidence that weight gain adversely affects disease-free survival, and predisposes women to cardiovascular disease and diabetes. Chemotherapy-induced weight gain also is distinct - patients lose muscle as they gain adipose tissue, thus calling for interventions that promote exercise. In a preliminary study, we found that losses in muscle and gains in fat can be prevented if patients participate in a clinic-based program that promotes specific exercises and a low fat, high vegetable and fruit diet during the time they receive treatment. While these data are encouraging, few patients participated due to barriers of travel. Since many cancer patients travel long distances to receive care, the purpose of this R21 application is to ascertain whether home-based exercise interventions are feasible using the framework of the cooperative group (Cooperative Community Oncology Program (CCOP)) and show promise for further testing in a larger group setting, such as the Cancer and Leukemia Group B (CALGB). We have adapted our program that was based in a state-of-the-art fitness facility to portable gym equipment, and have developed accompanying materials (i.e., videotapes and manuals), as well as a program of telephone counseling. We also have obtained the support of the Wake Forest Research Base CCOP to help us ascertain whether a home-based exercise program bears promise and is feasible to implement and test using the infrastructure of the cooperative group. We propose a study that will measure the effects of an exercise alone or exercise plus diet intervention on preventing weight gain and adverse changes in body composition, reducing depression, improving quality of life and influencing biomarkers associated with breast cancer and other co-morbid conditions (i.e., insulin, insulin-like growth factor-i, sex hormone binding globulin and lipoprotein profiles). We propose a pilot study where these endpoints will be assessed at baseline and 6 months post-diagnosis in 90 premenopausal early stage breast cancer patients who will receive adjuvant chemotherapy and are block randomized into 1 of 3 study arms (attention control, exercise alone or exercise plus diet). If data show promise, further and larger study will be pursued - study which will be focused on testing an optimal intervention and powered on known effect sizes.




Promoting a healthy lifestyle among cancer survivors.
Authors: Demark-Wahnefried W. , Jones L.W. .
Source: Hematology/oncology Clinics Of North America, 2008 Apr; 22(2), p. 319-42, viii.
PMID: 18395153
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Results Of A Diet/exercise Feasibility Trial To Prevent Adverse Body Composition Change In Breast Cancer Patients On Adjuvant Chemotherapy
Authors: Demark-Wahnefried W. , Case L.D. , Blackwell K. , Marcom P.K. , Kraus W. , Aziz N. , Snyder D.C. , Giguere J.K. , Shaw E. .
Source: Clinical Breast Cancer, 2008 Feb; 8(1), p. 70-9.
PMID: 18501061
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Move onward, press forward, and take a deep breath: can lifestyle interventions improve the quality of life of women with breast cancer, and how can we be sure?
Authors: Demark-Wahnefried W. .
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2007-10-01 00:00:00.0; 25(28), p. 4344-5.
EPub date: 2007-10-01 00:00:00.0.
PMID: 17785702
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Lifestyle interventions in cancer survivors: designing programs that meet the needs of this vulnerable and growing population.
Authors: Stull V.B. , Snyder D.C. , Demark-Wahnefried W. .
Source: The Journal Of Nutrition, 2007 Jan; 137(1 Suppl), p. 243S-248S.
PMID: 17182834
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Promoting health and physical function among cancer survivors: potential for prevention and questions that remain.
Authors: Demark-Wahnefried W. , Pinto B.M. , Gritz E.R. .
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2006-11-10 00:00:00.0; 24(32), p. 5125-31.
PMID: 17093274
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The older cancer survivor.
Authors: Rao A.V. , Demark-Wahnefried W. .
Source: Critical Reviews In Oncology/hematology, 2006 Nov; 60(2), p. 131-43.
PMID: 16965920
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Riding the crest of the teachable moment: promoting long-term health after the diagnosis of cancer.
Authors: Demark-Wahnefried W. , Aziz N.M. , Rowland J.H. , Pinto B.M. .
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2005-08-20 00:00:00.0; 23(24), p. 5814-30.
EPub date: 2005-08-20 00:00:00.0.
PMID: 16043830
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Nutrition-related issues for the breast cancer survivor.
Authors: Demark-Wahnefried W. , Rock C.L. .
Source: Seminars In Oncology, 2003 Dec; 30(6), p. 789-98.
PMID: 14663779
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Can lifestyle modification increase survival in women diagnosed with breast cancer?
Authors: Rock C.L. , Demark-Wahnefried W. .
Source: The Journal Of Nutrition, 2002 Nov; 132(11 Suppl), p. 3504S-3507S.
PMID: 12421877
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Nutrition and survival after the diagnosis of breast cancer: a review of the evidence.
Authors: Rock C.L. , Demark-Wahnefried W. .
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2002-08-01 00:00:00.0; 20(15), p. 3302-16.
PMID: 12149305
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Preventing Sarcopenic Obesity Among Breast Cancer Patients Who Receive Adjuvant Chemotherapy: Results Of A Feasibility Study
Authors: Demark-Wahnefried W. , Kenyon A.J. , Eberle P. , Skye A. , Kraus W.E. .
Source: Clinical Exercise Physiology, 2002 Feb; 4(1), p. 44-49.
PMID: 16946801
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