Phone calls improve health behaviors in colorectal cancer survivors

A telephone-delivered program, CanChange, helped survivors of colorectal cancer be more physically active, maintain their body weight, and have a healthier diet, according to a new study. These health behaviors affect the chance of cancer recurrence, along with physical functioning, quality of life, and fatigue after a colorectal cancer diagnosis.

The study, which was published in the Journal of Clinical Oncology (2013; doi: 10.1200/JCO.2012.45.5873), was a 12-month trial that compared the health of two groups of colorectal cancer survivors, one of which participated in the CanChange program.

"After 12 months we found a significant and positive difference in the physical activity of people who participated in the CanChange program," said lead author Professor Anna Hawkes of the Queensland University of Technology in Brisbane, Australia.

"CanChange participants also maintained their body mass index (BMI) whereas those who didn't take part in the trial significantly increased their BMI. Participants also reduced their fat intake and increased their vegetable intake."

The study found that survivors who received CanChange coaching had a mean of 28.5 more minutes of physical activity than survivors who did not receive coaching. Also, the CanChange participants had a decrease in BMI of 0.9 kg/m2, decrease of energy from total fat of 7.0%, and decrease of energy from saturated fat of 2.8% compared with colorectal cancer survivors who did not receive telephone coaching. The CanChange participants also increased vegetable intake by 0.4 servings per day compared with the control group. The telephone intervention was not found to affect health-related quality of life, cancer-related fatigue, intake of fruit, fiber, alcohol, or smoking.

Associate Professor Hawkes said colorectal cancer is a leading cause of illness and death in Australia and the Western world.

"The 5-year survival rate has increased to 65%, but survivors still face many physical and mental challenges that can have a significant effect on their quality of life," she said.

"But despite the challenges associated with a cancer diagnosis and treatment, survivors can be motivated to make behavioral improvements like those targeted in the CanChange program that can have a very positive effect on their lives."

Hawkes said this study was the first of its kind to use the telephone to target a range of health behaviors to improve health outcomes specifically for bowel cancer survivors. The success of this program has allowed it to be rolled out across Australia as well as internationally.

"Telephone-delivered programs are acceptable to cancer survivors, as they are convenient, flexible, and can be delivered across the country. They are also relatively low cost," she said. "The CanChange program would be immediately translatable through existing telephone help lines, which are widely used for patients with cancer in Australia and other countries."
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