Telephone call is effective support when breast cancer treatment includes weight loss

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A series of simple telephone calls can make a profound difference in helping women with breast cancer to meet their treatment goals for weight loss.

Obese women have a 25% to 30% greater risk of death compared to women who are not obese. Excess fat tissue in the body stimulates inflammation, and is associated with alterations in hormones such as insulin, leptin, and estradiol, which play a part in cancer growth and recurrence.

"That's why breast cancer treatment for women who are overweight often includes weight loss as an important treatment goal," said Pamela Goodwin, MD, director of the Marvelle Koffler Breast Centre at Mount Sinai Hospital and professor in the Department of Medicine at University of Toronto, Ontario, Canada.

Women with breast cancer who received advice about weight loss from a trained lifestyle coach by telephone achieved weight loss and maintained that weight loss for 2 years, lowering their risk of breast cancer recurrence.

The randomized trial included 338 postmenopausal women with a body mass index 24 kg/m2 or higher in Canada and the United States. All study participants received treatment with letrozole for T1-3N0-3M0 breast cancer. The study compared weight loss in women who received advice from a lifestyle coach over the telephone with weight loss in women who received information through the mail.

Mean weight loss was significantly greater in women who received telephone support and this occurred consistently across strata (BMI 24 to <30 vs ≥30 kg/m2; prior versus no prior adjuvant chemotherapy). Weight loss was greatest in those with higher baseline levels of physical activity or improved quality of life. Hospitalization rates and medical events in the two groups were similar.

Sustained weight loss in breast cancer patients who received telephone support after 2 years was comparable to that achieved by women who had an in-person consultation for weight loss.

"This study demonstrated a powerful result for a lifestyle change that is notoriously challenging," Goodwin said. "As much as we look to the technology and medical side of treatment, it's just as vital to understand the power of low-cost interventions that can make a difference in breast cancer survival and quality of life," she added.

"For women who face the dual challenges of breast cancer and obesity, we can't ignore the importance of low-cost support that may contribute to improved survival," said Goodwin. Large-scale randomized trials are planned to investigate effects of a telephone-based weight loss intervention on breast cancer outcomes.

This study was published in Journal of Clinical Oncology (2014; doi:10.1200/JCO.2013.53.1517).

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