Abstract
BackgroundBreast cancer survivors often encounter physiological and psychological problems related to their diagnosis and treatment that can influence long-term prognosis. The aim of this research is to investigate the effects of a lifestyle intervention on body weight and psychological well-being in women recovering from breast cancer treatment, and to determine the relationship between changes in these variables and biomarkers associated with disease recurrence and survival.Methods/designFollowing ethical approval, a total of 100 patients will be randomly assigned to a lifestyle intervention (incorporating dietary energy restriction in conjunction with aerobic exercise training) or normal care control group. Patients randomised to the dietary and exercise intervention will be given individualised healthy eating dietary advice and written information and attend moderate intensity aerobic exercise sessions on three to five days per week for a period of 24 weeks. The aim of this strategy is to induce a steady weight loss of up to 0.5 Kg each week. In addition, the overall quality of the diet will be examined with a view to (i) reducing the dietary intake of fat to ~25% of the total calories, (ii) eating at least 5 portions of fruit and vegetables a day, (iii) increasing the intake of fibre and reducing refined carbohydrates, and (iv) taking moderate amounts of alcohol. Outcome measures will include body weight and body composition, psychological health status (stress and depression), cardiorespiratory fitness and quality of life. In addition, biomarkers associated with disease recurrence, including stress hormones, estrogen status, inflammatory markers and indices of innate and adaptive immune function will be monitored.DiscussionThis research will provide valuable information on the effectiveness of a practical, easily implemented lifestyle intervention for evoking positive effects on body weight and psychological well-being, two important factors that can influence long-term prognosis in breast cancer survivors. However, the added value of the study is that it will also evaluate the effects of the lifestyle intervention on a range of biomarkers associated with disease recurrence and survival. Considered together, the results should improve our understanding of the potential role that lifestyle-modifiable factors could play in saving or prolonging lives.
Highlights
Breast cancer survivors often encounter physiological and psychological problems related to their diagnosis and treatment that can influence long-term prognosis
Up to 60% of women diagnosed with breast cancer experience an increase in body weight associated with chemotherapy and treatment-related menopause [6] and there is evidence that heavier women and women who gain weight after diagnosis have an increased risk of disease recurrence and death compared to normal weight women [1,2,3,4,5]
The aim of the intended research is to examine the effects of a dietary and exercise intervention on body weight, indices of psychological well-being and biomarkers associated with disease recurrence and physiological health status in female breast cancer survivors
Summary
Breast cancer survivors often encounter physiological and psychological problems related to their diagnosis and treatment that can influence long-term prognosis. There is evidence that elevated estrogen levels influence the risk of breast cancer in postmenopausal women [14,15,16] and it was recently shown that overweight postmenopausal breast cancer patients have higher estrogen and testosterone levels than normal-weight patients [13]. This led to the suggestion that circulating estrogen levels could be a useful biomarker for weight loss intervention studies [13]
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