Phone Counseling May Help Postmenopausal Women With Early-stage Breast Cancer Lose Weight

Breast Cancer News
August 28, 2014
By: 
Marcia Frellick
Reviewed By: 
Heather S. Jim, PhD

Getting advice about healthy living by phone from trained lifestyle coaches may help some overweight women treated for early-stage breast cancer lose more weight, a new study shows.

The article, published in the Journal of Clinical Oncology, compared weight loss in postmenopausal women coached by phone with those sent information by mail.

Background and Goals

Fat cells produce estrogen, a hormone that occurs naturally in the body. In hormone-positive breast cancer, estrogen causes cancer cells to divide and grow.

If a person carries extra fat, their bodies may make more estrogen. For people with hormone-positive breast cancer, this could encourage more cancer growth. Carrying too much extra body fat has a negative impact on health and also may affect breast cancer survival.

That’s why finding out what helps women lose weight was important to the trial team. To do that, they tested whether talking with a professional by phone would help motivate women to lose more weight than they would if they only read materials about healthy living.

Design

A total of 338 postmenopausal, overweight women who were taking the aromatase inhibitor letrozole (Femara) in the US and Canada and who had a body mass index of at least 24 were randomized into two groups. Body mass-index is a measure doctors use to determine whether a person is a healthy weight. Postmenopausal means a woman has stopped having her period because of age or for medical reasons.

  • Mail-based group: Received information on diet and exercise, facts about breast cancer and general medical information by mail at the beginning of the trial and at 1 year. They also received a 2 year subscription to Canadian Health Magazine
  • Lifestyle Intervention, LI, group: Received
    • The same mailed information
    • Nineteen phone calls over 2 years. Calls included goals for weight loss of 1 to 2 pounds a week; cutting calories by 500 to 1,000 per day; increasing exercise by 2 hours and 30 minutes to 3 hours and 20 minutes per week; and counseling to reduce stress, manage time and stay motivated
    • A workbook with detailed information about each 30- to 60-minute call

Participants in both groups were weighed in the clinic. They also completed surveys about exercise, quality of life and diet.

Results

Women in the LI group lost significantly more weight and exercised more often than the women in the mail-only group. The results were consistent over a 2-year period. On average:

  • at 6 months, women in the LI group lost about 9.5 pounds while those in the mail group lost about 1.3 pounds
  • at 2 years, the LI group lost a total of about 7 pounds while the mail group lost less than 1 pound
  • women in the LI group added 80 to 150 minutes to their weekly exercise while women in the mail group added 5 to 115 minutes a week

Limitations

These findings may not apply to the general population because only postmenopausal women with breast cancer were recruited. The bigger the group, the more likely results will be the same for other, similar women.

This study also only included postmenopausal women taking an aromatase inhibitor, an anti-estrogen treatment. The results may not be the same for people with breast cancer who still have their period or are taking different medicine.

What This Means for You

Losing weight can be hard for anyone, but may seem harder when life is disrupted by cancer treatment. These findings show that even with the life changes that happen after a breast cancer diagnosis, weight loss is still possible.

It may help to talk with a professional by phone. Researchers wanted to test this strategy because it is a low-cost option and may be available to more women. If you are interested in trying phone counseling, your doctor may be able to help recommend someone who is certified to help address your concerns. You may also be interested in programs like  LIVESTRONG at the YMCA.

Goodwin P, Segal R, Vallis M et al. Randomized Trial of a Telephone-Based Weight Loss Intervention in Postmenopausal Women With Breast Cancer Receiving Letrozole: The LISA Trial. Journal of Clinical Oncology. 2014; doi: 10.1200/JCO.2013.53.1517

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