With obesity now linked to 13 different cancers, pursuing interventions focused on healthy eating and exercise are of critical importance for the health of cancer survivors and their caregivers. After a diagnosis of cancer, many survivors report lingering symptoms such as fatigue, depression, anxiety, pain, and disrupted sleep. These symptoms are often a barrier to the adoption of healthy lifestyle behaviors such as diet and physical activity; behaviors known to impact cancer progression. “Our goal is to integrate symptom management with lifestyle behavior modification to improve diets and increase activity while managing symptoms,” says Dr. Crane. “We have evidence-based interventions for each of these things separately. We have effective lifestyle interventions and ways to manage symptoms, but this study is about pulling them together to see how they can work synergistically to benefit each other.”
“We have effective lifestyle interventions and ways to manage symptoms, but this study is about pulling them together to see how they can work congruently to benefit each other." ~ Tracy Crane
In January, University of Arizona Assistant Professor, Dr. Tracy Crane was awarded one of three $30,000 American Cancer Society (ACS) Institutional Research Grants (ACS-IRG) for her new study, “Improving Adherence to ACS Guidelines on Nutrition and Physical Activity through integrated symptom management in Latinas with cancer and their informal caregivers.”
Dr. Crane’s application was a follow up to a study she completed last year with College of Nursing Professor and Director of Community and Systems Health Sciences Division, Dr. Terry Badger, which identified the high symptom burden experienced by Latina breast cancer survivors. Realizing the detrimental impact these symptoms have on quality of life, Dr. Crane wants to address the next question: How best to manage the symptoms and at the same time help survivors adhere to healthy lifestyle behaviors involving diet and physical activity to reduce risk of cancer recurrence.
“It’s a telephone-based intervention,” explains Dr. Crane. “Theoretically, anybody anywhere can receive it. We work with them to identify the symptoms they’re experiencing and then tailor the lifestyle intervention to either alleviate these symptoms or avoid making these symptoms worse in an effort to increase activity and improve diet.” A novel aspect of the study is the involvement of an informal caregiver of the survivor’s choice to participate with them in the study. “We know from our past research, caregivers experience similar symptoms that directly impact the well-being of the survivor. Oftentimes, caregivers neglect self-care, which opens them up to negative repercussions as well,” Dr. Crane points out. “It never hurts anybody to eat better and exercise more. By including the caregiver as well, we believe this partnership will facilitate the most successful behavior change.”
The study is currently underway with more than a dozen dyads participating in the telephone-based intervention. Dr. Crane anticipates that it will take about a year to recruit 36 patients and their informal caregivers for the 12-week lifestyle intervention. Dr. Crane’s research lab is comprised of undergraduate and graduate students who deliver the telephone-based intervention, a model that not only benefits study participants but also serves to train students in the rigors of delivering successful interventions. “When you give students hands-on, real-life experience, you’re only benefiting everyone in the long run,” says Dr. Crane.
With a clinical background as a registered dietitian, Dr. Crane has been working with cancer survivors for nearly 20 years, to improve their diets and physical activity. Her goal of preventing cancer and helping survivors live the healthiest life possible hasn’t changed, but expanding her interventions to informal caregivers and integrating symptom management will expand her ability to find solutions to the complex problem of changing behaviors and managing symptoms.
Tracy Crane, PhD, MS, RDN, is an Assistant Professor at the University of Arizona College of Nursing