MONTREAL – African American breast cancer survivors who participated in fitness tracking and an online support program saw small but significant reductions in weight and improvement in quality of life, according to a new study.
Further, patients who reported a low baseline quality of life (QOL) achieved as much or more weight loss as did those whose QOL was initially high, said Jeanne Ferrante, MD, MPH, professor of family medicine and community health at Robert Wood Johnson Medical School, New Brunswick, N.J.
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Overall, but not cancer-related, QOL improved during the 6 months of the study as well.
“Low quality of life at baseline was not a barrier to weight loss, and there’s the potential for weight loss to improve quality of life” in this group of cancer survivors, Dr. Ferrante said at the annual meeting of the North American Primary Care Research Group.
Although weight loss is known to improve functional status and QOL, few studies have examined these issues in African American breast cancer survivors, who may have more comorbidities and a greater risk for obesity compared with the general population, said Dr. Ferrante.
Dr. Ferrante and her coinvestigators hypothesized that QOL would be a predictor of weight loss, and that weight loss, in turn, would have a positive impact on QOL. They conducted a secondary data analysis of a trial of participants using a physical activity monitor alone (in this study, a Fitbit), compared with using the wrist-worn activity monitor together with an Internet program, SparkPeople, designed to provide information and support for increased activity and weight loss.
Eligible participants (n = 61) were African American women who had completed treatment for early stage (0-III) breast cancer, were aged 21-75 (mean 62) years, and had a body mass index of at least 25 kg/m2 (mean, 37; range 26-52). They had to be English speaking, and have Internet and smartphone access. Half the number of participants were retired, half were college graduates, and about a third were married.
One-third of the women reported that they had five or more chronic conditions at enrollment. The mean waist circumference at baseline was 45 inches, and the mean weight was 216 pounds. Patients who had bariatric surgery, had recently lost at least 5% of their body weight, or had limitations to exercise participation or other serious medical or psychiatric conditions were excluded.
To assess QOL, the investigators used the Quality of Life in Adult Cancer Survivors (Q-LACS) scale, which measures both generic and cancer-specific quality of life.
The women in the study also reported how many days out of the past 30 days their mental and their physical health was “not good.”
At baseline, the mean QOL was 108, generic quality of life was 70, and cancer-specific quality of life was 39; lower numbers are better on the scale. Patients reported that their mental health had not been good for 9 of the past 30 days, on average, and that their physical health had not been good for a mean of 6 of the past 30 days.
After 6 months (but not at 3 months), the mean improvement for overall QOL on the Q-LACS scale was –7 (P = .054). Generic QOL improved significantly at both 3 and 6 months (P = .051 and P = .017, respectively), but cancer-specific QOL did not change significantly.
The women saw no significant change over the 6 months in the number of “not good” mental and physical health days.
Waist circumference reduction was about a half inch at 3 months (–0.45 inches, not significant), with a drop at 6 months of 0.91 inches from baseline that met criteria for statistical significance. (P = .013).
The study’s limitations included its small sample size and relatively short duration, said Dr. Ferrante; however, the study continued for 12 months and those data are being analyzed now. Some bias may have been introduced by the need for Internet connection and a smartphone as well, she said.
The investigators are now piloting use of a premium version of the SparkPeople app that offers more customization and interaction with participants.
Dr. Ferrante reported no conflicts of interest.
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