Breast cancer survivors face dual challenges: 1) risk of recurrent disease and 2) dealing with the long term sequelae of their treatments. Facing these challenges can be burdensome, resulting in reduced quality of life. Obesity and sedentary lifestyle further complicate these issues. The goal ofthe WISER Survivor trial is to assess the effects of exercise and/or weight loss through caloric restriction on a common long term adverse effect of treatment (lymphedema), biomarkers for recurrence, and quality of life. Lymphedema is a chronic, progressive, incurable condition characterized by arm swelling and negative alterations in function and appearance, as well as bothersome symptoms. It is among the more common, expensive, and feared persistent adverse breast cancer treatment effects. In our completed work, twice weekly weight-lifting reduced by half the number of incident clinical lymphedema events requiring medical care. In the proposed WISER Survivor trial we seek to assess whether adding aerobic exercise or weight loss through caloric restriction to the weight-lifting intervention further improves lymphedema clinical outcomes. The WISER Survivor Trial will also test the effects ofthe exercise and weight loss interventions on the same recurrence biomarkers to be tested in the mouse model study (Project 1). The biomarkers include sex hormones, markers of inflammation, growth factors, adipokines, and oxidative stress. The innovation of these two paired projects include the novel approach of assessing effects of these interventions in the recurrence setting, as well as comparing effects on biomarkers in equivalent interventions in mice and humans. In addition, we assess effects of our energy balance interventions on a novel biomarker related to pathogenic angiogenesis. Another innovation includes a unique opportunity to assess whether changes in any of these biomarkers are correlated with clinical lymphedema outcomes. Finally, we seek to assess effects of our interventions on quality of life in breast cancer survivors with lymphedema. Therefore, we propose a one year randomized controlled weight loss and exercise intervention trial in a multi-ethnic cohort of oven/veight and obese post-menopausal breast cancer survivors with clinically confirmed lymphedema. There will be four groups in this trial: exercise only, weight loss only, exercise and weight-loss combined, and a control group, with a sample size of 125 per group (total N=500).

Public Health Relevance

Breast cancer survivors face many unique challenges, including risk for recurrence and persistent adverse effects of cancer treatment. Obesity and sedentary lifestyle complicated these effects. We seek to examine whether exercise and/or weight loss will improve biomarkers for breast cancer recurrence, a persistent adverse effect called lymphedema, and quality of life within 500 survivors with breast cancer-related lymphedema.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Specialized Center--Cooperative Agreements (U54)
Project #
5U54CA155850-03
Application #
8504805
Study Section
Special Emphasis Panel (ZCA1-SRLB-4)
Project Start
Project End
Budget Start
2013-06-01
Budget End
2014-05-31
Support Year
3
Fiscal Year
2013
Total Cost
$431,426
Indirect Cost
$90,466
Name
University of Pennsylvania
Department
Type
DUNS #
042250712
City
Philadelphia
State
PA
Country
United States
Zip Code
19104
Brown, Justin C; Troxel, Andrea B; Ky, Bonnie et al. (2017) Dose-response Effects of Aerobic Exercise Among Colon Cancer Survivors: A Randomized Phase II Trial. Clin Colorectal Cancer :
Graul, Ashley; Latif, Nawar; Zhang, Xiaochen et al. (2017) Incidence of Venous Thromboembolism by Type of Gynecologic Malignancy and Surgical Modality in the National Surgical Quality Improvement Program. Int J Gynecol Cancer 27:581-587
Zhang, Xiaochen; Brown, Justin C; Paskett, Electra D et al. (2017) Changes in arm tissue composition with slowly progressive weight-lifting among women with breast cancer-related lymphedema. Breast Cancer Res Treat 164:79-88
Basen-Engquist, Karen; Alfano, Catherine M; Maitin-Shepard, Melissa et al. (2017) Agenda for Translating Physical Activity, Nutrition, and Weight Management Interventions for Cancer Survivors into Clinical and Community Practice. Obesity (Silver Spring) 25 Suppl 2:S9-S22
Igwebuike, Lotachukwu T; Zhang, Xiaochen; Brown, Justin C et al. (2017) Applying pre-participation exercise screening to breast cancer survivors: a cross-sectional study. Support Care Cancer :
Rogers, Benjamin H; Brown, Justin C; Gater, David R et al. (2017) Association Between Maximal Bench Press Strength and Isometric Handgrip Strength Among Breast Cancer Survivors. Arch Phys Med Rehabil 98:264-269
Brown, Justin C; Schmitz, Kathryn H (2017) The dose-response effects of aerobic exercise on musculoskeletal injury: a post hoc analysis of a randomized trial. Res Sports Med 25:277-289
James, Peter; Hart, Jaime E; Hipp, J Aaron et al. (2017) GPS-Based Exposure to Greenness and Walkability and Accelerometry-Based Physical Activity. Cancer Epidemiol Biomarkers Prev 26:525-532
Murray, Kate; Godbole, Suneeta; Natarajan, Loki et al. (2017) The relations between sleep, time of physical activity, and time outdoors among adult women. PLoS One 12:e0182013
Sturgeon, Kathleen M; Dean, Lorraine T; Heroux, Mariane et al. (2017) Commercially available lifestyle modification program: randomized controlled trial addressing heart and bone health in BRCA1/2+ breast cancer survivors after risk-reducing salpingo-oophorectomy. J Cancer Surviv 11:246-255

Showing the most recent 10 out of 49 publications