Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2024

Feasibility of a structured telehealth intervention study ‘Lifestyle intervention (Exercise And Diet) for early-stage Breast Cancer Survivors (LEAD-4-BCS) undergoing neo-/adjuvant chemotherapy (#268)

Sim Yee (Cindy) Tan 1 2 3 , Isaac Yeboah Addo 2 , Gemma Collett 4 , Eliza R Macdonald 1 , Jane Turner 1 , Shannon Gerber 1 , Liane Lee 2 , Hau Yi Yau 2 , Sama Saleem 3 , Jasmine Yee 4 , Adrian Bauman 5 , Belinda E Kiely 1 , Natalie Taylor 6 , Richard De Abreu Lourenco 7 , Haryana Dhillon 4 8 , Janette Vardy 1 2
  1. Concord Cancer Centre , Concord Hospital, Concord, NSW, Australia
  2. Faculty of Health and Medicine, The University of Sydney, Sydney, NSW
  3. Nutrition and Dietetics Department, Concord Hospital, Concord, NSW, Australia
  4. Centre for Medical Psychology and Evidence-based Decision-making, University of Sydney, Sydney, NSW, Australia
  5. School of Public Health, The University of Sydney, Sydney, NSW, Australia
  6. Implementation to Impact, School of Population Health, Faculty of Medicine and Health, UNSW , Sydney
  7. Centre for Health Economics Research and Evaluation, University of Technology , Sydney
  8. Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology,, University of Sydney, Sydney, Sydney, New South Wales , Australia

Background:

Weight gain and physical inactivity during treatment for early-stage breast cancer are common.  

Aim:

To investigate the feasibility of delivering a virtual lifestyle intervention (exercise and diet) to breast cancer survivors (BCS) during chemotherapy.

Methods:

Phase II single-arm study of supervised exercise and diet education sessions (1 hour each/week) for 12 weeks. BCS (stage I-III) starting (neo)adjuvant chemotherapy, from 11 NSW sites (7 metropolitan, 4 regional) were eligible.  Screening, intervention and assessments were conducted via telehealth.  Assessments completed at: T0=baseline, T1=post-intervention, T2=3-months post-intervention. Primary outcome: adherence to individualised pre-set exercise and dietary goals. Secondary outcomes: acceptability (participation, attendance, completion,), physical health, lifestyle outcomes.

Results:

Of 73 referrals, 64 underwent screening with 60 BCS (82%) eligible, 58 (97%) consented and 51 (85%) started the intervention. Baseline characteristics for the 34 BCS completing the 12-week intervention (completion rate 67%): mean age 51years (SD 8.8), body mass index 25.8kg/m2 (interquartile range 7.4), neoadjuvant chemotherapy (50%). Attendance was lower for exercise than diet sessions (65% versus 88% attended >50% of sessions).  Of the 33 completing T1 assessment, 36% adhered to ≥50% of pre-set goals; 30% adhered to no goals. There was no significant difference in median weight pre- and post-intervention (p=0.199) but a significant reduction in waist circumference (1.9cm, p=0.014), improvements in total time spent on exercise (median difference 38.5mins/week, p=0.038), and average fruit (+0.5 serve) and vegetable (+0.9 serve) intake (p<0.05).  More participants met diet recommendations (fruit 33% vs 3%, p=0.02; vegetable 21% vs 3%, p=0.07) and exercise guidelines (18% vs 6%, p=0.125) post-intervention than baseline.

Conclusion:

Our study did not meet its primary outcome (adherence rate >60%), but those completing the intervention attended at least half the diet and exercise sessions despite the challenges of concurrent chemotherapy. Results will inform the intervention design for a phase III study.