Feasibility evaluation of a virtual lifestyle intervention for early-stage breast cancer survivors undergoing chemotherapy

TL;DR

A virtual lifestyle intervention for breast cancer survivors during chemotherapy was tested, showing improved exercise adherence and waist reduction over time.

Contribution

The study demonstrates the feasibility of a telehealth lifestyle intervention for breast cancer survivors undergoing chemotherapy.

Findings

Only 36% of participants met lifestyle goals immediately after the intervention, but 62.5% did so 3 months later.

Waist circumference decreased significantly at both post-intervention assessments.

Exercise adherence improved from 6% to 41% of participants meeting guidelines by the end of the study.

Abstract

Weight gain and physical inactivity during chemotherapy for patients with early-stage breast cancer are common. We sought to investigate the feasibility of a virtual lifestyle (exercise and diet) intervention for breast cancer survivors during chemotherapy.

This single-arm phase 2 trial delivered 12 weekly 1-hour telehealth sessions of supervised exercise and diet education to breast cancer survivors (patients with stage I-III disease) starting neoadjuvant chemotherapy. Screening, recruitment, intervention, and study assessments completed at baseline (T0), immediately after the intervention (T1), and 3 months after the intervention (T2) were conducted by telehealth in 2022-2023. The primary outcome was that at least 60% of participants achieved 50% of the predetermined exercise and dietary goals. Secondary outcomes were acceptability (participation, attendance, completion), physical health, and lifestyle outcomes.

Of 73 referrals, 60 individuals were eligible, 58 (97%) provided consent, 51 (85%) commenced the intervention, and 34 (57%) completed at least 1 postintervention assessment (completion rate = 67%). The mean (SD) age of participants was 51 (8.8) years, and 50% of participants were receiving neoadjuvant chemotherapy. Attendance was lower for exercise than for diet sessions (44% vs 62% attended ≥75% sessions). At T1, 36% of participants adhered to at at least 50% of the preset goals, improving at T2 (62.5%). Weight was not statistically significantly different between T0 and T1 (P = .199) but increased substantially at T2 (P = .018). Average waist circumference was reduced at T1 (‒1.9 cm, P = .014) and at T2 (‒3.3 cm, P < .001). Weekly exercise time increased by 38.5 minutes from T0 to T1 (P = .038), and the proportion of participants who met exercise guidelines improved from 6% (T0) to 41% (T2).

Our primary outcome was not achieved immediately after the intervention but was observed 3 months later. Individuals completing the intervention attended at least half the diet and exercise sessions during chemotherapy. Results of this study will inform design of a phase 3 study.

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