Phoning for function--Promoting health after cancer

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This year, nearly 1 million older Americans will be diagnosed with cancer. Given improvements in early detection and treatment, most of these individuals will be "cured." However, they may be left with significant morbidity, either from the cancer itself or from its treatment. Furthermore, this population either because of genetic, treatment or lifestyle factors is at increased risk for developing secondary cancers, as well as diabetes, osteoporosis, & cardiovascular disease. Therefore, the older cancer survivor is at even greater risk for developing secondary cancers, as well as diabetes, osteoporosis, & cardiovascular disease. Therefore, the older cancer survivor is at even greater risk of functional decline than the average older adult. However, while cancer may bring a greater risk for functional decline, it may also bring a greater risk for functional decline, it also may bring a "teachable moment." Major lifestyle events, such as a cancer diagnosis, often increase receptivity toward positive lifestyle change. To date, however, little has been done among older cancer survivors to capitalize on this opportunity. Given increased cure rates coupled with the ever growing numbers of elderly, there is significant public health potential for interventions that can reorient the functional decline trajectory of this high risk population. A multi-disciplinary team of investigators in the fields of aging, nutrition, physical activity, behavioral psychology & biostatistics at Duke University Medical Center proposes to test whether a telephone counseling program is effective in improving diet & physical activity behaviors among elderly cancer patients with early stage disease-behavior changes which should ultimately improve their physical function. The specific aims of this study are to determine 1) the efficacy of a diet- physical activity telephone counseling program in improving physical function among elders who are newly diagnosed with early stage breast or prostate cancer in both the short and longer term, 2) differences between experimental & control groups with regard to secondary endpoints (diet quality, physical activity, depression, quality of life, etc.) &3) factors that interact with program efficacy (social support, comorbidity, etc.) We will recruit 420 early stage, breast & prostate cancer patients greater than 65 years throughout North Carolina and randomize them into 1 of 2 arms: 1) EXPERIMENTAL ARM-a group that receives a 6-month telephone counseling program tailored to stage of readiness to improve dietary & physical activity behaviors; & 2) ATTENTION CONTROL ARM- a group that receives telephone counseling in unrelated areas (e.g, cancer screening). Results will increase our knowledge of the use of telephone counseling to deliver multiple risk factor interventions to elderly with early state-cancers-a rapidly growing population that may be highly receptive, where health promotion is greatly needed & where historically little research has been done.