Phoning for function--Promoting health after cancer

今年，将近100万美国老年人将被诊断出患有癌症。如果在早期发现和治疗方面有所改进，这些人中的大多数将被“治愈”。然而，他们可能会因为癌症本身或治疗而留下严重的发病率。此外，由于遗传、治疗或生活方式因素，这些人群患继发性癌症、糖尿病、骨质疏松症和心血管疾病的风险增加。因此，老年癌症幸存者患继发性癌症、糖尿病、骨质疏松症和心血管疾病的风险更大。因此，老年癌症幸存者比普通老年人面临更大的功能衰退风险。然而，虽然癌症可能带来更大的功能衰退风险，但它也可能带来更大的功能衰退风险，它也可能带来一个“教育时刻”。生活方式的重大事件，如癌症诊断，通常会增加积极改变生活方式的接受度。然而，到目前为止，在老年癌症幸存者中，很少有人利用这个机会。鉴于治愈率的提高以及老年人数量的不断增加，干预措施具有重大的公共卫生潜力，可以重新定位这一高危人群的功能衰退轨迹。杜克大学医学中心的一个由衰老、营养、身体活动、行为心理学和生物统计学等领域的多学科研究人员组成的研究小组提出，测试电话咨询项目是否能有效改善早期老年癌症患者的饮食和身体活动行为——这些行为的改变最终会改善他们的身体功能。本研究的具体目的是确定1)饮食-身体活动电话咨询项目在改善新诊断为早期乳腺癌或前列腺癌的老年人的短期和长期身体功能方面的效果；2)实验组和对照组在次要终点（饮食质量、身体活动、抑郁、生活质量等）方面的差异；3)与项目效果相互作用的因素(社会支持、共病等)我们将在北卡罗莱纳州招募420名年龄大于65岁的早期乳腺癌和前列腺癌患者，并将他们随机分为两组：1)实验组-一组接受为期6个月的电话咨询计划，该计划根据准备阶段量身定制，以改善饮食和体育活动行为；& 2)注意力控制组——在不相关的领域（如癌症筛查）接受电话咨询的小组。结果将增加我们使用电话咨询的知识，为患有早期癌症的老年人提供多种风险因素干预-这是一个快速增长的人群，可能高度接受，非常需要健康促进，历史上很少做研究。

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.