Phoning for function--Promoting health after cancer

今年，近100万美国老年人将被诊断出患有癌症。考虑到早期发现和治疗的改进，这些人中的大多数将被“治愈”。然而，他们可能会留下显著的发病率，无论是癌症本身还是其治疗。此外，由于遗传、治疗或生活方式因素，这一人群罹患继发性癌症以及糖尿病、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以及糖尿病、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，虽然癌症可能会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，它也可能会带来一个“可教的时刻”。重大的生活方式事件，如癌症诊断，通常会增加人们对积极生活方式改变的接受度。然而，到目前为止，在老年癌症幸存者中，几乎没有采取什么行动来利用这个机会。鉴于治愈率的提高和老年人数的不断增加，有很大的公共卫生潜力进行干预，以重新定位这一高危人群的功能下降轨迹。杜克大学医学中心一个由老龄化、营养、身体活动、行为心理学和生物统计学领域的多学科研究人员组成的团队提议测试电话咨询计划是否有效地改善了患有早期疾病行为变化的老年癌症患者的饮食和身体活动行为，最终应该会改善他们的身体功能。这项研究的具体目的是确定1)饮食-体力活动电话咨询计划在短期和长期内改善新诊断为早期乳腺癌或前列腺癌的老年人的身体功能的有效性，2)试验组和控制组在次级终点(饮食质量、体力活动、抑郁、生活质量等)方面的差异，3)与计划有效性交互作用的因素(社会支持、共病等)。我们将在北卡罗来纳州招募420名年龄超过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中的一组：1)试验组-接受为期6个月的电话咨询计划，以改善准备阶段的饮食和体力活动行为；以及2)注意力控制组-接受无关领域(如癌症筛查)的电话咨询。结果将增加我们对使用电话咨询为患有早期州癌症的老年患者提供多风险因素干预的知识-这是一个快速增长的人口，可能非常容易接受，那里非常需要健康促进-历史上几乎没有做过什么研究。

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.