Fitness for Cancer Survivors

While millions of Americans place fitness as one of their top New Year's resolutions to improve shape, muscle tone and overall appearance, cancer survivors have another priority - life.

Researchers at The University of Texas M. D. Anderson Cancer Center have developed a customized fitness program to help survivors of endometrial cancer - or cancer of the uterus - shed pounds and keep cancer at bay. Karen Basen-Engquist, Ph.D., principal investigator of the five-year "Steps to Health" study and associate professor in the Department of Behavioral Science, aims to determine how well participants adhere to a personalized fitness plan, motivation both for beginning and sustaining regular workouts and the role of a support system in encouraging determination.

All endometrial cancer survivors who are six months post treatment - from M. D. Anderson or elsewhere - are eligible to participate in the Steps to Health study, funded by the National Cancer Institute.

Following an initial 30-minute orientation, including an electrocardiogram, researchers will assess participants at baseline and again every two months using a series of health and quality-of-life questionnaires, as well as fitness tests on an exercise bike. Depending on a participant's current physical ability, exercise physiologists and fitness specialists then will create a customized plan for each survivor.

According to Basen-Engquist, cancer survivors' confidence following a stressful course of treatment often can be diminished.

"I'm most interested in learning which factors encourage survivors to persist with exercise and take charge of their cancer prevention for the future," said Basen-Engquist. "As the risk for endometrial cancer is two-to four-fold greater in obese women than the general population, we hope that providing a personalized exercise plan for this population will be an incentive to achieve improved physical and psychological well-being.

Basen-Engquist and her team intend to enroll 270 participants into the study, each of whom will personally record her physical activity for six months using a portable personal computer. Researchers will build on the body of evidence gleaned from a five-week pilot study conducted before the official launch of the Steps to Health study.

"Our team is interested in assisting participants with the actual process of initiating and incorporating physical activity into daily life," said Basen-Engquist. "We hope to discover individual traits and tools that enable certain people to stay with an exercise plan better than others."

In addition to bimonthly assessments, M. D. Anderson researchers will mail information regarding goal setting and fitness tools to all participants and provide weekly telephone counseling.

Study leaders will use social cognitive theory, which measures how individuals adopt and maintain behavioral patterns, in developing intervention strategies for participants.

"By participating in the Steps to Health pilot study, I developed an increased awareness of how essential exercise really is to maintain health," said Maureen Hughes, endometrial cancer survivor. "It is easy to keep putting exercise off, but when I was presented with all the information, I couldn't deny its importance for my well-being."

While researchers will measure physical and biological changes in participants, they also will evaluate self-efficacy, or survivors' confidence that they can succeed. Researchers also plan to determine the level of support participants need to exercise and feel successful.