Reducing breast cancer recurrence with weight loss, a vanguard trial: The Exercise and Nutrition to Enhance Recovery and Good Health for You (ENERGY) Trial

Abstract

Breast cancer is the most common invasive cancer among women in developed countries. Obesity is a major risk factor for breast cancer recurrence and mortality in both pre-and postmenopausal women. Co-morbid medical conditions are common among breast cancer survivors. The Exercise and Nutrition to Enhance Recovery and Good Health for You (ENERGY) study is a 4-year randomized clinical trial of 693 overweight/obese women aged ≥21 years diagnosed with any early stage breast cancer (stages I[≥1 cm]-III) within the previous five years, designed to demonstrate the feasibility of achieving sustained weight loss and to examine the impact of weight loss on quality of life and co-morbidities, and to enable future exploration of biochemical mechanisms linking obesity to lower likelihood of disease-free survival. This trial is strategically designed as a vanguard for a fully-powered trial of women who will be evaluated for breast cancer recurrence and disease-free survival. Participants were recruited between 2010 and 2012 at four sites, had completed initial therapies, and had a body mass index between 25 and 45 kg/m2. The intervention featured a group-based cognitive-behavioral weight loss program with telephone counseling and tailored newsletters to support initial weight loss and subsequent maintenance, with the goal of 7% weight loss at two years. This study has high potential to have a major impact on clinical management and outcomes after a breast cancer diagnosis. This trial initiates the effort to establish weight loss support for overweight or obese breast cancer survivors as a new standard of clinical care.

Metabolic Syndrome and Breast Cancer: Is There a Link?

“…increased adiponectin levels and decreased free-estrogen concentrations and C-reactive protein (CRP) levels. At present, there are 2 large ongoing prospective studies on the effect of weight loss on survival [37] and comorbidities [37,38] in breast cancer patients.…”

The Effect of Exercise Type on Inflammatory Markers in Obese Survivors With Breast Cancer: Randomized Control Trial

“…This risk factor is further highlighted by the fact that the majority of breast cancer survivors are overweight or obese. The combination of being overweight and inactive has been attributed to a quarter of all the cases of cancer (12)(13)(14).…”

Effect of Low-fat Diet on Breast Cancer Survival: a Meta-analysis

“…Now, more and more diet intervention studies are ongoing in breast cancer survivors, such as ENERGY (Rock et al, 2012), SUCCESS-C (Rack (Villarini et al, 2012). We are looking forward to the results of this studies and then we will update our meta-analysis to direct the diet intervention of breast cancer survivors.…”