By Linda Thompson
Dr. Cheryl Rock, professor of Family and Preventive Medicine at the UCSD School of Medicine, is committed to helping the 2.5 million women who are breast cancer survivors. To do that, she needs 200 women from San Diego for a two-year study involving diet modification and exercise. These volunteers must be between the ages of 21 to 85, overweight, and surviving breast cancer.
The goal is for the women to lose at least seven percent of their body fat.
Funded by a National Cancer Institute grant of $5.3 million, Dr. Rock's study, ENERGY (Exercise and Nutrition to Enhance Recovery and Good Health for You) will involve cancer survivors in San Diego, Denver, Birmingham and St. Louis.
She is working in collaboration with other doctors recruiting a total of 800 women from these four cities.
In explaining the study, Dr. Rock said many women experience weight gain while battling breast cancer — and not from overeating. She said the side effects of chemotherapy and radiation often make it difficult for women to maintain an active lifestyle. This inactivity creates muscle atrophy that in turn lowers the metabolic rate needed to burn calories.
Rock said being overweight is the “big gorilla in the closet,” which needs to be tackled because 60 percent of U.S. adults are overweight and data indicates a 78 percent increase in risk for recurrence of breast cancer patients if they are overweight at the time of diagnosis.
During the clinical trial, scientific evidence will be collected that either proves or disproves her hypotheses. If the evidence supports her beliefs, the study could change the way doctors treat breast cancer patients. Data is also necessary to ensure insurance companies provide coverage to support weight loss and management for breast cancer survivors as a new standard of clinical care.
Dr. Rock said study participants could expect to have their blood samples analyzed for estrogen and insulin hormone levels. Scientists are concerned about high levels of insulin and estrogen because these hormones are designed to grow cells — whether cells are cancerous or not.
Studying the issue since 1997, Dr. Rock authored a paper that showed a correlation between high blood estrogen and the recurrence of cancer. Her study has raised the call for postmenopausal women to lose excess body fat because at this stage of life, estrogen is no longer produced by ovaries, but by fat.
The new study will include participation in a 2-year behavioral weight loss program, with a support group that will meet weekly for the first 16 weeks.
"Changing behavior is not easy. Losing weight is not easy," said Dr. Rock, "and that is the reason for having weekly meetings comprised of about 12 women in each group. The program is to encourage a greater consumption of fruits, vegetables and high fibers in the diet and fewer calories. The trial doesn't provide food, but participants will receive a scale, a food diary to track food intake, and a pedometer.”
After 16 weeks, participants will not simply be cut loose, but they will enter a less intense program created by Dr. Wendy Demark-Wahnefried, Ph.D., R.D. in Birmingham, Ala.
As far as the exercise involved, Dr. Rock said she encourages women to aim for an average of one hour each day of moderate purposeful exercise to be tailored by study coordinator and certified cancer exercise trainer Shoshi Barkai, M.S., R.D. Related issues, like incontinence, hot flashing, and mastectomies have all been taken into consideration.
Dr. Rock discussed the positive transformation women encountered in her previous study, SHAPE. She said the women in the program went from "literally being couch potatoes" to exercise addicts.
About Dr. Rock:
Dr. Cheryl Rock, Ph.D., R.D., is a professor in the Department of Family and Preventive Medicine and the Cancer Prevention and Control Program, at the UCSD School of Medicine. She completed undergraduate training in nutrition and dietetics at Michigan State University, achieved a Master of Medical Science degree in clinical nutrition at Emory University, and was awarded her doctoral degree in nutritional sciences from UCLA School of Public Health.
To join the study:
Participants must be at least 21 years old and have been diagnosed with stage I, II, or III A breast cancer. They will be involved in a two-year active intervention program. If interested, contact Shoshi Barkai at Moores UCSD Cancer Center, (858) 822-2779.