Exercise and Healthy Diet or Standard Care in Patients in Remission From Stage I or Stage II Endometrial Cancer

NCT ID: NCT00732173

Last Updated: 2013-02-08

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

74 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-07-31

Study Completion Date

2011-03-31

Brief Summary

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RATIONALE: Participating in a diet and exercise program may improve the quality of life of overweight and obese patients who are in remission from endometrial cancer.

PURPOSE: This randomized phase I trial is studying an exercise and healthy diet program to see how well it works compared with standard care in patients in remission from stage I or stage II endometrial cancer.

Detailed Description

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PRIMARY OBJECTIVE:

\* To reduce morbidity and early mortality in endometrial cancer (EC) survivors through obesity management.

SECONDARY OBJECTIVES:

* To expand and refine a previous pilot study of a behavioral, lifestyle-change education intervention for use in overweight and obese patients in remission from endometrial carcinoma.
* To determine the potential effects and variation of each regimen in these patients.
* To explore potential mediators (self-efficacy, depression) and moderators (body mass index) of healthful dietary and exercise behaviors.
* To evaluate neuronal response to high-versus-low calorie visual food stimuli under fasted (hunger) and fed (satiated) states in brain regions of interest (hypothalamus, lateral orbitofrontal cortex, ventral striatum, insula) using blood oxygenation level dependent (BOLD) functional magnetic resonance imaging (fMRI) before and after a lifestyle (diet and exercise counseling) intervention or usual care in obese EC patients. We will also compare the neuronal responses in obese EC patients to those from normal weight subjects without cancer being seen at the same gynecologic clinic; and, explore modification of the neuronal signals by candidate genes and serum biomarkers in the hypothalamic pituitary-adrenal axis, serotonergic and inflammatory pathways.

OUTLINE: Patients are stratified according to body mass index (25.0-39.9 vs ≥ 40) and randomized to 1 of 2 intervention arms.

* Arm I: Patients receive a lifestyle intervention, "Survivors of Uterine Cancer Empowered by Exercise and Healthy Diet (SUCCEED)", on a group and individual basis consisting of nutrition, exercise, and behavioral modification counseling from a physician, psychologist, registered dietitian, and physical therapist. Sixteen group sessions will be conducted (10 weekly, 6 bi-weekly) for 6 months. Weight and body mass index, satisfaction with study treatment, and exercise/activity logs are assessed weekly and biweekly. Patients receive additional feedback and support during the weeks not met in a group, including newsletters and telephone and e-mail contact.
* Arm II (control): Patients receive usual care informational brochures, but no lifestyle counseling, related to weight loss, physical activity, and nutrition.

Patients undergo physician counseling sessions at baseline and 3, 6, and 12 months. Patients are assessed by weight, anthropometric measures, and body mass index; biomarkers; body composition by dual-energy x-ray absorptiometry/densitometry (DEXA); co-morbidities by the Charlson co-morbidity score; depression by the Beck Depression Inventory (BDI); eating patterns by the Three-Factor Eating Inventory (EI); exercise/physical activity by Leisure Score Index (LSI) and pedometer step count; nutrient intake by 24-hour recall; quality of life by the Functional Assessment of Cancer Therapy-General (FACT-G) and Short-form Medical Outcomes (SF-36); and self-efficacy by the Self-Efficacy Questionnaire (SEQ) and the Weight Efficacy Life-Style (WEL).

Conditions

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Endometrial Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Blinding Strategy

NONE

Study Groups

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Arm I

Patients receive a lifestyle intervention, "Survivors of Uterine Cancer Empowered by Exercise and Healthy Diet (SUCCEED)", on a group and individual basis consisting of nutrition, exercise, and behavioral modification counseling from a physician, psychologist, registered dietitian, and physical therapist. Sixteen group sessions will be conducted (10 weekly, 6 bi-weekly) for 6 months. Weight and body mass index, satisfaction with study treatment, and exercise/activity logs are assessed weekly and biweekly. Patients receive additional feedback and support during the weeks not met in a group, including newsletters and telephone and e-mail contact.

Group Type EXPERIMENTAL

behavioral dietary intervention

Intervention Type BEHAVIORAL

Undergo SUCCEED lifestyle intervention

exercise intervention

Intervention Type BEHAVIORAL

Undergo SUCCEED lifestyle intervention

counseling intervention

Intervention Type OTHER

Undergo SUCCEED lifestyle intervention

educational intervention

Intervention Type OTHER

Receive information

survey administration

Intervention Type OTHER

Undergo SUCCEED lifestyle intervention

Arm II

Patients receive usual care informational brochures but no lifestyle counseling related to weight loss, physical activity, and nutrition.

Group Type ACTIVE_COMPARATOR

educational intervention

Intervention Type OTHER

Receive information

Interventions

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behavioral dietary intervention

Undergo SUCCEED lifestyle intervention

Intervention Type BEHAVIORAL

exercise intervention

Undergo SUCCEED lifestyle intervention

Intervention Type BEHAVIORAL

counseling intervention

Undergo SUCCEED lifestyle intervention

Intervention Type OTHER

educational intervention

Receive information

Intervention Type OTHER

survey administration

Undergo SUCCEED lifestyle intervention

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

DISEASE CHARACTERISTICS:

* Histologically confirmed stage I or II (early) endometrial carcinoma

* Diagnosed within the past 3 years
* Underwent prior surgery consisting of a total abdominal hysterectomy and bilateral salpingo-oophorectomy

* No evidence of disease

PATIENT CHARACTERISTICS:

* ECOG performance status 0-2
* BMI ≥ 25 (overweight/obese)
* Medical clearance from primary care physician
* Approved for contact by treating gynecologic oncologist
* At least a 6th-grade reading level to complete significant reading and homework
* No severe psychiatric illness (e.g., schizophrenia, bipolar disorder) or major depression (Beck Depression Inventory \> 29) that needs more aggressive, problem-focused interventions
* No dementia or cognitive deficits
* No pre-existing medical conditions that would be a barrier for participation in unsupervised walking
* No participation in a structured weight loss or exercise program in the past 6 months
* Must agree to and be available for longitudinal follow-up assessments
* Non-English speakers may bring an English-speaking person to all group sessions and visits

PRIOR CONCURRENT THERAPY:

* See Disease Characteristics
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

Case Comprehensive Cancer Center

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Peter G. Rose, MD

Role: PRINCIPAL_INVESTIGATOR

Cleveland Clinic Taussig Cancer Institute, Case Comprehensive Cancer Center

Vivian von Gruenigen, MD

Role: PRINCIPAL_INVESTIGATOR

Case Medical Center, University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center

Locations

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Case Medical Center, University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center

Cleveland, Ohio, United States

Site Status

Countries

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United States

References

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von Gruenigen VE, Waggoner SE, Frasure HE, Kavanagh MB, Janata JW, Rose PG, Courneya KS, Lerner E. Lifestyle challenges in endometrial cancer survivorship. Obstet Gynecol. 2011 Jan;117(1):93-100. doi: 10.1097/AOG.0b013e31820205b3.

Reference Type DERIVED
PMID: 21173649 (View on PubMed)

Other Identifiers

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P30CA043703

Identifier Type: NIH

Identifier Source: secondary_id

View Link

CASE8808

Identifier Type: OTHER

Identifier Source: secondary_id

CASE-8808-CC516

Identifier Type: OTHER

Identifier Source: secondary_id

CASE8808

Identifier Type: -

Identifier Source: org_study_id

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