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Combined Modality Exercise and Appetite in Breast Cancer Survivors (CARE)

Primary Purpose

Breast Cancer Female, Overweight and Obesity

Status
Terminated
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Combined aerobic and resistance exercise
Sponsored by
University of Colorado, Denver
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Breast Cancer Female

Eligibility Criteria

18 Years - 45 Years (Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  • Female sex
  • Age: 18 - 45 years
  • Body mass index [BMI]: 25 - 35 kg/m2
  • Pre-menopausal before cancer diagnosis and treatment
  • <1 hour/week of planned physical activity by self-report in the previous 12 months
  • Diagnosis of primary stage I - III estrogen receptor/progesterone receptor-positive (ER/PR+) breast cancer, according to institutional standards.
  • All chemotherapy, radiation, and surgery completed at least two weeks (14 days), but less than 6 months prior to registration

Exclusion Criteria:

  • Self-reported diabetes mellitus, untreated/uncontrolled thyroid disease, history of cardiovascular disease or symptoms suggestive of cardiovascular disease (chest pain, shortness of breath at rest or with mild exertion, syncope), cancer diagnosis in the last 5 years before breast cancer (any site, excluding skin cancer), or any other medical condition affecting weight or energy metabolism.
  • Uncontrolled hypertension defined as: systolic blood pressure >160 mmHg or diastolic blood pressure >100mmHg, as measured during the screening visit. Participants who are deemed ineligible based upon uncontrolled hypertension criteria will be referred to their primary care physicians for treatment. If this condition becomes controlled they will be allowed to be re-evaluated for inclusion in the current trial.
  • Unable to exercise due to cardiac, pulmonary, neurological, orthopedic reasons.
  • Currently smoking and/or nicotine use.
  • Treatment with medications known to significantly affect appetite, weight, energy intake or expenditure in the last 3 months (e.g. appetite suppressants, lithium, stimulants, anti-psychotics, tricyclic antidepressants).
  • Corticosteroid use within the last two weeks
  • History of surgical procedure for weight loss at any time (e.g. gastroplasty, gastric bypass, gastrectomy or partial gastrectomy, adjustable banding, gastric sleeve); history of extensive bowel resection for other reasons
  • Currently pregnant, lactating or less than 6 months post-partum.
  • Score of ≥ 2 on the CAGE (cut-annoyed-guilty-eye opener) questionnaire adapted to include drug use55
  • Score of > 20 on the Eating Attitude Test - 26 (EATS-26), indicative of disordered eating. Participants with a score >20 on the EATS-26 will be referred to their primary care physician for further evaluation.
  • Significant food intolerances/allergies that cannot be accommodated by the University of Colorado Hospital Clinical Translational Research Center Metabolic Kitchen.
  • Currently participating in any formal weight loss or physical activity programs or clinical trials for weight loss.
  • Other medical, psychiatric, or behavioral limitations that may interfere with participation (as determined by study physician).
  • Unable or unwilling to undergo study procedures

Sites / Locations

  • Univeristy of Colorado Anschutz Medical Campus
  • University of Colorado Cancer Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Combined aerobic and resistance exercise

Arm Description

12 weeks of supervised resistance exercise and unsupervised aerobic exercise.

Outcomes

Primary Outcome Measures

Recruitment and enrollment feasibility
Number of individuals approached, meeting inclusion criteria, reasons for exclusion, and enrolled in the study
Subjective exercise adherence
Participants will be asked to rate on a 1-10 Likert scale: 1) how adherent they were to the prescribed exercise over the past week, 2) how difficult it was to adhere to the prescribed exercise over the past week, and 3) how likely they feel they can adhere to the prescribed exercise for the next month.
Exercise self efficacy
Self Efficacy for Exercise Scale; 9 items; score range: 0-9, with higher scores indicating higher exercise self-efficacy
Exercise enjoyment
Physical Activity Enjoyment Scale; 8 items; range: 7-56, with higher scores indicating higher exercise enjoyment
Intervention acceptability
Subjective ability to adhere to combined AEx/REx
Intervention acceptability
Barriers to completing AEx/REx
Intervention acceptability
Open-ended opinions on the structure and content of the exercise training sessions
Intervention acceptability
Changes in subjective physical function, cancer-specific side effects, and overall well-being directly related to the exercise intervention
Objective exercise adherence
Adherence to additional study-specific AEx will be tracked through heart rate monitor data, logs of attendance, and participant diaries and compared to the REx-only intervention

Secondary Outcome Measures

Changes in ghrelin
Fasting ghrelin, ghrelin area under the curve in response to a control meal
Changes in peptide-YY (PYY)
Fasting PYY, PYY area under the curve in response to a control meal
Changes in subjective appetite ratings
Changes in hunger, satiety, and prospective food consumption via visual analog scales
Changes in ad libitum energy intake
Energy intake from buffet-style meal
Changes in physical activity
Step count measured by accelerometers
Changes in sedentary behavior
Time in sedentary activities measured by accelerometers

Full Information

First Posted
September 15, 2020
Last Updated
May 31, 2022
Sponsor
University of Colorado, Denver
Collaborators
Colorado Clinical & Translational Sciences Institute, National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT04576247
Brief Title
Combined Modality Exercise and Appetite in Breast Cancer Survivors
Acronym
CARE
Official Title
Feasibility, Acceptability, and Effects of Combined Aerobic and Resistance Exercise in Breast Cancer Survivors: A Pilot Study (the CARE Study)
Study Type
Interventional

2. Study Status

Record Verification Date
May 2022
Overall Recruitment Status
Terminated
Why Stopped
Low accrual
Study Start Date
June 5, 2020 (Actual)
Primary Completion Date
September 20, 2021 (Actual)
Study Completion Date
September 20, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Colorado, Denver
Collaborators
Colorado Clinical & Translational Sciences Institute, National Cancer Institute (NCI)

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The overall aim of this research is to assess the feasibility of a 12-week combined aerobic exercise (AEx) and resistance exercise (REx) intervention and elucidate the impact of AEx/REx on several physiological and behavioral components of energy balance among breast cancer survivors (BCS).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Cancer Female, Overweight and Obesity

7. Study Design

Primary Purpose
Other
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Masking Description
Masking is not possible because this is a single-arm exercise study.
Allocation
N/A
Enrollment
3 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Combined aerobic and resistance exercise
Arm Type
Experimental
Arm Description
12 weeks of supervised resistance exercise and unsupervised aerobic exercise.
Intervention Type
Behavioral
Intervention Name(s)
Combined aerobic and resistance exercise
Intervention Description
The 12-week intervention will build upon an ongoing resistance exercise program for cancer patients and survivors at the University of Colorado's Anschutz Health and Wellness Center. Resistance exercise will be led by certified cancer exercise specialists who provide individualized exercise programs to cancer patients and survivors. Exercise sessions are progressive, target all major muscle groups, are 50 minutes in duration, and completed 2x/week. The intervention will also include 3 self-directed moderate-intensity aerobic exercise sessions/week, building to 50 minutes at 60% heart rate maximum (determined at baseline). Target exercise will be achieved by a gradual progression of exercise duration over the first four weeks of the program.
Primary Outcome Measure Information:
Title
Recruitment and enrollment feasibility
Description
Number of individuals approached, meeting inclusion criteria, reasons for exclusion, and enrolled in the study
Time Frame
Through study completion, up to two years
Title
Subjective exercise adherence
Description
Participants will be asked to rate on a 1-10 Likert scale: 1) how adherent they were to the prescribed exercise over the past week, 2) how difficult it was to adhere to the prescribed exercise over the past week, and 3) how likely they feel they can adhere to the prescribed exercise for the next month.
Time Frame
Changes across weeks 4, 8, and 12
Title
Exercise self efficacy
Description
Self Efficacy for Exercise Scale; 9 items; score range: 0-9, with higher scores indicating higher exercise self-efficacy
Time Frame
Changes across weeks 4, 8, and 12
Title
Exercise enjoyment
Description
Physical Activity Enjoyment Scale; 8 items; range: 7-56, with higher scores indicating higher exercise enjoyment
Time Frame
Changes across weeks 4, 8, and 12
Title
Intervention acceptability
Description
Subjective ability to adhere to combined AEx/REx
Time Frame
12 weeks
Title
Intervention acceptability
Description
Barriers to completing AEx/REx
Time Frame
12 weeks
Title
Intervention acceptability
Description
Open-ended opinions on the structure and content of the exercise training sessions
Time Frame
12 weeks
Title
Intervention acceptability
Description
Changes in subjective physical function, cancer-specific side effects, and overall well-being directly related to the exercise intervention
Time Frame
12 weeks
Title
Objective exercise adherence
Description
Adherence to additional study-specific AEx will be tracked through heart rate monitor data, logs of attendance, and participant diaries and compared to the REx-only intervention
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
Changes in ghrelin
Description
Fasting ghrelin, ghrelin area under the curve in response to a control meal
Time Frame
Baseline, 12 weeks
Title
Changes in peptide-YY (PYY)
Description
Fasting PYY, PYY area under the curve in response to a control meal
Time Frame
Baseline, 12 weeks
Title
Changes in subjective appetite ratings
Description
Changes in hunger, satiety, and prospective food consumption via visual analog scales
Time Frame
Baseline, 12 weeks
Title
Changes in ad libitum energy intake
Description
Energy intake from buffet-style meal
Time Frame
Baseline, 12 weeks
Title
Changes in physical activity
Description
Step count measured by accelerometers
Time Frame
Baseline, 12 weeks
Title
Changes in sedentary behavior
Description
Time in sedentary activities measured by accelerometers
Time Frame
Baseline, 12 weeks
Other Pre-specified Outcome Measures:
Title
Changes in resting energy expenditure
Description
Resting energy expenditure measured by metabolic cart and adjusted for body composition changes
Time Frame
Baseline, 12 weeks
Title
Changes in body composition
Description
Fat mass and fat-free mass in kg, measured by dual X-ray absorptiometry
Time Frame
Baseline, 12 weeks
Title
Changes in fatigue
Description
Measured by the Functional Assessment of Chronic Illness and Therapy - Fatigue; 13 questions; score range: 0-52, with higher score indicating higher fatigue
Time Frame
Baseline, 12 weeks

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
45 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Female sex Age: 18 - 45 years Body mass index [BMI]: 25 - 35 kg/m2 Pre-menopausal before cancer diagnosis and treatment <1 hour/week of planned physical activity by self-report in the previous 12 months Diagnosis of primary stage I - III estrogen receptor/progesterone receptor-positive (ER/PR+) breast cancer, according to institutional standards. All chemotherapy, radiation, and surgery completed at least two weeks (14 days), but less than 6 months prior to registration Exclusion Criteria: Self-reported diabetes mellitus, untreated/uncontrolled thyroid disease, history of cardiovascular disease or symptoms suggestive of cardiovascular disease (chest pain, shortness of breath at rest or with mild exertion, syncope), cancer diagnosis in the last 5 years before breast cancer (any site, excluding skin cancer), or any other medical condition affecting weight or energy metabolism. Uncontrolled hypertension defined as: systolic blood pressure >160 mmHg or diastolic blood pressure >100mmHg, as measured during the screening visit. Participants who are deemed ineligible based upon uncontrolled hypertension criteria will be referred to their primary care physicians for treatment. If this condition becomes controlled they will be allowed to be re-evaluated for inclusion in the current trial. Unable to exercise due to cardiac, pulmonary, neurological, orthopedic reasons. Currently smoking and/or nicotine use. Treatment with medications known to significantly affect appetite, weight, energy intake or expenditure in the last 3 months (e.g. appetite suppressants, lithium, stimulants, anti-psychotics, tricyclic antidepressants). Corticosteroid use within the last two weeks History of surgical procedure for weight loss at any time (e.g. gastroplasty, gastric bypass, gastrectomy or partial gastrectomy, adjustable banding, gastric sleeve); history of extensive bowel resection for other reasons Currently pregnant, lactating or less than 6 months post-partum. Score of ≥ 2 on the CAGE (cut-annoyed-guilty-eye opener) questionnaire adapted to include drug use55 Score of > 20 on the Eating Attitude Test - 26 (EATS-26), indicative of disordered eating. Participants with a score >20 on the EATS-26 will be referred to their primary care physician for further evaluation. Significant food intolerances/allergies that cannot be accommodated by the University of Colorado Hospital Clinical Translational Research Center Metabolic Kitchen. Currently participating in any formal weight loss or physical activity programs or clinical trials for weight loss. Other medical, psychiatric, or behavioral limitations that may interfere with participation (as determined by study physician). Unable or unwilling to undergo study procedures
Facility Information:
Facility Name
Univeristy of Colorado Anschutz Medical Campus
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Facility Name
University of Colorado Cancer Center
City
Denver
State/Province
Colorado
ZIP/Postal Code
80238
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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Combined Modality Exercise and Appetite in Breast Cancer Survivors

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