Understanding the connection between excess weight and breast cancer and designing effective weight loss interventions to reduce the risk of cancer posed by obesity.

Impact

Women with breast cancer who are overweight or obese experience poorer outcomes compared to those of average weight, despite standard optimal local and adjuvant therapy. Many women gain weight following a breast cancer diagnosis, which may increase the risk of recurrence and death. Studies suggest that weight loss may be associated with improved breast cancer survival outcomes and Dr. Stearns is focused on enhancing interventions for weight loss to better understand the biological processes involved. Dr. Stearns’ research is designed to assess weight loss approaches and how they affect breast cancer biomarkers. Her team has designed and tested the POWER-remote study to evaluate the effectiveness of a remote (telephone-based) dietary counseling program in overweight or obese women with early-stage breast cancer. In other studies, Dr. Stearns is also investigating the association between insufficient sleep and increased BMI/obesity. Collectively, this research that has the potential to reduce risk of breast cancer or its recurrence and thus improve outcomes for patients.

Progress Thus Far

Dr. Stearns found that 46 percent of women enrolled in the POWER-remote intervention were successful in losing five percent of their body weight compared to their self-directed peers at 6 months. In addition, patients in the remote intervention group sustained their weight loss over 12 months and achieved a significant decrease in circulating factors related to breast cancer growth and cardiovascular risk. Furthermore, participants that reported poor sleep had half the weight loss that those with better sleep. Building on this observation, the team initiated a cognitive-behavioral intervention for insomnia-the Cancer, Obesity/Overweight, and Insomnia study (COIN) to assess whether a sleep intervention will augment the benefits of POWER-remote.  The results did not show a significant difference in weight loss between those who received the intervention compared to those who did not. In related work, Dr. Stearns and her team are testing the combination of a weight loss medication (Contrave®) with POWER-remote in women with a history of breast cancer. The study called Adaptive Nutrition and Exercise Weight Loss/A-NEW  is enrolling patients for an eight-week intervention. 

What's next

The team will validate their findings from the POWER-remote and COIN studies in larger trials. They will continue to conduct the A-NEW study and evaluate the efficacy of behavioral interventions on weight loss with and without the addition of Contrave®. In addition, Dr. Stearns and her colleagues will evaluate blood and stool samples to compare the microbiome in both groups.