Overweight or obese women who have been diagnosed with breast cancer have a higher risk of recurrence (the breast cancer coming back). More than 50% of breast cancer survivors are considered overweight or obese. Only about one-third of women who’ve been treated for breast cancer meet the American Cancer Society’s exercise recommendations: 150 minutes of moderate or 75 minutes of vigorous exercise, plus two strength training sessions, per week.
A pilot study suggests a smartphone app giving women real-time contact with their healthcare team can help breast cancer survivors lose weight.
The research was published online on Nov. 30, 2018, by the journal JCO Clinical Cancer Informatics. Read the abstract of “A Behavior-Modification, Clinical-Grade Mobile Application to Improve Breast Cancer Survivors’ Accountability and Health Outcomes.”
The link between excess fat and breast cancer
Overweight women have a higher recurrence risk in part because fat cells make estrogen; extra fat cells mean more estrogen in the body and estrogen can make hormone-receptor-positive breast cancers develop and grow. Scientists also have found that extra fat cells can trigger long-term, low-grade inflammation in the body. Chronic inflammation has been linked to a higher risk of breast cancer recurrence; the proteins secreted by the immune system seem to stimulate breast cancer cells to grow, especially estrogen-receptor-positive breast cancer in postmenopausal women.
App offers link to healthcare team
To help women stick to a healthy eating and exercise plan, researchers at Houston Methodist Hospital developed a smartphone app called MOCHA that gave the women daily, real-time contact with members of their healthcare team, including a registered dietitian and an oncologist.
MOCHA includes a number of features aimed at helping women make healthy lifestyle choices about exercise, food, and sleep. Women can enter the type, amount, and intensity level of their exercise activities, as well as keep a food diary and use the app to see nutritional information about the food. MOCHA also can synchronize with a Fitbit account to automatically track steps per day and calories burned.
A dietitian monitored each women’s information and contacted her by the app or by text if she wasn’t meeting her exercise goals or was making less than optimal food choices.
The pilot study on MOCHA included 33 women diagnosed with early-stage breast cancer who were not on active treatment — meaning they were not receiving chemotherapy or radiation therapy, but may have been taking hormonal therapy.
The women ranged in age from 35 to 78 years. Many of them had other health problems:
- 16.1% had diabetes
- 45.2% had high blood pressure
- 29% had high cholesterol
- 38.7% were overweight
- 61.3% had obesity
Many of the women (64.5%) said they had tried other health apps but lost interest because they forgot or didn’t feel it was helping them lose weight.
MOCHA was installed on the women’s phones for 4 weeks, and they were encouraged to use the app at least 5 days per week to log what they ate, their exercise, and well-being. At the end of 4 weeks, the women provided feedback on using MOCHA and also told the researchers their weight.
Overall, the women found MOCHA easy to use. The women said they were motivated to use it and preferred it over other health apps they had tried. More than half (56%) of the women lost an average of 3.5 pounds during the 4 weeks of the study. The results showed that the more the women used the app, the more likely they were to lose weight.
Expanding access to MOCHA
While the app is currently only available to the women in the pilot study, the goal is to offer it widely through the Apple App Store and Google Play, according to Tejal Patel, M.D., one of the study’s senior authors and a breast medical oncologist at Houston Methodist Cancer Center.
“We want the app to be used by a lot of people,” she said. “It gives patients more contact with their doctor’s office, especially the dietitian. This adds accountability to our app, which isn’t part of many other health apps.”
Patel added that while it may seem that expanding the app to thousands of users would take more time on the part of the healthcare team, that isn’t really true.
“Currently, the dietitian in our office meets with patients for 30 minutes once after they’re done with treatment,” Patel explained. “The app allows the nutritionist to see what the women are eating and whether or not they’re meeting their exercise goals and then send them a text asking them if something is going on or if they need more specific help or information. The app allowed the dietitian to interact with more patients in one day than she normally would in person.”
Losing weight can be hard but is so important
If you’ve been diagnosed with breast cancer, try to make exercise and a healthy diet part of your daily routine, especially if you’re overweight. It may be hard to make these kinds of changes if you’re struggling to recover from treatment. Some women say it helps to think of eating well and exercising as important parts of their treatment plans. As this study suggests, it seems to be easier to make diet and exercise changes if you have someone to talk to you and motivate you. You might want to talk to your doctor or a registered dietitian about developing a healthy eating plan designed specifically for you and your needs.
It’s also a good idea to talk to your primary care doctor and your surgeon before you start an exercise program. Tell them the exercises you plan to do, and ask if there are any movements you should avoid or if you should limit your range of motion in any way. It’s also smart to talk about any other medical conditions you have (asthma or osteoporosis, for example) and how they may affect your ability to exercise.
Losing weight can be hard to do, but it can be done with careful diet and exercise changes. Be nice to yourself; don’t punish yourself.
In the Breastcancer.org Nutrition section, the Eating to Lose Weight After Treatment pages can help you assess your weight and create a healthy eating plan. And the Breastcancer.org Exercise section can help you find a trainer and learn how to stick to an exercise routine.
To discuss exercise and nutrition after a breast cancer diagnosis with others, join the Breastcancer.org Discussion Board forums Fitness and Getting Back in Shape and Heathy Recipes for Everyday Living.
Written by: Jamie DePolo, senior editor
Reviewed by: Brian Wojciechowski, M.D., medical adviser