1. Goodwin, Peter M.

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A study group of breast cancer survivors achieved impressive weight reductions with the help of a new telehealth method reported at the 2022 American Society of Clinical Oncology Annual Meeting (Abstract TPS1603). The researchers regarded the technique as a potential method of reducing risk in this vulnerable population.

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"When we look at our breast cancer patients across our entire health care system, at least 30 percent have obesity and we know that patients with obesity in breast cancer have worse outcomes. And losing weight will improve their outcomes," said lead author Julia C. Tchou, MD, PhD, FACS, Breast Cancer Surgeon and Director of Breast Surgery Research at the University of Pennsylvania in Philadelphia.


The new research was to establish whether patients could be helped to lose weight through a program of remote contact-by phone or video calls-in which they became members of a community of individuals losing weight, together with their clinician mentors. Such a community offered advantages. The researchers wanted to test the plausible hypothesis that telehealth was a good platform that may be more acceptable to patients.

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"Having them not come into the health care or hospital may be easier for most patients," Tchou told Oncology Times.


Research Details

Current weight loss programs for breast cancer survivors generally used a hybrid of in-person visits or individualized telephone-based sessions. The hypothesis was that telehealth may be an effective and efficient means of communicating with patients who otherwise cannot go to in-person visits.


A pilot single-arm study examined the feasibility and acceptability of a weight loss group program via telehealth for breast cancer survivors. Patients over 18 years old who had completed adjuvant radiotherapy and/or chemotherapy at least 6 months previously, had ECOG performance status of 0 or 1, and a BMI of 3 25 kg/m2 were recruited.


Patients attended weekly Zoom teleconference counseling-grouped sessions either at 12 pm or 5 pm, led by a licensed clinical psychologist, for 20 weeks followed by sessions in weeks 22 and 24. Patients were encouraged to use, an online tool to monitor calorie intake and physical activity, and digital scales to monitor their weight to share with study staff to enhance accountability and provide opportunity for feedback.


Feasibility was defined as a ratio of enrolled to eligible patients of at least 50 percent. Acceptability was assessed from surveys before and after treatment, and qualitatively from exit interviews.


Secondary endpoints were changes in Quality of Life-Breast Cancer Patient (QOF-BC), Patient Health Questionnaire (PHQ-9), and percent weight loss from baseline to 24 weeks.


Research Results

The ratio of enrolled (12) to eligible (23) participants was 52 percent, confirming the study feasibility. One patient dropped out after two sessions. Seven out of nine patients rated the telehealth format as "extremely acceptable." Surveys also indicated that the format and delivery of the program remained acceptable throughout the study with no significant changes, except an increase in "approval" from 4.1 to 4.7.


Patients' mood improved on the PHQ-9 from 4.2 to 1.2, and QOL-Physical Wellbeing improved from 56.9 to 66.3. Overall, 199 of 236 participant sessions (84%) were attended. Weight loss was 6.5 percent plus or minus 2.5 percent.


The researchers concluded that this proof-of-concept weight loss program was feasible and acceptable for patients, yielding improvements in QOL, mood, and a clinically significant weight loss over 6 months.


The patients were contacted initially by phone, giving their consent by phone. "And then they participate [with] weekly sessions, and we make it very flexible in the Zoom group sessions-for 20 weeks-and we have 84 percent attendance," Tchou said. "When we survey these patients before the intervention and after the program, they report that the program is extremely acceptable. The patients also reported that their quality of life had improved after the program. The average weight loss in the entire program is 6.5 percent-which is clinically meaningful. I think that incorporating weight loss intervention into the care of breast cancer is super important."


As well as addressing wellness in the period after initial treatment, Tchou noted that the time for cancer teams to intervene and educate patients to adopt healthy lifestyle was when patients were well and being followed with maintenance visits.


"Group-based telehealth weight loss programs are feasible and acceptable, and could potentially be widely disseminated. The program is not restricted to just one region: everyone in the entire nation can join the program," Tchou noted.


Peter M. Goodwin is a contributing writer.


Listen to the Podcast

At the ASCO 2022 Annual Meeting, Oncology Times reporter Peter Goodwin caught up with Julia C. Tchou, MD, PhD, FACS, from the University of Pennsylvania Health System, during her poster session. Learn more about her research in the podcast at