Cancer survivors may suffer from a range of ongoing psychosocial and physical problems. The number of cancer survivors is increasing due to the ageing population, a rising incidence in some cancers, and improvements in early detection and treatment. As such, there is increasing interest in how to reduce the ongoing problems for this population to ultimately enhance their quality of life. In Australia and the developed world, colorectal cancer or bowel cancer is the most common invasive cancer for men and women and the risk of developing the disease increases with age.

While 60 per cent of patients diagnosed with bowel cancer survive the disease, many suffer from ongoing distress and have poor lifestyle factors (physical activity, nutrition, smoking, body weight) which is detrimental to: treatment adherence and self-care; physical and emotional functioning; quality of life; cancer recurrence; development of other chronic diseases such as diabetes and heart disease; and ultimately survival. As such, there is a need to develop and trial supportive care programs or interventions for colorectal cancer survivors with a focus on emotional well being and lifestyle behaviours to improve their psychosocial and physical functioning.

'CanChange' is a randomised controlled trial of a lifestyle intervention for colorectal cancer survivors. The purpose of this project is to investigate the effect of a lifestyle intervention on lifestyle factors and health outcomes for recently diagnosed colorectal cancer survivors.

Previous research has suggested that interventions to improve quality of life after colorectal cancer may be most effective if they target symptom management, psychosocial and lifestyle factors in a comprehensive and integrated approach. The CanChange intervention is delivered by highly skilled health professionals (‘health coaches’) and covers the cancer experience, symptom-management and lifestyle behaviours in an integrated program. The intervention is also telephone-delivered to increase the reach for disadvantaged groups living in rural and remote areas of Queensland.

Staff involved: Anna Hawkes, Suzanne Chambers, Joanne Aitken, Peter Baade, Rhianna Murray, Sue Bell, Bernice Kelly, Sarah Mitchell, Julieta Ferreira, Tania Patrao.

Collaborators: Ken Pakenham (University of Queensland), Kerry Courneya (University of Alberta), Louisa Gordon (Queensland Institute of Medical Research), Maree Colosimo (Medical Oncologist), Victoria White (Cancer Council Victoria) and Muriel White (Consumer Advisor).

Funded by: Cancer Australia.

Contact: Anna Hawkes

Colorectal (bowel) cancer is one of the most common invasive cancers in Australia, accounting for 12,536 new cases and 4,372 deaths in 2003. The risk of developing colorectal cancer increases with age, and is greatest in those over 50. As the Australian population ages, the number of people diagnosed with colorectal cancer will rise accordingly. Little is known about the long-term outcomes, needs and concerns of the 60 per cent of patients who survive colorectal cancer.

The purpose of this project is to describe the patterns of diagnoses and treatment, as well as predictors of quality of life up to five years post-diagnosis for colorectal cancer survivors.
The Colorectal Cancer and Quality of Life study examines in detail how patients fare after their treatment, and identifies the factors that influence quality of life in the years after diagnosis. Approximately 2000 people have been recruited to take part in this study, making it the largest colorectal cancer study of its type to be undertaken. Participants complete a telephone interview and a written questionnaire on an annual basis, over five years.

One of the aims of the study is to uncover how lifestyle factors, particularly physical activity, may improve quality of life and reduce the risk of developing other chronic diseases that cancer survivors are prone to, such as heart disease and diabetes. This information will help Cancer Council Queensland properly design and target lifestyle interventions to help improve the health and well-being of the growing number of colorectal cancer survivors in our community.

Staff involved: Joanne Aitken, Jeff Dunn, Suzanne Chambers, Anna Hawkes, Peter Baade, Rachel Austin, Monica West.

Collaborators: Beth Newman (Queensland University of Technology), Barbara Leggett (Royal Brisbane and Women’s Hospital), Ken Pakenham (University of Queensland), Neville Owen (University of Queensland).

Contact: Joanne Aitken

A randomised controlled trial of a secondary prevention program for myocardial infarction patients: ‘ProActive Heart’

Coronary heart disease (CHD) is a significant cause of health and economic burden. Secondary prevention programs with a focus on psychosocial support, medication compliance and lifestyle factors (physical activity, nutrition, smoking and weight management) play a pivotal role in the treatment and management of those affected by CHD. However, participation rates in traditional hospital-based secondary prevention programs are poor in Australia and internationally due to a range of barriers including transport and return to work. As such, there is a need to develop innovative secondary prevention programs to address the treatment gap. Telephone-delivered care is convenient, flexible and has been shown to improve behavioural and clinical outcomes following myocardial infarction.

ProActive Heart is a randomised controlled trial of a secondary prevention program for myocardial infarction patients. The purpose of this project is to investigate the effect of a telephone-delivered secondary prevention program on health outcomes and lifestyle factors for recently diagnosed myocardial infarction or heart attack patients.

The ProActive Heart intervention is delivered by highly skilled health professionals (‘health coaches’) during ten telephone health coaching sessions over a six month period. The program targets clinical risk factors, adoption of a healthy lifestyle, medication compliance, and management of psychological issues including depression.

ProActive Heart study participants have been recruited (n=430) through Brisbane metropolitan hospitals and final results will be available in 2010.

ProActive Heart project is administered by Monash University and delivered from the VCRCC at Cancer Council Queensland.

Staff involved: Anna Hawkes, Kathy Eadie, Dominique Bird, Brigid Hanley, Bernice Kelly, Julieta Ferreira, Helen Maxwell.

Collaborators: Prof Brian Oldenburg (Monash University), Prof Barr Taylor (Stanford University), A/Prof John Atherton (Queensland Government).

Funded by: National Health and Medical Research Council.

Contact: Kathy Eadie