After people are diagnosed with cancer, their health risk behaviors such as smoking, overeating, and lack of physical activity may affect the likelihood that they will not respond to treatment, have side effects from treatment, may get a new cancer, and are more likely to get heart disease or diabetes.
In addition, patients who smoke or are obese add $124.3 million per year to the cost of cancer treatment at Northwestern Medicine https://news.feinberg.northwestern.edu. The costs accumulate because obesity adds $3,216 per person per year to medical expenses for cancer survivors, and Northwestern’s eleven hospitals treat 27,024 patients with cancer and obesity per year. The cost for overcoming first line treatment failures caused by smoking is $10,678 per patient, and Northwestern treats 3,500 cancer patients who smoke in a single year.
In a trial NCI within NIH will test whether a telehealth based intervention that addresses behavioral risk factors can modify cancer patients’ lifestyles to improve their outcomes. The trial will recruit 3,000 participants at eleven Northwestern Medicine hospitals.
To study the telehealth based intervention, Northwestern’s program for Scalable Telehealth Cancer Care will receive $5.5 million over five years as part of a new initiative that is funding four NCI Telehealth Cancer Research Centers of Excellence to accelerate the rate of progress against cancer.
Patients are coached remotely by phone and trained to use an app that can track their behaviors. They self-report their diet and smoking, stand on a Wi-Fi scale, and wear a Fitbit. The data is sent to their coach electronically, so when they have a bi-weekly coaching call, the coach is up to speed on how the person is doing.
According to Bonne Spring PhD, Chief of Behavioral Medicine in the Department of Preventative Medicine Program, “These risk behaviors are the same for most chronic diseases, which is important because many cancer patients are more likely to die from cardiovascular diseases than from cancer.”
The remote telehealth aspect is critical to success, according to Dr. Spring. “It is important because we think this may be a way to reach more underserved people who can’t access treatment because of distance, work multiple jobs, don’t have reliable transportation, can’t get childcare, or can’t get time off work”.
The data obtained is integrated into the patient’s EHR to update the cancer team. Also, Dr Spring reports, “Telehealth treatments have generally been effective and seem to enable underserved patients to access care more easily. That is why there is a need to establish a strong research evidence base as to whether telehealth works for cancer care and can be made more equitable.