Jill Sittenauer, left, regional communications director for the American Cancer Society, visits with researcher Christie Befort, of Preventive Medicine & Public Health at Kansas University Medical Center, on May 3, 2012, in Befort's office. The American Cancer Society helped fund Befort's pilot weight loss study for rural breast cancer survivors, and Befort is showing Sittenhauer some of those promising results. Befort said women who are overweight and women who gain weight after diagnosis have an increased risk for breast cancer recurrence and worse prognosis compared to women with a normal body weight. by Kevin Anderson

Editor’s Note: This is the third in a three-part series about Relay For Life of Douglas County, a benefit for the American Cancer Society. Today: Research.

Breast cancer survivor Pat Cashatt received a letter that intrigued her. It was from a Kansas University Medical Center researcher who wanted to know if she would be interested in participating in a study on weight loss.

“I had fought weight all of my life, so I filled it out and sent it in,” she said. “I didn’t think it work, but I thought it was worth a try.”

It was a six-month study that provided Cashatt with a weight loss regimen that included nutrition, exercise and support. She lost 45 pounds during the study which ended one year ago. Since then, she’s kept the weight off.

“I feel better than I’ve felt in years,” Cashatt, 72, a retired high school business teacher, said. “I’ve gotten off of all my medications. I have more energy and everything. So I’m really high on this program.”

•••

The weight loss study is the brainchild of KU researcher Christie Befort, 37. She’s researching how to cost-effectively help rural breast cancer survivors lose weight and then maintain it.

She said studies have shown that women who are overweight and women who gain weight after diagnosis have an increased risk for breast cancer recurrence and worse prognosis compared to women with a normal body weight. Additionally, the obesity rate is higher among rural women than urban.

Befort received a $30,000 grant from the American Cancer Society for her pilot study, and KU provided $5,000. She enrolled 35 women who lived near Hays, Pittsburg and Salina, including Cashatt, who lives in Beloit, about 65 miles north of Salina.

All of the women had been diagnosed with breast cancer in the past 10 years, had finished their treatments at least three months earlier and were considered overweight or obese with a Body Mass Index between 27 and 45.

During the study, they were placed on a 1,200-to-1,500 calorie plan that consisted of two shakes, two pre-packaged entrees and five one-cup servings of fruits and vegetables each day.

They started with 45 minutes of exercise per week and worked up to nearly four hours per week. They received support by participating in weekly conference calls with the other women, a dietitian and clinical psychologist. Each one lasted at least an hour. Participants kept track of their activities and weight on forms which were mailed in on a weekly basis.

“The women were amazing and very motivated,” Befort said. “We had really great results.”

Collectively, the group lost 14 percent of its starting weight.

The results of the study were so impressive that Befort recently landed a $3 million grant from the National Cancer Institute for a five-year study to expand her research. She’s currently enrolling 208 women who fit the same criteria. The women will be enrolled for 18 months instead of just six months, and there will be two phases to the project instead of one.

Befort said the first phase will be similar to the pilot study where the women will receive the diet and exercise regimen for six months. Then they will be randomly assigned a maintenance program where they will either participate in biweekly conference calls or get biweekly newsletters.

“So both of those approaches are low-tech and low-cost. Our primary endpoint is looking at prevention of weight gain from six to 18 months,” Befort said.

Once she proves the most effective tools in helping breast cancer patients with weight management, the goal would be to make it widely available; perhaps insurance companies would help cover the costs. Ultimately, it could save lives.

Christie Befort, a researcher in Preventive Medicine & Public Health at Kansas University Medical Center, recently received a $3 million grant from the National Cancer Institute for a five-year study to expand her research on weight loss among rural breast cancer survivors. Befort received the grant after conducting a pilot study with a $30,000 grant from the American Cancer Society. by Kevin Anderson

•••

Jill Sittenauer, regional communications director for the American Cancer Society, said the nonprofit organization looks for researchers like Befort who are in the early part of their careers and need some funding to get started.

“We look for the people who haven’t been proven yet, who have the unique, different ideas and then they do it, and they do it so well that they get big federal funding which is what everybody wants,” she said.

Forty-six researchers who have received American Cancer Society funding have gone on to win the Nobel Prize, the highest accolade of scientific achievement. The American Cancer Society, or ACS, also has helped provide funding for research that has led to major breakthroughs such as:

• mammography to screen for breast cancer.

• lumpectomy plus radiation for treatment of breast cancer.

• use of Tamoxifen to reduce risk of breast cancer.

• confirmed smoking as a cause of lung cancer.

• PSA test for prostate cancer screening.

Sittenauer said ACS is the second-leading funder of cancer research; it’s second only to the federal government. Last year, it invested $148 million in cancer research. There currently are ACS grants worth a total $2.5 million that have been given to KU researchers.

Sittenauer said the American Cancer Society is only able to fund 20 percent of the research applications that it receives. It then has a “Pay If” list of researchers. If they receive more donations than expected from events like Relay For Life, then whoever is at the top of the “Pay If” list will get funded. She said Tamoxifen, a drug that’s used for prevention and treatment of breast cancer, was once on that list.

She added that it’s not just researchers and scientists who decide which applications get funding — it’s citizens who have a passion for helping people with cancer.

•••

Cashatt, who has been cancer-free for five years after a double mastectomy, said she continues to apply what she learned through Befort’s pilot weight loss study.

“I’ve just stayed on the program basically. I never felt like it was a diet,” she said. “It was a change in eating habits.”

While 1,500 calories per day didn’t sound like much, she said she struggled sometimes to eat everything that she was required to. That’s because the fruits, vegetables and shakes were filling.

“They weren’t empty calories. They were good, healthy calories,” she said.

She learned how to cut down on fats and processed sugars, and how to cope with food triggers, among other things.

As for exercise, that wasn’t difficult for her because she is a walker; she just needed to pick up the pace. She wore a pedometer because participants were required to get at least 10,000 steps a day. She said that was tough for the women who worked at a desk all day and then had children to tend to at night.

Cashatt said she wasn't looking forward to the weekly phone conferences which were at 5:30 p.m. Wednesdays. Each one had a topic such as food labels, managing stress, and eating on the go.

Pat Cashatt

"I'm not a group person and I was really dreading the phone conferences and I can't say that I really liked them, but the information that I got from the group and the leaders really helped."

She said the weekly forms that she had to turn in kept her accountable. On them she tracked her weight and whether she met her nutrition and exercise requirements. Once a month, they tracked everything they ate.

“I hated that,” she said, with laughter. “But it made me realize having a couple bites of this or a couple bites of that while fixing my husband’s meal can quickly add up.”

Since the study ended, Cashatt has received a few follow-up phone calls from researchers. There was a phone conference call in mid-May with all of the participants.

Even if her cancer returns, Cashatt’s glad she participated in the study. It proved to be life-changing.

KU RESEARCH STUDY

Kansas University researcher Christie Befort is seeking breast cancer survivors who live in rural areas to participate in an 18-month weight loss study.

To be eligible, you must be:

• female.

• overweight or obese with a Body Mass Index between 27 and 45.

• 75 years old or younger.

• postmenopausal.

• diagnosed with breast cancer within past 10 years.

• finished with treatments for least three months.

• able to walk briskly unassisted for at least 10 minutes.

To learn more, contact Heather Austin at haustin@kumc.edu or 913-588-3030.

AMERICAN CANCER SOCIETY'S EXPENDITURES

Here's a breakdown on how the American Cancer Society spends its money:

• 32 percent — Research.

• 30 percent — Patient services and programs.

• 18 percent — Prevention and early detection programs.

• 17 percent — Fundraising.

• 3 percent — Management.

Luminarias lined the track during the 2011 Relay For Life of Douglas County at Free State High School. There were 2,950 at the event. by Kevin Anderson

JOIN RELAY

Relay For Life of Douglas County will be from 7 p.m. June 8 to 7 a.m. June 9 at Free State High School's track. The event is free and open to the public. Here's the lineup of activities:

• 5:30 p.m. June 8 — Children's activities area opens.

• 6:45 p.m. — Presentation of Colors.

• 7 p.m. — Opening ceremony and survivor's lap.

• 9:15 p.m. — Luminaria ceremony begins. Dr. Rod Barnes, a leukemia survivor, will be the keynote speaker.

• 5:30 a.m. — Closing ceremony begins.

To make a donation to Relay For Life of Douglas County, visit relayforlife.org/douglasks or make a donation at the event. This year's goal is to raise $175,000.

OTHER STORIES

Part 1: A look at the fundraising efforts in Douglas County and one woman's volunteer efforts in memory of her daughter-in-law.

Part 2: A look at the services and programs, including Hope Lodge, that the American Cancer Society funds for cancer patients and caregivers.

Hope Lodge is located in downtown in Kansas City, Mo., in the historic Quality Hill neighborhood. The American Cancer Society provides free housing to cancer patients traveling to Kansas City for treatment. Since opening in 2000, Hope Lodge has served 2,387 patients, including 41 from Douglas County. by Kevin Anderson