Scientist in the Spotlight: Karen Basen-Engquist, PhD, MPH
A speaker at the 2013 AICR Annual Research Conference, Karen Basen-Engquist is a psychologist who works with cancer survivors to improve their well-being and quality of life by seeing how to best help them adopt healthier lifestyles. Here, Basen-Engquist, a professor at the University of Texas M.D. Anderson Cancer Center, spoke about her new transdisciplinary center and research involving health and surviving cancer.
Q: Tell us about your research with cancer survivors and why it’s important.
A: My research relates to cancer survivorship and the impact of exercise, weight management and healthy eating on quality of life. We study behavior change processes to find out what helps people make positive changes in their lives and do intervention trials to look at how outcomes, such as weight loss, can affect the lives of cancer survivors. We also look at the effect of exercise and behavior change on biomarkers related to chronic disease and cancer. We mainly study gynecological and breast cancers. But we are doing a study right now with late stage colon cancer, working to help improve patients’ physical functioning and quality of life.
Q: What led to your interest in this field?
A: I came to M.D. Anderson in 1996 with an interest in the quality of life of cancer survivors. Before the 1990s, we weren’t doing a lot to encourage cancer survivors to change. At that time, most quality of life work was focused on measurement. I saw a need to do more work on what we can actually do to improve the quality of life for cancer survivors. My tools were from health behavioral change and I applied them to quality of life work.
The first question we asked was whether it was safe for cancer patients to incorporate exercise. We found out that the answer was “yes.”
Q: What are the benefits to people with cancer who exercise and eat healthy?
A: There is evidence that exercise can lower cancer risk, but there's also strong evidence that exercise benefits quality of life. It helps with pain, fatigue and the ability to do the tasks required of daily living. It can also improve other chronic conditions and protect against heart disease, stroke and diabetes. The reality is that a lot of cancer survivors will die of something other than cancer, like cardiovascular disease.
The evidence related to healthy eating is more incomplete, but a lot of data shows that for most types of cancer, obesity is negatively related to recurrence, especially with breast and prostate cancers. While behavior change is a very individual process and often depends on peoples’ beliefs, it may be best to address both diet and exercise at the same time.
Q: What are some of the studies you are working on now?
A: One of the studies we are doing is with endometrial cancer survivors. We are looking at the factors that affect the likelihood they pursue exercise. We're using many assessments, including an ecological momentary assessment, which is similar to a handheld computer that asks questions about barriers and outcomes at the moment exercise occurs. We recently published this work in Health Psychology and found that confidence in the morning was related to how much exercise a person did that day. If they were confident, they were more likely to exercise. We also found that confidence varied day to day.
"The first question we asked was whether it was safe for cancer patients to incorporate exercise. We found out that the answer was 'yes.' "
Q: You also are working with mobile health technologies, right?
A: We are particularly interested in influencing self-efficacy in real-time by using smart phone applications that assess behavior, as well as deliver messaging, to help motivate people. We also use mHealth as a way to self-monitor behavior and have found that it’s a terrific way to help modify behavior. There are a lot of smart phone apps available to monitor behavior, but they aren’t all evidence-based, so we are partnering with a company to develop and test new apps.
Q: Can you share any tips for those who want to help survivors incorporate exercise into their lives?
A: Exercising came to me later in life, so I am able to take the perspective of a non-exerciser. I think the best way to go about it is to make small and incremental changes. It’s important for us to address the needs of people who aren’t active at all and to get them to start slowly. Those are the type of people who will be helped the most by incorporating exercise.
There really aren’t any guidelines that advise on the best time to adopt a healthier lifestyle once you’ve had cancer. But, ”why wait?” There are really no good reasons to wait to become healthier.
We’ve found that once cancer treatment ends, people are a bit more receptive. It’s kind of scary for treatment to end. All of a sudden, it stops, along with seeing your doctor and the constant care you received. Filling that void with something active can be empowering
Excerpted from AICR's ScienceNow.