Researcher puts focus on the health of Latina breast cancer survivors

Breast cancer is the leading cause of cancer death among Latinas in the United States. Latinas are also twice as likely to experience other conditions that crop up, including insulin resistance and metabolic syndrome—a cluster of health conditions that includes high blood pressure, excessive body fat and high cholesterol.

To deal with some of these secondary conditions, Assistant Professor of Research Christina Dieli-Conwright is launching a new study of 160 Latina breast cancer survivors to take part in a yearlong exercise study at the USC Division of Biokinesiology and Physical Therapy.

The subject matter is well-tread territory for Dieli-Conwright, who has conducted previous studies on the effects of exercise on women from all backgrounds who had survived breast cancer.

Latinas: under-researched population

For this study, funded by a $792,000 grant from the American Cancer Society, Dieli-Conwright will focus on Latina breast cancer survivors.

She said that while finishing her prior study, she recognized the unique opportunity she had in Los Angeles to study women from the Latino community, so she zeroed in her efforts on that.

"This population is at a higher risk for sedentary behaviors, Type 2 diabetes and heart disease," said Dieli-Conwright, who added that preliminary work shows there could be genetic differences, though that's not the focus of this study. This research will look exclusively at Latina women's behavior and lifestyle, which often differs from non-minority women.

Dieli-Conwright recently did a search on studies examining the impact of exercise on breast cancer and was surprised to find how few looked at minority participants.

"Out of the 475 exercise studies, fewer than a dozen focused on a minority population," she said. The bulk of research focuses on individuals of a higher socioeconomic status population, primarily Caucasian women.

She explained that Latinos, overall, have more unique barriers to participating in exercise and clinical trials, and are less represented in clinical research as an ethnic group than other groups. USC's geographic location and community connections offer a unique access to get these women involved in cancer research.

"There are very few institutions that have access to these populations and have national cancer centers," Dieli-Conwright said.

Clinic-to-community approach

The new randomized, controlled study will test the effects on risk factors related to Type 2 diabetes and heart disease after cancer survival. One group of breast cancer survivors will undergo a three-part exercise regimen over the course of a year, while the other, a control group, will continue their same lifestyle.

For the exercise group, the first four-month period will be spent in the exercise center at USC, using American Cancer Society guidelines for exercise while participating in one-on-one sessions three times a week with the research staff.

Then the same women are phased out of a clinical environment and put in a community-based exercise program. They will be given a YMCA membership at no cost and get exercises to do on their own.

And during the final four-month period, the women will be completely on their own.

"We will give them a program of what exercises to do, but we will not pay for gym membership," Dieli-Conwright said.

"At the end of the 12-month period, we want them to understand the benefits of physical activity and feel more confident in exercising on their own," she said.

Those benefits may include longer, healthier lives.

Exercise interventions

There is a great deal of research that tests home-based and phone-based exercise interventions, Dieli-Conwright said. But she wanted to educate participants, get them in the clinic first and give them supervision before sending them out into the world—slowly building their confidence to exercise on their own.

It's an approach called clinic-to-community or de la clínica a la comunidad, she said.

"We think we can get them to buy in better if they get exposure to exercise in a clinical design setting."