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Lifestyle Program for Breast Cancer Improves Body Composition, Fitness, and Patient-Reported Outcomes: A Randomized Clinical Trial †
by
, , , , , , and
Catherine Powers-James
‡
,
Aimee J. Christie
‡,
Banu Arun
,
Taylor Austin
,
Gildy Babiera
,
Karen Basen-Engquist
,
Cindy L. Carmack
,
Alejandro Chaoul
,
Lisa Connelly Newton
,
Robin Haddad
,
Carol Harrison
,
Cheuk Hong Leung
,
Yisheng Li
,
Smitha Mallaiah
,
Raghuram Nagarathna
,
Patricia A. Parker
,
George H. Perkins
,
Amy Spelman
,
Anil K. Sood
,
Richard W. Wagner
,
Peiying Yang
,
Sai-Ching J. Yeung
and
Lorenzo Cohen
*add
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Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1414, Houston, TX 77030, USA
*
Author to whom correspondence should be addressed.
†
Portions of this work were presented at the International Congress on Integrative Medicine & Health (2024) and the American Psychosomatic Society Annual Meeting (2024).
‡
These authors contributed equally to this work. All other authors are listed in alphabetical order except for corresponding author.
Cancers 2026, 18(11), 1757; https://doi.org/10.3390/cancers18111757
Submission received: 19 February 2026
/
Revised: 1 May 2026
/
Accepted: 8 May 2026
/
Published: 27 May 2026
(This article belongs to the Section Clinical Research of Cancer)
Simple Summary
Lifestyle factors have been linked to better symptom control and clinical outcomes for women undergoing treatment for breast cancer. However, there are limited comprehensive programs that support patients during and after treatment. The current study examined the benefits of a comprehensive program that included healthy eating, exercise, stress management, and emotional and behavioral support (starting during radiation and continuing for a year) on anthropometrics, cardiorespiratory fitness, fiber intake, and quality of life outcomes in women with breast cancer. The findings reveal that this approach may benefit patients in multiple areas, suggesting the value of incorporating structured comprehensive lifestyle programs into standard care. The paper highlights the importance of studying whole-person interventions and supports the need for larger studies to confirm these promising results.
Abstract
Importance: Lifestyle and supportive care interventions may improve treatment tolerance, long-term health behaviors, and survivorship outcomes among breast cancer patients receiving radiotherapy. Few randomized trials have integrated nutrition, exercise, stress management, and psychosocial counseling concurrently with radiotherapy and extended across survivorship. Objective: To evaluate the effects of a comprehensive lifestyle intervention (CompLife) initiated during radiotherapy and maintained for 12 months on body composition, fitness, quality of life, symptoms, and nutrition. Design, Setting, and Participants: Randomized clinical trial at a single cancer center. Eligible women were aged ≥18 years with stage II/III breast cancer scheduled for radiotherapy, BMI ≥ 24.5, and ≥2 lifestyle risk factors. Participants were randomized to CompLife or standard of care (SOC). Assessments occurred at baseline, end of radiotherapy, and 3, 6, and 12 months. The primary outcome of recurrence is ongoing; this report examines prespecified secondary outcomes. Interventions: CompLife included 6 weeks of in-person counseling integrating nutrition, physical activity, mindfulness, stress management, and psychosocial support; twice-weekly exercise, diet, and mind–body sessions during radiotherapy; and telehealth counseling for 12 months. SOC participants received standard educational materials. Main Outcomes and Measures: Secondary outcomes included visceral adipose tissue (VAT), weight, waist circumference, fitness (VO2 max, strength), SF-36 Physical and Mental Component Summary scores, MD Anderson Symptom Inventory scores, mindfulness (FFMQ), and dietary fiber intake. Results: Ninety-five women were randomized (CompLife, n = 50; SOC, n = 45). CompLife participants had lower VAT at 3 and 6 months (e.g., 3 months: 118 vs. 141 cm2; p = 0.044) and greater improvements in VO2 max at 3 (23.4 vs. 18.8 mL/kg/min; p = 0.025) and 6 months. SF-36 Physical scores improved to within population norms for CompLife at all follow-ups but remained below norms in SOC. CompLife participants reported fewer symptoms at 12 months (MDASI: 1.3 vs. 2.5; p = 0.014). Fiber intake was consistently higher in CompLife participants (20.5 g vs. 14.0 g; p < 0.001). The results should be interpreted with caution due to the large number of comparisons among the secondary outcomes. Conclusions and Relevance: A multidisciplinary lifestyle intervention delivered during radiotherapy and extended across survivorship produced clinically meaningful improvements in body composition, fitness, diet, and patient-reported outcomes. The findings suggest potential value in integrating structured lifestyle and psychosocial counseling into oncology care and warrant confirmation in larger multicenter trials with mature recurrence endpoints.
