A study looking at giving lifestyle advice to people having treatment for bowel cancer (TreatWELL)

Cancer type:

Bowel (colorectal) cancer

Colon cancer

Rectal cancer

Status:

Results

Phase:

Other

This study looked at giving advice about diet, physical activity and other lifestyle factors to people who have had treatment for bowel cancer.

They were also given active social and behaviour support to help them change their lifestyle.

More about this trial

Certain lifestyle changes might improve the outcome of treatment for bowel cancer.

Researchers provided a lifestyle advice and support programme for people with bowel cancer from shortly after diagnosis until the end of their treatment.

In this study they wanted to see how practical this was to do.

They used an intervention programme called TreatWELL. It includes advice, social support and support to change behaviour about increasing the amount of physical activity and improving diet.

Advice, social support and support to change behaviour about stopping smoking and reducing alcohol intake was also given where appropriate.

Summary of results

The study found that further work needs to be done before it is possible to do a randomised clinical trial using the TreatWELL programme.

This study was open for people to join between 1st April 2014 and 31st October 2014.

These results were published in 2017.

About this trial

This was a feasibility study.

22 people from the Ninewells Hospital in Dundee and the Royal Perth Infirmary joined this study.

Everyone had a lifestyle coach. The lifestyle coach had a nursing background and experience in working with cancer patients. They also had training about the TreatWELL programme.

There were 3 stages in the TreatWELL programme. At each stage everyone saw a lifestyle coach and had at least 9 phone calls. These happened:

between diagnosis and having surgery (stage 1)
just after surgery (stage 2)
during recovery or treatment after surgery (stage 3)

Factors that the lifestyle coaches looked at included:

physical activity
diet and weight loss
alcohol
smoking

The main aim of the study was to find how practical and possible it was to do a randomised clinical trial using the TreatWELL programme. This included finding out:

if enough people would join the study
if enough people would complete the study
how well the TreatWELL programme would run
if the TreatWELL programme could achieve its goals
how acceptable the TreatWELL programme was to people

Results

During the time of the study 84 people were diagnosed with bowel cancer. Of these 22 (26%) agreed to join the TreatWELL study. 15 people (18%) completed the study.

The average time it took to deliver each stage of the programme was 5½ hours.

The lifestyle coaches reported they completed most (more than 70%) of each stage. They reported that most people were ‘fairly engaged’ at every stage. And were open to and interested in the information.

The major challenges of delivering the TreatWELL programme reported by the lifestyle coaches were:

the short time between diagnosis and surgery
people trying to find the time for the programme visits in addition to the visits for their tests for diagnosis and preparing for treatment
the short time available to see people in stage 2 of the TreatWELL programme just after surgery
difficulty identifying when stage 2 stops and stage 3 of the TreatWELL programme starts
poor recovery after surgery (some people needed to go back into hospital)
complications of surgery needing stage 3 to be extended
mixed messages from the NHS staff and the TreatWELL lifestyle coaches

After the study 11 people were interviewed about the TreatWELL programme and their experiences of taking part.

They reported that the amount of contact and the balance between visits and phone calls was acceptable. And they really appreciated the home visits.

They liked the lifestyle coaches and felt they were able to gently move them into doing things they were reluctant to do.

Factors that helped engage with the TreatWELL programme included:

previous enjoyment of physical activity such as walking
previous experience of weight loss programmes
supportive family members

Another major factor was the diagnosis of cancer as they wanted to overcome the diagnosis and regain their health.

A major negative factor to staying with the TreatWELL programme was the person’s physical health. Some felt too unwell to do any physical activity or they had other health problems that interfered with their ability to do so.

They also said that the NHS staff appeared to be unaware of the TreatWELL programme. And this caused concern and confusion as they were getting conflicting advice from the NHS staff and the lifestyle coaches.

Conclusion

The study team concluded that to test the TreatWELL programme in a randomised clinical trial the following need to be addressed:

look at ways to increase the number of people who decided to join
consider which tools are the best to use
look at the amount of time and flexibility needed to complete stage 2 and stage 3
look at ways for the NHS staff to assist with the programme

Where this information comes from

We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item

) and published in a medical journal. The figures we quote above were provided by the trial team who did the research. We have not analysed the data ourselves.