Table 3.

Recommendations for advancing the field of energy balance and cancer recurrence and survival

Administrative
•Expand grant review panel capacity to reflect scientific expertise to adequately review current research issues in cancer survivors, including biologic and behavioral dynamics, such as the impact of energy balance.
•Strengthen resources to share innovative measures and methodologies to foster cutting-edge science.
•Network with public and private organizations to create innovative and relevant research opportunities; strengthen translational research to bridge scientific discovery to improvements in public health.
•Establish a better understanding of cost-effectiveness of approaches. Increase research on economic questions as they relate to obesity and cancer.
•Promote transdisciplinary training opportunities for new investigators and provide funding mechanisms that spur translational science among the entire research community.
Observational studies and intervention trials:
•Identify/develop and evaluate newer technologies and tools to deliver interventions (e.g., smart phones, tablets) and to more accurately measure diet (dietary recalls, ASA24, ecological momentary assessment (EMA) technology and physical activity (accelerometry, ACT24, EMA technology).
•Collect additional data pertinent to the evaluation of energy balance and cancer outcomes:
‐Weight (adiposity) status
‐Biologic samples (tumor and normal tissue, blood, urine, buccal cells, and others)
‐Comorbid conditions
‐Complete cancer treatment data
‐Complete data on medication-use (including over-the-counter)
•Determine whether there are differences in the association of obesity/weight gain with cancer outcomes in cancer patients by timing relative to cancer diagnosis and treatment (prediagnosis, at diagnosis/treatment, in the months and years following diagnosis/treatment, or over the life course).
•Explore the potential to pool data from existing cohorts of cancer patients to facilitate the examination of whether the effects of obesity and physical activity vary by specific subgroups of patients or tumor subtypes.
•Expand translational research with an emphasis on cancer survivors.
•Promote a transdisciplinary research focus that engages expertise from basic laboratory, clinical, environmental, public health, and community expertise.
•Integrate individual and social–environmental approaches to explain and modify energy balance–related health behaviors and cancer survivorship.
•Expand policy-specific research as it addresses obesity and energy balance behavior, and the larger systems (environment) that influence behavior change.
•Promote dissemination and implementation research to help strengthen the capacity of programs and policies to have maximum reach and impact.
Pharmacologic trials:
•Capture BMI (as well as other measures of adiposity and components of energy balance, for example, dietary intake and physical activity) within pharmacologic RCTs to analyze the impact of weight status, either synergistically or independently, on survival endpoints.
•Collect biologic samples (tumor and normal tissue, blood).
•Promote comprehensive common measures within datasets that can be used across agencies, researchers, and policy makers, and develop facile interfaces, whereby data can be seamlessly transferred.
Mechanistic studies:
•Identify and validate biomarkers for cancer recurrence and death.
•Determine the biologic mechanisms that regulate energy balance and inform the development of more effective lifestyle interventions that better reflect the biologic influence of human behavior.