Q&A with Tracy Crane, Ph.D., RDN

Sylvester’s director of lifestyle medicine examines the critical roles of nutrition and exercise on cancer prevention, treatment outcomes and long-term quality of life.

Tracy E. Crane, Ph.D., RDN, believes personalized nutrition and exercise programs should be part of the prescribed treatment for people who have or are at elevated risk for cancer. Her aim is to conduct cutting-edge trials that lead to individualized lifestyle strategies for patients that improve outcomes.

Today, as co-lead of the Cancer Control Program and director of lifestyle medicine, prevention and digital health at Sylvester Comprehensive Cancer Center, part of the University of Miami Miller School of Medicine, Dr. Crane is well on her way to achieving that goal and positioning the cancer center as a recognized national leader in lifestyle medicine.

We recently chatted with Dr. Crane, also associate professor in medical oncology with affiliate appointments in kinesiology and public health at the Miller School, about what motivates her, how her research has evolved and what she feels are her greatest professional accomplishments.

Dr. Crane, what motivates you?

My motivation begins with this compelling statistic. Upwards of 40% of all cancers could be averted if people ate healthier, moved their bodies more and were at a healthy body weight, all factors we have control over.

Knowing this motivates me to figure out precisely how people can take lifestyle factors that are in their control to reduce cancer’s potential negative impact on people’s lives, whether it’s a person at elevated risk due to a genetic mutation who doesn’t yet have cancer, an individual undergoing treatment for cancer or a longer-term cancer survivor.

Some of the questions we’re asking in the Crane Lab are:

• How do we use specific diet patterns and exercise programs to help diminish or prevent fatigue, nausea and other known side effects of specific cancer therapies?
• What is the best intervention for nutrition and exercise, given a person’s individual and unique needs?
• Who benefits most from one-on-one training sessions versus lifestyle support delivered via a wearable device, like a Fitbit, and supportive text messages?

You use wearable and other digital technologies in your studies and created the My Wellness Research Platform. Why are digital technologies so important in what you do?

Digital technologies are changing the landscape in research and we aim to be among the leaders of digitally driven lifestyle medicine research and care.

I realized the utility of digital solutions over a decade ago during the Lifestyle Intervention in Ovarian Cancer Enhanced Survival (LIVES) study, which is the largest non-pharmacologic trial in ovarian cancer, with more than 1,200 participants. It involved more than 100 cancer centers from across the country recruiting patients. However, the intervention was centralized in one location, and I was responsible for the delivery and fidelity of this lifestyle intervention.

I needed a way to deliver this telephone-based intervention that was cost-effective and allowed me to monitor large groups of interventionists in an efficient way. As a result, we built a cloud-based technology that could record phone sessions digitally to monitor the interventions and provide support for study management.

These phone recordings were important for monitoring fidelity, but within those recordings, there was also a treasure trove of valuable data that was largely unused.

That’s when I received a grant from the National Cancer Institute to look at these conversations at an individual level and build natural language processing models to help better understand how behavior change occurs, predict who may need a shift in coaching to a different approach or identify interventionists who need retraining.  

When I built My Wellness Research here at Sylvester, one of the key requirements was the recording of intervention sessions for protocol monitoring, as well as to better understand nuanced information like how do we work with individuals who speak another language or who are facing different symptoms?

Add to that the remote monitoring device data, such as from a Fitbit, and you get the idea. We’re building a comprehensive picture of each person, with the ability to start prescribing and delivering the best intervention for each individual, moving away from a one-size-fits-all approach.

What do you love most about what you do?

I’ve always loved designing intervention trials and sitting in the space between technology and lifestyle behavior change research—seeing these two very different sciences come together to solve a problem. This brings together the most interesting, multidisciplinary teams, who, over the years, I have learned so much from.

Tell us about the potential impact of research you’re doing now.

I would say there are two main areas in which our research is most impactful. First, our work in the lab is transformative, bringing together data and computational sciences with the more traditional behavioral sciences for lifestyle medicine.

Sylvester is committed to rapidly moving advances in lifestyle medicine into clinical practice and is one of the few cancer centers committed to doing this in a big way. The integration Sylvester offers, spanning from prevention to survivorship research and beyond, along with computational sciences and the Sylvester Data Portal, and the leading-edge research generated by four scientific research programs, results in limitless research questions to be generated and answered.

The other area that is likely to change current practice is the work we’re doing during cancer treatment for patients with lymphoma and ovarian cancer. In these two trials, LIFE-L and TEAL, we are testing whether diet and exercise can improve the on-time delivery, dose of treatment and reduction in side effects for patients. What we’re learning in these trials is paradigm shifting, and it will, I believe, change how we deliver care.   

What are your goals at Sylvester?

My goals are that the research coming from the Crane Lab and resulting interventions lead to maximized outcomes for patients across the continuum of cancer and are integrated into clinical care. We have evidenced-based programs in our prevention and survivorship clinics, and patients who receive the diagnosis of cancer are provided with a tailored prescription for lifestyle medicine with nutrition and exercise interventions unique to them and their treatment plan.

And, perhaps most importantly, I give back to the next generation of scientists, helping to ensure they have the path forward to continue this work, leading to discoveries we haven’t yet dreamt of.

Tags: cancer q and a, Dr. Tracy Crane, nutrition, Sylverster Comprehensive Cancer Center