Context Five-year survival rates for early stage colorectal, breast, and prostate cancer currently exceed 90% and are increasing. Cancer survivors are at greater risk for second malignancies, other comorbidities, and accelerated functional decline. Lifestyle interventions may provide benefit, but it is unknown whether long-term cancer survivors can modify their lifestyle behaviors sufficiently to improve functional status.Objective To determine whether a telephone counseling and mailed print materialbased diet and exercise intervention is effective in reorienting functional decline in older, overweight cancer survivors.Design, Setting, and Participants Randomized controlled trial of 641 overweight (body mass index Ն25 and Ͻ40), long-term (Ն5 years) survivors (aged 65-91 years) of colorectal, breast, and prostate cancer, who were randomly assigned to an intervention group (n=319) or delayed intervention (control) group (n=322) in Canada, the United Kingdom, and 21 US states. Individuals were recruited for the Reach out to

Mailed material interventions, especially those that are tailored, are effective in promoting healthful lifestyle changes among cancer survivors. Further study is needed to determine sustainability, cost to benefit, and generalizability to other cancer populations.

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