© 2005-2012 American Society of Clinical Oncology (ASCO). All rights reserved worldwide.
A review of more than 100 studies of cancer survivors showed that many survivors initiate diet, exercise, and other beneficial lifestyle changes following a cancer diagnosis, but that those who are male, older, and less educated are less likely to adopt such changes. The term "cancer survivor" refers to a person who is at least one-year beyond a cancer diagnosis.The review, published online in the Journal of Clinical Oncology (JCO), says that a cancer diagnosis often prompts immediate changes in health behavior, including significant changes in diet and physical activity.
Using the MEDLINE and PubMed databases, researchers from Duke University Medical Center, the National Cancer Institute, and Brown University identified and reviewed more than 100 studies of cancer survivors published since 1996.
They found that many survivors adopt healthier behaviors, such as following a healthier diet (30-60% of survivors), quitting smoking (46-96% of smokers with tobacco-related cancers, such as lung or head and neck), abstaining from alcohol (47-59% of those with head and neck cancers, which are closely linked to alcohol use), and regular physical activity (with up to 70% of survivors reporting 30 minutes of exercise a day, at least 5 days a week). Many of these changes should be beneficial because cancer survivors are a vulnerable population, at increased risk for second cancers, osteoporosis, obesity, cardiovascular disease, and diabetes.However, researchers noted that not all cancer patients adopted healthier behaviors, with only 25-42% of survivors consuming adequate amounts of fruits and vegetables, and roughly 70% of breast and prostate cancer survivors remaining overweight or obese.
The analysis also found conflicting data on physical activity as well as smoking status, noting that although survivors with tobacco- or alcohol-related cancers were more likely to reduce or eliminate these behaviors, 20% of survivors continue to smoke, a figure that is not much different from smoking status in the general population (24%).
In addition, researchers found that males, less educated individuals, survivors over age 65, and those who live in urban areas were less likely to initiate or maintain healthy lifestyle changes.
Finally, the study found that while physicians are among the most powerful catalysts for promoting behavior change, only 20% of oncologists provide such guidance because of time constraints, competing treatment or health concerns, and uncertainty regarding the delivery of health behavior messages and their potential impact on a patient's survival.
What Does This Mean For Patients?
There are a number of actions cancer survivors can take to improve their health, including striving for a healthy weight, eating a healthy diet rich in fruits and vegetables and low in saturated fat, getting regular exercise, maintaining a normal body weight, and eliminating or reducing alcohol and tobacco use.
In addition, patients should seek guidance from their oncologist or other health care professionals (such as nurses or nutritional counselors) on how to implement lifestyle changes that may benefit overall health and prevent some of the late effects of cancer treatment. Patients may also want to consider participating in clinical trials evaluating lifestyle interventions in cancer survivors.
ASCO Survivorship Initiatives
In December 2004, ASCO announced the formation of a new Survivorship Task Force, which is undertaking a range of initiatives to improve the care of cancer survivors. These initiatives will include revising the organization's oncology training curriculum and enhancing ASCO's educational programs to ensure that physicians are better prepared to address the unique needs of cancer survivors; developing clinical practice guidelines on long-term care and monitoring of cancer survivors; and supporting additional research on interventions to improve the long-term care of survivors.
People Living with Cancer www.plwc.org
The LIVESTRONG Foundation Website www.livestrong.org
National Coalition for Cancer Survivorship www.canceradvocacy.org
National Cancer Institute Office of Survivorship http://dccps.nci.nih.gov/ocs