An analysis of more than 100 studies of cancer survivors shows 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 has been diagnosed with cancer.
The review, which will be published online July 25 in the Journal of Clinical Oncology (JCO), says that a cancer diagnosis often prompts immediate changes in health behavior, including significant modifications in diet and physical activity.
Using the MEDLINE and PubMed databases, lead author Wendy Demark-Wahnefried, PhD, RD, LDN, of Duke University Medical Center, and colleagues from the National Cancer Institute and Brown University identified and reviewed more than 100 studies of cancer survivors published since 1996.
Researchers 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.
The study also 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 outcome.