In 2001, the American Cancer Society (ACS) first published an article summarizing the relatively small amount of scientific evidence regarding the impact of nutrition and physical activity among cancer survivors. Since that time, new studies have emerged, demonstrating the benefits of maintaining a healthy weight, getting adequate physical activity, and eating a healthy diet. The key benefits include reducing the chance of recurrence and increasing the likelihood of disease-free survival after a diagnosis.
Based on this new and accumulating evidence, an expert panel convened by the ACS issued formal guidelines for cancer survivors for the first time in the CA: A Cancer Journal for Clinicians.
Encourage Regular Exercise
The ACS update recommends that clinicians encourage survivors to participate in regular physical activity. Patients should aim to exercise at moderate intensity at least 150 minutes per week and perform strength training exercises at least 2 days per week. Clinicians need to encourage patients to avoid inactivity and return to normal daily activities as soon as possible following a diagnosis.
However, in some cases, particular issues affect the ability of patients who are recovering from cancer treatment to exercise. The guidelines provide information on many of these issues and how these circumstances should be factored into the equation when recommending activities.
Weight Management & Diet Among Cancer Survivors
Many patients are overweight or obese when they are diagnosed with cancer, and there’s increasing evidence that obesity increases risks for cancer recurrence and reduces survival. Achieving and maintaining a healthy weight is another key recommendation in the 2012 guidelines. If cancer survivors are overweight or obese, they should be encouraged to limit consumption of high-calorie foods and beverages and increase physical activity to promote weight loss.
The guidelines also stress the importance of achieving a diet rich in fruit, vegetables, and whole grains. When informing cancer survivors about diet, clinicians should refer to the ACS guidelines on nutrition and physical activity for cancer prevention. These guidelines, as well as the recommendations for cancer survivors, are available for free online at www.cancer.org.
It should be noted that standard vitamin and mineral supplements were recommended during and after cancer treatment in the past. Recent studies, however, suggest that many of these agents are either ineffective or may actually increase mortality risk. More data are needed on dietary supplements and multivitamins in cancer survivors. In addition, future research should further explore the benefits of exercise, weight management, and diet in cancers other than breast, prostate, and colorectal cancer.
A Unique Opportunity to Guide Cancer Survivors
Clinicians should realize that they have a unique opportunity to guide cancer survivors toward healthy lifestyle choices. We can favorably influence the cancer survivorship trajectory by fostering healthy nutrition and regular physical activity. The power of our advice and encouragement to patients cannot be underestimated.
Click here to view the full guidelines on nutrition and physical activity for cancer survivors.
Readings & Resources (click to view)
Rock CL, Doyle C, Demark-Wahnefried W, et al. Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin. 2012;62:242-274. Available at: http://onlinelibrary.wiley.com/doi/10.3322/caac.21142/full.
Doyle C, Kushi LH, Byers T, et al; 2006 Nutrition, Physical Activity and Cancer Survivorship Advisory Committee; American Cancer Society. Nutrition and physical activity during and after cancer treatment: an American Cancer Society guide for informed choices. CA Cancer J Clin. 2006;56:323-353.
Jones LW, Courneya KS, Fairey AS, Mackey JR. Effects of an oncologist’s recommendation to exercise on self-reported exercise behavior in newly diagnosed breast cancer survivors: a single-blind, randomized controlled trial. Ann Behav Med. 2004;28:105-113.
Pekmezi DW, Demark-Wahnefried W. Updated evidence in support of diet and exercise interventions in cancer survivors. Acta Oncol. 2011;50:167-178.
Jones LW, Demark-Wahnefried W. Diet, exercise, and complementary therapies after primary treatment for cancer. Lancet Oncol. 2006;7:1017-1026.
Siegel R, Naishadham D, Jemal A. Cancer statistics, 2012. CA Cancer J Clin. 2012;62:10-29.