Promoting Health and Well-Being After Cancer

National Cancer Institute Bulletin | 10.17.2006

Survivorship Spectrum, Part I

Many cancer survivors attempt to make lifestyle changes such as exercising, quitting smoking, and improving their diet to provide a better quality of life after treatment, as well as reduce the likelihood of future illness. However, reviews of the existing literature and data collected from the National Health Interview Survey show that these kinds of changes are difficult to initiate and to maintain in the long run.

"Despite evidence of potential benefits, lifestyle changes are difficult for everybody, not just cancer survivors," said Dr. Linda Nebeling, chief of the Health Promotion Research Branch in DCCPS. "You may have an episode in your life such as a cancer diagnosis that makes it very personal, but you still have to work through the processes to help overcome triggers that make you more likely to fall into old habits."

Colleen Doyle, lead author of the ACS guidelines, Nutrition and Physical Activity During and After Cancer Treatment: An American Cancer Society Guide for Informed Choices, sees a reworking of our environment as a necessary adjunct to education in this area. "As with the general population, education and increased awareness will only go so far in promoting healthier living - even among people who may be highly motivated to make changes - because our environments are huge barriers to all of us living well. The long-term solution is going to have to include changing environments and social norms, as we've seen with tobacco control." ACS recently addressed some of these issues in a Recommendation for Community Action that focused on promoting healthy changes in schools, worksites, and communities, published within their 2006 Prevention Guidelines.

NCI is currently funding extensive research into the mechanics of what exercise, diet, and the combination of the two can do to help the body physiologically, explained Dr. Nebeling. "Are there ways to combine diet and exercise to improve the resistance of your body to developing a recurrence?"

One example of this is the Transdisciplinary Research on Energetics and Cancer (TREC) initiative, launched in 2005. TREC research centers are studying how the combined effects of obesity, poor diet, and lack of physical activity increase cancer risk. "A lot of the biological work is very relevant to cancer survivors," said Dr. Ann McTiernan, a TREC researcher from Fred Hutchinson Cancer Research Center in Seattle. "Evidence is increasing that keeping weight in normal ranges and increasing physical activity are associated with improved survival and reduced recurrence in patients with several types of cancer including breast, colon, and prostate."

In addition to the large-scale projects, she explained, TREC investigators also are beginning several survivor-specific research studies, such as looking at yoga as a method to improve weight control and quality of life in breast cancer survivors, and ways to increase exercise in children who are cancer survivors and their families.

NCI Survivorship Resources:

National Organizations

Reports

Cancer Follow-up Care Guidelines

NCI Fact Sheets and Tips

Clinic and Long-Term Care Referrals

Copyright 2006 National Cancer Institute