Saturday, May 10, 2008
Do Cancer Survivors Make Suggested Lifestyle Changes?
A recent article published showed the results of a survey conducted by The American Cancer Society that asked cancer survivors about lifestyle changes done after their cancer diagnosis. Here are the findings:
* Only 14–19% of cancer survivors were eating five servings per day of fruit and vegetables.
* Physical activity recommendations were met by 29–47% of cancer survivors.
* Smoking cessation was met by 82–91% of cancer survivors.
* 12.5% were meeting none of the recommended changes
* <10% of the survivors were meeting two of the recommended changes in any of the different cancer diagoses
* Overall, only 5% of survivors met all three of the recommendations.
Hmmm, these data are really good to have documented. However, a higher percentage of diet and lifestyle changes in cancer survivors is not a surprise to me. Yes, a cancer diagnosis is a "teachable moment", but so are other diagnoses or events. Yet, would anyone really expect a person who has just been diagnosed with diabetes or has had an MI or by-pass surgery
to find, sort through, prioritize, and make all the necessary diet and lifestyle changes completely on their own to optimize the disease process and quality of life from that point forward?
I know how hard it was to first physically recover from cancer surgery
and treatments and then both figure out and then make major
meaningful changes myself to my diet and lifestyle. When left on my
own after my cancer therapies were completed, I essentially created my own individual and personal "oncology rehab program" similar to a cardiac rehab program or an intensive diabetes management education program. No only do I know how hard this was to do by myself, even as an RD, I know how hard it is to stick to these changes every single day of the year, year after year after year. (I thank my lucky stars that I did not need to quit smoking, in addition to diet and exercises changes.)
It is beyond my intellectual capacity to understand how the oncology
community expects most cancer survivors to "do this on their own"
without the professional and group education and support that the
cardiac community provides for continuity of care for their patients.
Granted many cancer survivors are "health seekers" and will find their
way to reliable information and find the individual drive and
motivation to make changes, but if that only ends up being 5%, well I
guess 5% is better than 0%. (can you hear me sighing.........?)
Simplifying the goals to eating 5 servings of fruits and vegetables
per day and exercising 30 minutes per day for each day of the week
sounds simple enough, but the point is people are not doing that
before the diagnosis for multiple reasons. With so much else weighing on you, distracting you, and/or needing immediate attention (like figuring out how to sort through the medical insurance info - if you're lucky enough to have insurance - and figure out how to pay for everything else not covered by insurance, just for starters!!), I think it is abundantly clear that cancer survivors are not going to jump on the health bandwagon quickly or easily, and it is unreasonable to expect them to "stop smoking, eat right, and exercise" completely on their own.
I don't know what it's going to take to move oncology to the point
that nutrition and other lifestyle changes are fully incorporated
pro-actively into comprehensive cancer care. Cancer patients need "oncology rehab" as much as people with cardiac disease and diabetes do (and I sure I could add other diagnoses here, too).
As a cancer survivor, I'm glad I'm in the 5% group but as a health
care professional, I'm not proud of the 5% figure. Somehow we have to
figure out a way to do better, much better, and sooner rather than
later. Maybe implementing the use of the upcoming nutrition survival care plans will help increase these figures. (Sounds like a research project to me for some center/RD to do.)
I'd love to hear others' reactions and thoughts to the results of this
survey, and I always love hearing ideas for how RDs can be (and are!!) involved with improving health and quality of life after cancer. I will add that for those of you who moving the curve forward by providing nutrition information and support for cancer survivor, I first say "Thank you!" and then add that I hope some type of outcome data are being collected since "lack of research" always seems to be a reason given for why nutrition is not included in comprehensive cancer care. (I admit to getting weary of hearing that there is not yet enough research; granted, I know I am an impatient person!)
Diana Dyer, MS, RD