For years, AICR has written about the growing body of evidence showing that the same lifestyle choices found to reduce the risk of developing cancer – a healthy diet, a healthy weight and physical activity –can also help survivors live longer and healthier. Research is still growing but last week, the evidence became even clearer when the American Cancer Society released new guidelines for survivors.
The ACS guidelines advise survivors to exercise, eat healthy, and maintain a healthy weight. The expert panelists who evaluated the evidence concluded that following these recommendations can lower the risk of the cancer recurring and improve the chances of disease-free survival.
The updated guidelines for survivors were published last week in CA: A Cancer Journal for Clinicians. You can read the complete guidelines here.
We asked Elisa Bandera, MD, PhD, one of the expert panelists, to help explain the recommendations. Bandera, a nutritional epidemiologist at The Cancer Institute of New Jersey, is also a member of the expert panel on AICR’s Continuous Update Project
Q: Can you give a sense of how much research there is on diet, weight, and exercise related to survivorship, and how recent it is?
A: Surprisingly, not much research has been done in this area, compared to the literature on nutrition and physical activity and cancer risk. Currently, most of the evidence comes from studies on breast cancer. However, this is an area that is growing exponentially and several ongoing studies are going to be producing more results in the near future.
In general, I would say that both the experimental and epidemiologic evidence clearly points to a detrimental effect of obesity on cancer survival. There is also growing evidence that sedentary lifestyles and unhealthy food choices affect cancer progression, and risk of recurrence and cancer death.
Q: As you know, most survivors die of a disease other than cancer. Is the evidence relating to a healthy lifestyle preventing recurrence distinct from reducing the risk of heart disease or other chronic disease?
A: It all tends to point in the same direction, which means that by following a healthy lifestyle cancer survivors can reduce their risk of a recurrence as well as other chronic diseases. In that sense, one factor that may be a bit confusing is moderate alcohol drinking. There is evidence that moderate drinking (no more than one drink per day for women or two for men) can reduce the risk of cardiovascular disease. For breast cancer survivors, however, findings have been inconsistent regarding the impact of moderate drinking on breast cancer survival. This is an area that needs more research. Clearly, heavy drinking is not recommended for health and has been associated with increased cancer risk.
Q: Aside from breast cancer, what are some of the other well-studied cancers in this area?
A: There are a few studies on colorectal and prostate cancer and other cancers. All tend to point in the same direction. However, more research is needed.
Q: What would you say to survivors who have faced the cancers not as well represented in the research, such as throat cancer for example?
A: Following the general recommendations for cancer prevention should help them too, such as maintaining a healthy weight, eating a healthy diet and exercise regularly.
Q: Why are these guidelines so important?
A: Cancer survivors more than any other group want to know what they can do to improve their chances of survival and to avoid a recurrence. They specifically want to know how they can change their lifestyle to improve their survival. These are things that survivors can control and can give them a sense of self-efficacy. The best part is that by following these guidelines, survivors will reduce risk of other cancers as well as other chronic diseases, such as diabetes or cardiovascular disease. These guidelines also help health providers to advise their cancer patients regarding the best lifestyle choices to maximize their chances of survival.
I am a strong believer that leading a healthy lifestyle through a healthy diet, regular exercise and avoiding smoking can improve people’s well-being and quality of life, regardless of their age, gender, or race. For this reason, I have devoted a large part of my career helping WCRF/AICR and ACS develop nutrition guidelines for cancer prevention and survival to help people make the right choices in life.