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Nutrition priorities for people living with cancer.

Article Excerpt
KEY POINTS

* In Australia, the number of cancer survivors has been estimated at 267000 and is increasing. Cancer survivors are at increased risk of other health problems after a diagnosis of cancer, including heart disease, diabetes and functional impairment, which may benefit from lifestyle intervention.

* There is evidence that weight management and physical activity will positively impact on quality of life, cancer recurrence and overall survival for cancer survivors.

* Evidence that dietary intakes of vegetables, fruit or related nutrients affect recurrence or survival is somewhat supportive but not conclusive. Further randomised controlled trials are required.

* Although dietary supplement use is very common among cancer survivors, there are very few studies of the effect of nutritional supplements on cancer recurrence and survival.

* Lifestyle interventions have shown promise for cancer survivors, in particular women with breast cancer. Further research is required to determine the efficacy and effectiveness of specific lifestyle interventions designed for both breast cancer survivors and survivors of other forms of cancer.

INTRODUCTION

The role of lifestyle factors, such as nutrition, physical activity and a healthy weight, in improving survival rates for people with cancer is an emerging area of research. According to the American Cancer Society's expert committee, who reviewed the evidence on the impact of lifestyle factors on quality of life, cancer recurrence and overall survival, convincing data exist that obesity is associated with breast cancer recurrence, and evidence on obesity and prognosis is also accumulating for other cancers. (1) They also concluded that physical activity may be important for reducing the risk of recurrence and extending survival for some cancer survivors. (1)

The number of people surviving with cancer is on the rise due to the ageing population, increasing incidence of some types of cancers, improvements in early detection and treatment. In Australia, the number of cancer survivors has been estimated at 267 000. (2)

Although survivorship should be celebrated, it is important to acknowledge that the impact of cancer is significant and associated with several long-term health and psychosocial sequelae. (3) Cancer survivors may be at increased risk of weight gain, functional impairment, fatigue, other chronic diseases (osteoporosis, cardiovascular disease, diabetes), secondary cancers and death from non-cancer causes, which may be amenable to lifestyle intervention. There is evidence that cancer patients die of non-cancer causes at a higher rate than persons in the general population; the non-cancer relative hazards ratio has been estimated at 1.37, with almost half of the deaths being from cardiovascular disease. (4-7) This paper defines cancer survival and discusses lifestyle factors in the cancer survival context.

DEFINITION OF A CANCER SURVIVOR

For the purposes of this paper, a cancer survivor is defined as someone who has completed their active treatment phase and...