NUTRITION NOTES: Changing the Picture for Senior Cancer Survivors

August 17, 2009 Contact: Mya R. Nelson, (202) 328-7744

Changing the Picture for Senior Cancer Survivors

Karen Collins, MS, RD, CDN

American Institute for Cancer Research

Plans to control health care costs and improve care need to consider the growing population of seniors who are cancer survivors. This group is not only at risk of a secondary cancer, but also of functional decline due to loss of strength or balance and other health conditions. Research suggests that weight control, regular moderate physical activity and healthy eating may reduce cancer survivors’ risk of cancer, improve quality of life and reduce the burden of functional decline. Now research also is identifying ways to help survivors make healthy lifestyle changes.

Cancer survivors an at risk population: Even cancer survivors without recurrence may experience lasting effects of the disease and its treatment. This can include increased risk of heart disease, high blood pressure, diabetes or osteoporosis as well as reduced fitness and strength.

Overall, studies suggest that cancer patients tend to make few if any improvements in eating or activity habits or may make changes soon after diagnosis but not maintain them. Yet among breast cancer survivors, those who gain less weight show greater survival. Regular moderate physical activity may enhance survival and help counteract the decreases in functioning and quality of life that otherwise come with loss of strength and fitness.

Interventions at work: Programs to teach and support healthier lifestyles can successfully address these problems. Researchers have been developing and testing home-based programs delivered by mail, telephone or Internet to improve participation by older adults.

Initial studies often showed habits improving and then reverting back to usual when the program was over. A program from researchers at Duke University added methods to participants’ materials to match their readiness to change and personality. Information also included testimonials of similar survivors who successfully made lifestyle changes. The program is ongoing but short-term data shows increased physical activity, improved diet and slight reduction of overweight.

Focus on function

Another recent study added efforts to improve physical functioning among cancer survivors who were at least 65 years old and at least five years past diagnosis. All the participants were overweight or obese and sedentary. This 12-month study used print materials and telephone counseling to encourage healthier lifestyles. The goals included daily moderate activity, eating more vegetables and fruits, eating less saturated fat, modest weight loss, and 15 minutes of lower body strength-training three times weekly. A “wait-list” control group made no changes.

Participants averaged less than half the strength-training target, but compared to the control group who showed significant drop in a score of basic physical function, they showed almost no detectable impact on quality of life. Participants also made modest improvements in other lifestyle goals, while the wait-list group made little or no change.

We can view these results pessimistically or optimistically. Even this well-designed, personalized program still resulted in less than one in five participants meeting recommended walking or vegetable and fruit consumption targets. Although the program generally did not improve physical functioning, it did reduce the decline in physical function often seen with age and in many cancer survivors. Delivered at a cost of about a thousand dollars per person, these could be dollars well spent. We must remember that because some cancer survivors have physical limitations, efforts to improve physical function should be evaluated by each individual’s physician before they jump in.

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The American Institute for Cancer Research (AICR) is the cancer charity that fosters research on the relationship of nutrition, physical activity and weight management to cancer risk, interprets the scientific literature and educates the public about the results. It has contributed more than $87 million for innovative research conducted at universities, hospitals and research centers across the country. AICR has published two landmark reports that interpret the accumulated research in the field and is committed to a process of continuous review. AICR also provides a wide range of educational programs to help millions of Americans learn to make dietary changes for lower cancer risk. Its award-winning New American Plate program is presented in brochures, seminars and on its Web site, www.aicr.org. AICR is a member of the World Cancer Research Fund International.