Diet, exercise tied to cancer survivor well-being

17 may 2008--Just 5 percent of U.S. cancer survivors are meeting experts' recommendations on diet, physical activity and cigarette smoking, a new survey shows.
But the more recommendations a cancer survivor did meet, the better his or her health-related quality of life (HRQoL), Dr. Christopher Blanchard, of Dalhousie University in Halifax, Canada, and colleagues found.
"It appears that meeting multiple lifestyle recommendations may not only be beneficial from a cancer recurrence/mortality perspective, but also from a HRQoL perspective," they write in the May 1 issue of the Journal of Clinical Oncology.
In 2006, the American Cancer Society issued three recommendations on healthy lifestyle behaviors for America's more than 10 million cancer survivors: get at least 150 minutes of moderate-to-strenuous exercise, or an hour of strenuous physical activity every week; eat at least five servings of fruits and vegetables daily; and quit smoking. But research done in the U.S. and Australia has shown that many cancer survivors do not follow these recommendations.
To investigate the percentage of U.S. cancer survivors who followed the recommendations, and see if doing so had a relationship to health-related quality of life, the researchers surveyed 9,105 survivors of six different types of cancer.
Roughly 15 percent to 19 percent were eating at least five servings of fruit and vegetables daily, the researchers found, while 30 percent to 47 percent were getting the recommended amount of exercise. From 83 percent to 92 percent had quit smoking.
Overall, 5 percent were meeting all three requirements, while 12.5 percent were meeting none. Fewer than 10 percent of survivors of any of the six cancer types were meeting two or more recommendations.
Among breast, prostate, colorectal, bladder, uterine and melanoma survivors -- all of the cancer types the researchers looked at - health-related quality of life rose steadily with the number of lifestyle recommendations met.
In the general U.S. population, the researchers note, an estimated 49 percent meet physical activity recommendations, 24 percent meet the 5-A-Day requirement, and 79.5 percent do not smoke -- the one area where cancer survivors in this study were doing better.
"This suggests that a cancer diagnosis may have greater potential to be a 'teachable moment' across several cancer groups in terms of changing smoking behavior, but it may be less effective in changing physical activity and fruit and vegetable consumption," the researchers say.
SOURCE: Journal of Clinical Oncology, May 1, 2008.

Wife's mental state key to cancer-survivor couples

By Anne Harding
Whether a man is recovering from cancer or helping his spouse to deal with cancer, how his wife is coping emotionally will play a key role in his physical health, a new American Cancer Society (ACS)-funded study shows.
"Regardless of your status as a caregiver or a cancer patient, gender matters," the study's first author, Dr. Youngmee Kim of the ACS's Behavioral Research Center in Atlanta, told Reuters Health.
While health professionals treating cancer patients are increasingly recognizing the importance of emotional health, Kim added, less attention has been paid to how the emotional health of a patient's spouse might affect his or her quality of life. To investigate, she and her colleagues looked at 168 married couples. One member of each pair had been diagnosed with prostate or breast cancer roughly two years before joining the study.
The cancer patient's own level of psychological stress was the most important factor in determining his or her quality of life, the researchers found.
Overall, patients and their spouses tended to have similar levels of emotional distress, and the level of emotional distress a partner had didn't independently influence his or her spouse's distress levels.
However, the researchers did find that the emotional stress level of breast cancer survivors was related to the physical health of their spouse, and the degree of emotional stress experienced by the wives of prostate cancer survivors influenced their husbands' physical health.
"Although these two partner effects may seem disparate, they are actually very similar in that they both show that the woman's psychological distress (as either survivors or caregivers) was negatively related to her husband's physical health," Kim and her colleagues write in the Annals of Behavioral Medicine.
Women's psychological distress is a stressor for men, she noted in an interview. While men may not to feel this stress psychologically, they will feel it in their bodies, for example as backaches or headaches -- a phenomenon known as somatization.
Women tend to have friends beyond their husband, whom they can rely on for emotional help, but a man's spouse may be his sole emotional resource. "If their wives are psychologically distressed, that means their wives are not emotionally available," she added.
The findings show, Kim said, that while the focus of cancer care is expanding to include the whole person, not just his or her disease, it should expand further. "We need to deal with the whole family, beyond the whole person."
SOURCE: Annals of Behavioral Medicine, April 2008.