American Cancer Society nutrition and physical activity guideline for cancer survivors

Cheryl L Rock, Cynthia A Thomson, Kristen R Sullivan, Carol L Howe, Lawrence H Kushi, Bette J Caan, Marian L Neuhouser, Elisa V Bandera, Ying Wang, Kimberly Robien, Karen M Basen-Engquist, Justin C Brown, Kerry S Courneya, Tracy E Crane, David O Garcia, Barbara L Grant, Kathryn K Hamilton, Sheri J Hartman, Stacey A Kenfield, Maria Elena Martinez, Jeffrey A Meyerhardt, Larissa Nekhlyudov, Linda Overholser, Alpa V Patel, Bernardine M Pinto, Mary E Platek, Erika Rees-Punia, Colleen K Spees, Susan M Gapstur, Marjorie L McCullough, Cheryl L Rock, Cynthia A Thomson, Kristen R Sullivan, Carol L Howe, Lawrence H Kushi, Bette J Caan, Marian L Neuhouser, Elisa V Bandera, Ying Wang, Kimberly Robien, Karen M Basen-Engquist, Justin C Brown, Kerry S Courneya, Tracy E Crane, David O Garcia, Barbara L Grant, Kathryn K Hamilton, Sheri J Hartman, Stacey A Kenfield, Maria Elena Martinez, Jeffrey A Meyerhardt, Larissa Nekhlyudov, Linda Overholser, Alpa V Patel, Bernardine M Pinto, Mary E Platek, Erika Rees-Punia, Colleen K Spees, Susan M Gapstur, Marjorie L McCullough

Abstract

The overall 5-year relative survival rate for all cancers combined is now 68%, and there are over 16.9 million survivors in the United States. Evidence from laboratory and observational studies suggests that factors such as diet, physical activity, and obesity may affect risk for recurrence and overall survival after a cancer diagnosis. The purpose of this American Cancer Society guideline is to provide evidence-based, cancer-specific recommendations for anthropometric parameters, physical activity, diet, and alcohol intake for reducing recurrence and cancer-specific and overall mortality. The audiences for this guideline are health care providers caring for cancer survivors as well as cancer survivors and their families. The guideline is intended to serve as a resource for informing American Cancer Society programs, health policy, and the media. Sources of evidence that form the basis of this guideline are systematic literature reviews, meta-analyses, pooled analyses of cohort studies, and large randomized clinical trials published since 2012. Recommendations for nutrition and physical activity during cancer treatment, informed by current practice, large cancer care organizations, and reviews of other expert bodies, are also presented. To provide additional context for the guidelines, the authors also include information on the relationship between health-related behaviors and comorbidities, long-term sequelae and patient-reported outcomes, and health disparities, with attention to enabling survivors' ability to adhere to recommendations. Approaches to meet survivors' needs are addressed as well as clinical care coordination and resources for nutrition and physical activity counseling after a cancer diagnosis.

Keywords: alcohol; cancer survivors; dietary patterns; nutrition; obesity; physical activity.

© 2022 The Authors. CA: A Cancer Journal for Clinicians published by Wiley Periodicals LLC on behalf of American Cancer Society.

References

    1. Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2022. CA Cancer J Clin. 2022;72:7-33.
    1. American Cancer Society. Cancer Treatment & Survivorship Facts & Figures 2019-2021. American Cancer Society; 2019.
    1. Miller KD, Nogueira L, Mariotto AB, et al. Cancer treatment and survivorship statistics, 2019. CA Cancer J Clin. 2019;69:363-385.
    1. Rock CL, Thomson C, Gansler T, et al. American Cancer Society guideline for diet and physical activity for cancer prevention. CA Cancer J Clin. 2020;70:245-271.
    1. Doyle C, Kushi LH, Byers T, et al. Nutrition and physical activity during and after cancer treatment: an American Cancer Society guide for informed choices. CA Cancer J Clin. 2006;56:323-353.
    1. Rock CL, Doyle C, Demark-Wahnefried W, et al. Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin. 2012;62:243-274.
    1. Stacey FG, James EL, Chapman K, Courneya KS, Lubans DR. A systematic review and meta-analysis of social cognitive theory-based physical activity and/or nutrition behavior change interventions for cancer survivors. J Cancer Surviv. 2015;9:305-338.
    1. Goode AD, Lawler SP, Brakenridge CL, Reeves MM, Eakin EG. Telephone, print, and web-based interventions for physical activity, diet, and weight control among cancer survivors: a systematic review. J Cancer Surviv. 2015;9:660-682.
    1. Institute of Medicine (US) Committee on Standards for Systematic Reviews of Comparative Effectiveness Research, Eden J, Levit L, Berg A, Morton S, eds. Finding What Works in Health Care: Standards for Systematic Reviews. National Academies Press; 2011.
    1. Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6:e1000097.
    1. World Cancer Research Fund International/American Institute for Cancer Research Continuous Update Project (CUP). Diet, Nutrition, Physical Activity, and Breast Cancer Survivors: 2014. World Cancer Research Fund International/American Institute for Cancer Research; 2014.
    1. Patel AV, Friedenreich CM, Moore SC, et al. American College of Sports Medicine roundtable report on physical activity, sedentary behavior, and cancer prevention and control. Med Sci Sports Exerc. 2019;51:2391-2402.
    1. Campbell KL, Winters-Stone KM, Wiskemann J, et al. Exercise guidelines for cancer survivors: consensus statement from international multidisciplinary roundtable. Med Sci Sports Exerc. 2019;51:2375-2390.
    1. National Comprehensive Cancer Network (NCCN). NCCN Guidelines for Patients. Survivorship Care for Healthy Living. NCCN; 2020. Accessed June 6, 2021.
    1. Bland KA, Zadravec K, Landry T, Weller S, Meyers L, Campbell KL. Impact of exercise on chemotherapy completion rate: a systematic review of the evidence and recommendations for future exercise oncology research. Crit Rev Oncol Hematol. 2019;136:79-85.
    1. Yang L, Morielli AR, Heer E, et al. Effects of exercise on cancer treatment efficacy: a systematic review of preclinical and clinical studies. Cancer Res. 2021;81:488904895.
    1. American Society of Clinical Oncology (ASCO). Nutrition Recommendations During and After Treatment. : Doctor approved patient information from ASCO. Accessed June 17, 2021.
    1. Liposits G, Orrevall Y, Kaasa S, Osterlund P, Cederholm T. Nutrition in cancer care: a brief, practical guide with a focus on clinical practice. JCO Oncol Pract. 2021;17:e992-e998.
    1. Ryan AM, Power DG, Daly L, Cushen SJ, Ni Bhuachalla E, Prado CM. Cancer-associated malnutrition, cachexia and sarcopenia: the skeleton in the hospital closet 40 years later. Proc Nutr Soc. 2016;75:199-211.
    1. Thompson KL, Elliott L, Fuchs-Tarlovsky V, Levin RM, Voss AC, Piemonte T. Oncology evidence-based nutrition practice guideline for adults. J Acad Nutr Diet. 2017;117:297-310.e47.
    1. Arends J, Bachmann P, Baracos V, et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr. 2017;36:11-48.
    1. Arends J, Baracos V, Bertz H, et al. ESPEN expert group recommendations for action against cancer-related malnutrition. Clin Nutr. 2017;36:1187-1196.
    1. Chan DSM, Vieira AR, Aune D, et al. Body mass index and survival in women with breast cancer-systematic literature review and meta-analysis of 82 follow-up studies. Ann Oncol. 2014;25:1901-1914.
    1. Norat T, Chan D, Vieira AR, et al. World Cancer Research Fund International Continuous Update Project: Systematic Review on Diet, Nutrition, Physical Activity and Survival and Second Cancers in Breast Cancer Survivors. World Cancer Research Fund International; 2014. Accessed June 17, 2021.
    1. World Cancer Research Fund/American Institute for Cancer Research. Third Expert Report on Diet, Nutrition, Physical Activity and Cancer: A Global Perspective. Continuous Update Project Expert Report 2019. World Cancer Research Fund/American Institute for Cancer Research; 2018.
    1. Bowen KJ, Sullivan VK, Kris-Etherton PM, Petersen KS. Nutrition and cardiovascular disease-an update. Curr Atheroscler Rep. 2018;20:8.
    1. Eckel RH, Jakicic JM, Ard JD, et al. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;63:2960-2984.
    1. National Institute of Diabetes and Digestive and Kidney Diseases, US Department of Health and Human Services. National Institute of Diabetes and Digestive and Kidney Diseases website. Accessed February 15, 2021.
    1. US Department of Health and Human Services. Physical Activity Guidelines for Americans. 2nd ed. US Department of Health and Human Services; 2018. Accessed February 24, 2021.
    1. US Department of Agriculture, US Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. 9th ed. US Department of Agriculture; 2020. Accessed February 24, 2021.
    1. Breast Cancer Research Foundation. Breast Cancer Statistics and Resources. Accessed July 9, 2021.
    1. Jackson SE, Heinrich M, Beeken RJ, Wardle J. Weight loss and mortality in overweight and obese cancer survivors: a systematic review. PLoS One. 2017;12:e0169173.
    1. Nechuta S, Chen WY, Cai H, et al. A pooled analysis of post-diagnosis lifestyle factors in association with late estrogen-receptor-positive breast cancer prognosis. Int J Cancer. 2016;138:2088-2097.
    1. Parekh N, Chandran U, Bandera EV. Obesity in cancer survival. Annu Rev Nutr. 2012;32:311-342.
    1. Greenlee H, Unger JM, LeBlanc M, Ramsey S, Hershman DL. Association between body mass index and cancer survival in a pooled analysis of 22 clinical trials. Cancer Epidemiol Biomarkers Prev. 2017;26:21-29.
    1. Friedenreich CM, Stone CR, Cheung WY, Hayes SC. Physical activity and mortality in cancer survivors: a systematic review and meta-analysis. JNCI Cancer Spectr. 2020;4:pkz080.
    1. Lee J. A meta-analysis of the association between physical activity and breast cancer mortality. Cancer Nurs. 2019;42:271-285.
    1. Spei ME, Samoli E, Bravi F, La Vecchia C, Bamia C, Benetou V. Physical activity in breast cancer survivors: a systematic review and meta-analysis on overall and breast cancer survival. Breast. 2019;44:144-152.
    1. Morishita S, Hamaue Y, Fukushima T, Tanaka T, Fu JB, Nakano J. Effect of exercise on mortality and recurrence in patients with cancer: a systematic review and meta-analysis. Integr Cancer Ther. 2020;19:1534735420917462.
    1. Akdeniz D, Klaver MM, Smith CZA, Koppert LB, Hooning MJ. The impact of lifestyle and reproductive factors on the risk of a second new primary cancer in the contralateral breast: a systematic review and meta-analysis. Cancer Causes Control. 2020;31:403-416.
    1. Wang Y, Song H, Yin Y, Feng L. Cancer survivors could get survival benefits from postdiagnosis physical activity: a meta-analysis. Evid Based Complement Alternat Med. 2019;2019:1940903.
    1. Swain CTV, Nguyen NH, Eagles T, et al. Postdiagnosis sedentary behavior and health outcomes in cancer survivors: a systematic review and meta-analysis. Cancer. 2020;126:861-869.
    1. Krebs-Smith SM, Pannucci TE, Subar AF, et al. Update of the Healthy Eating Index: HEI-2015. J Acad Nutr Diet. 2018;118:1591-1602.
    1. Fung TT, McCullough ML, Newby PK, et al. Diet-quality scores and plasma concentrations of markers of inflammation and endothelial dysfunction. Am J Clin Nutr. 2005;82:163-173.
    1. Arnett DK, Blumenthal RS, Albert MA, et al. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;140:e563-e595.
    1. Jochems SHJ, Van Osch FHM, Bryan RT, et al. Impact of dietary patterns and the main food groups on mortality and recurrence in cancer survivors: a systematic review of current epidemiological literature. BMJ Open. 2018;8:e014530.
    1. Molina-Montes E, Salamanca-Fernandez E, Garcia-Villanova B, Sanchez MJ. The impact of plant-based dietary patterns on cancer-related outcomes: a rapid review and meta-analysis. Nutrients. 2020;12:2010.
    1. Terranova CO, Protani MM, Reeves MM. Overall dietary intake and prognosis after breast cancer: a systematic review. Nutr Cancer. 2018;70:153-163.
    1. Schwedhelm C, Boeing H, Hoffmann G, Aleksandrova K, Schwingshackl L. Effect of diet on mortality and cancer recurrence among cancer survivors: a systematic review and meta-analysis of cohort studies. Nutr Rev. 2016;74:737-748.
    1. Makarem N, Chandran U, Bandera EV, Parekh N. Dietary fat in breast cancer survival. Annu Rev Nutr. 2013;33:319-348.
    1. Fritz H, Seely D, Flower G, et al. Soy, red clover, and isoflavones and breast cancer: a systematic review. PLoS One. 2013;8:e81968.
    1. Qiu S, Jiang C. Soy and isoflavones consumption and breast cancer survival and recurrence: a systematic review and meta-analysis. Eur J Nutr. 2019;58:3079-3090.
    1. Nechuta SJ, Caan BJ, Chen WY, et al. Soy food intake after diagnosis of breast cancer and survival: an in-depth analysis of combined evidence from cohort studies of US and Chinese women. Am J Clin Nutr. 2012;96:123-132.
    1. Simapivapan P, Boltong A, Hodge A. To what extent is alcohol consumption associated with breast cancer recurrence and second primary breast cancer?: A systematic review. Cancer Treat Rev. 2016;50:155-167.
    1. American Cancer Society. Cancer Facts & Figures 2022. American Cancer Society; 2022.
    1. Han J, Zhou Y, Zheng Y, et al. Positive effect of higher adult body mass index on overall survival of digestive system cancers except pancreatic cancer: a systematic review and meta-analysis. Biomed Res Int. 2017;2017:1049602.
    1. Liu Y, Zhang M. Effect of higher pre-operation body mass index on overall survival of esophageal, gastric and pancreatic cancer: a systematic review and meta-analysis. Int J Clin Exp Med. 2018;11:12-22.
    1. Lee J, Meyerhardt JA, Giovannucci E, Jeon JY. Association between body mass index and prognosis of colorectal cancer: a meta-analysis of prospective cohort studies. PLoS One. 2015;10:e0120706.
    1. Schlesinger S, Siegert S, Koch M, et al. Postdiagnosis body mass index and risk of mortality in colorectal cancer survivors: a prospective study and meta-analysis. Cancer Causes Control. 2014;25:1407-1418.
    1. Petrelli F, Cortellini A, Indini A, et al. Association of obesity with survival outcomes in patients with cancer: a systematic review and meta-analysis. JAMA Netw Open. 2021;4:e213520.
    1. Xiao J, Mazurak VC, Olobatuyi TA, Caan BJ, Prado CM. Visceral adiposity and cancer survival: a review of imaging studies. Eur J Cancer Care (Engl). 2018;27:e12611.
    1. Qiu S, Jiang C, Zhou L. Physical activity and mortality in patients with colorectal cancer: a meta-analysis of prospective cohort studies. Eur J Cancer Prev. 2020;29:15-26.
    1. Hu FB, Satija A, Rimm EB, et al. Diet assessment methods in the Nurses Health Studies and contribution to evidence-based nutritional policies and guidelines. Am J Public Health. 2016;106:1567-1572.
    1. Hurtado-Barroso S, Trius-Soler M, Lamuela-Raventos RM, Zamora-Ros R. Vegetable and fruit consumption and prognosis among cancer survivors: a systematic review and meta-analysis of cohort studies. Adv Nutr. 2020;11:1569-1582.
    1. World Cancer Research Fund, American Institute for Cancer Research. Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective. Vol 1. American Institute for Cancer Research; 2007.
    1. Solans M, Chan DSM, Mitrou P, Norat T, Romaguera D. A systematic review and meta-analysis of the 2007 WCRF/AICR score in relation to cancer-related health outcomes. Ann Oncol. 2020;31:352-368.
    1. Kim Y, Je Y, Giovannucci EL. Association between alcohol consumption and survival in colorectal cancer: a meta-analysis. Cancer Epidemiol Biomarkers Prev. 2019;28:1891-1901.
    1. Zuniga K, Graff R, Feiger D, Meng M, Proteh S, Kenfield S. Lifestyle and non-muscle invasive bladder cancer recurrence, progression and mortality: available research and future directions. Bladder Cancer. 2020;6:9-23.
    1. Benke IN, Leitzmann MF, Behrens G, Schmid D. Physical activity in relation to risk of prostate cancer: a systematic review and meta-analysis. Ann Oncol. 2018;29:1154-1179.
    1. Renehan AG, Tyson M, Egger M, Heller RF, Zwahlen M. Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet. 2008;371:569-578.
    1. Arem H, Irwin ML. Obesity and endometrial cancer survival: a systematic review. Int J Obes (Lond). 2013;37:634-639.
    1. Secord AA, Hasselblad V, Von Gruenigen VE, et al. Body mass index and mortality in endometrial cancer: a systematic review and meta-analysis. Gynecol Oncol. 2016;140:184-190.
    1. Yeganeh L, Harrison C, Vincent AJ, Teede H, Boyle JA. Effects of lifestyle modification on cancer recurrence, overall survival and quality of life in gynaecological cancer survivors: systematic review and meta-analysis. Maturitas. 2018;111:82-89.
    1. Kirtane K, Lee SJ. Racial and ethnic disparities in hematologic malignancies. Blood. 2017;130:1699-1705.
    1. Rodriguez-Abreu D, Bordoni A, Zucca E. Epidemiology of hematological malignancies. Ann Oncol. 2007;18(suppl 1):i3-i8.
    1. Sergentanis TN, Psaltopoulou T, Ntanasis-Stathopoulos I, Liaskas A, Tzanninis IG, Dimopoulos MA. Consumption of fruits, vegetables, and risk of hematological malignancies: a systematic review and meta-analysis of prospective studies. Leuk Lymphoma. 2018;59:434-447.
    1. Oeffinger KC, Mertens AC, Sklar CA, et al. Chronic health conditions in adult survivors of childhood cancer. N Engl J Med. 2006;355:1572-1582.
    1. Armstrong GT, Kawashima T, Leisenring W, et al. Aging and risk of severe, disabling, life-threatening, and fatal events in the Childhood Cancer Survivor Study. J Clin Oncol. 2014;32:1218-1227.
    1. Gibson TM, Mostoufi-Moab S, Stratton KL, et al. Temporal patterns in the risk of chronic health conditions in survivors of childhood cancer diagnosed 1970-99: a report from the Childhood Cancer Survivor Study cohort. Lancet Oncol. 2018;19:1590-1601.
    1. Children's Oncology Group Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancers. Version 5.0 (October 2018). Accessed March 16, 2021.
    1. Dieli-Conwright CM, Lee K, Kiwata JL. Reducing the risk of breast cancer recurrence: an evaluation of the effects and mechanisms of diet and exercise. Curr Breast Cancer Rep. 2016;8:139-150.
    1. Bower JE, Ganz PA, Irwin MR, Kwan L, Breen EC, Cole SW. Inflammation and behavioral symptoms after breast cancer treatment: do fatigue, depression and sleep disturbance share a common underlying mechanism? J Clin Oncol. 2011;29:3517-3522.
    1. Scott JM, Zabor EC, Schwitzer E, et al. Efficacy of exercise therapy on cardiorespiratory fitness in patients with cancer: a systematic review and meta-analysis. J Clin Oncol. 2018;36:2297-2305.
    1. Koh D, Song S, Moon SE, et al. Adherence to the American Cancer Society guidelines for cancer survivors and health-related quality of life among breast cancer survivors. Nutrients. 2019;11:2924.
    1. Bruno E, Gargano G, Villarini A, et al. Adherence to WCRF/AICR cancer prevention recommendations and metabolic syndrome in breast cancer patients. Int J Cancer. 2016;138:237-244.
    1. Patnaik JL, Byers T, DiGuiseppi C, Dabelea D, Denberg TD. Cardiovascular disease competes with breast cancer as the leading cause of death for older females diagnosed with breast cancer: a retrospective cohort study. Breast Cancer Res. 2011;13:R64.
    1. Hawkins NA, Smith T, Zhao L, Rodriguez J, Berkowitz Z, Stein KD. Health-related behavior change after cancer: results of the American Cancer Society's Studies of Cancer Survivors (SCS). J Cancer Surviv. 2010;4:20-32.
    1. Hawkins NA, Soman A, Buchanan Lunsford N, Leadbetter S, Rodriguez JL. Use of medications for treating anxiety and depression in cancer survivors in the United States. J Clin Oncol. 2017;35:78-85.
    1. Underwood JM, Townsend JS, Stewart SL, et al. Surveillance of demographic characteristics and health behaviors among adult cancer survivors-Behavioral Risk Factor Surveillance System, United States, 2009. MMWR Surveill Summ. 2012;61:1-23.
    1. Williams K, Steptoe A, Wardle J. Is a cancer diagnosis a trigger for health behaviour change? Findings from a prospective, population-based study. Br J Cancer. 2013;108:2407-2412.
    1. Sullivan ES, Rice N, Kingston E, et al. A national survey of oncology survivors examining nutrition attitudes, problems and behaviours, and access to dietetic care throughout the cancer journey. Clin Nutr ESPEN. 2021;41:331-339.
    1. LoConte NK, Brewster AM, Kaur JS, Merrill JK, Alberg AJ. Alcohol and cancer: a statement of the American Society of Clinical Oncology. J Clin Oncol. 2018;36:83-93.
    1. Weaver KE, Foraker RE, Alfano CM, et al. Cardiovascular risk factors among long-term survivors of breast, prostate, colorectal, and gynecologic cancers: a gap in survivorship care? J Cancer Surviv. 2013;7:253-261.
    1. Rudd RE. Health literacy considerations for a new cancer prevention initiative. Gerontologist. 2019;59(suppl 1):S7-S16.
    1. Park SH, Knobf MT, Kerstetter J, Jeon S. Adherence to American Cancer Society guidelines on nutrition and physical activity in female cancer survivors: results from a randomized controlled trial (Yale Fitness Intervention Trial). Cancer Nurs. 2019;42:242-250.
    1. Keaver L, McGough AM, Du M, et al. Self-reported changes and perceived barriers to healthy eating and physical activity among global breast cancer survivors: results from an exploratory online novel survey. J Acad Nutr Diet. 2021;121:233-241.e8.
    1. Alfano CM, Day JM, Katz ML, et al. Exercise and dietary change after diagnosis and cancer-related symptoms in long-term survivors of breast cancer: CALGB 79804. Psychooncology. 2009;18:128-133.
    1. Humpel N, Magee C, Jones SC. The impact of a cancer diagnosis on the health behaviors of cancer survivors and their family and friends. Support Care Cancer. 2007;15:621-630.
    1. Patterson RE, Neuhouser ML, Hedderson MM, Schwartz SM, Standish LJ, Bowen DJ. Changes in diet, physical activity, and supplement use among adults diagnosed with cancer. J Am Diet Assoc. 2003;103:323-328.
    1. Basch E, Barbera L, Kerrigan CL, Velikova G. Implementation of patient-reported outcomes in routine medical care. Am Soc Clin Oncol Educ Book. 2018;38:122-134.
    1. Gordon BE, Chen RC. Patient-reported outcomes in cancer survivorship. Acta Oncol. 2017;56:166-173.
    1. Silver JK, Baima J. Cancer prehabilitation: an opportunity to decrease treatment-related morbidity, increase cancer treatment options, and improve physical and psychological health outcomes. Am J Phys Med Rehabil. 2013;92:715-727.
    1. Faithfull S, Turner L, Poole K, et al. Prehabilitation for adults diagnosed with cancer: a systematic review of long-term physical function, nutrition and patient-reported outcomes. Eur J Cancer Care (Engl). 2019;28:e13023.
    1. Edwards BK, Noone AM, Mariotto AB, et al. Annual Report to the Nation on the status of cancer, 1975-2010, featuring prevalence of comorbidity and impact on survival among persons with lung, colorectal, breast, or prostate cancer. Cancer. 2014;120:1290-1314.
    1. Gilchrist SC, Barac A, Ades PA, et al. Cardio-oncology rehabilitation to manage cardiovascular outcomes in cancer patients and survivors: a scientific statement from the American Heart Association. Circulation. 2019;139:e997-e1012.
    1. Howard-Anderson J, Ganz PA, Bower JE, Stanton AL. Quality of life, fertility concerns, and behavioral health outcomes in younger breast cancer survivors: a systematic review. J Natl Cancer Inst. 2012;104:386-405.
    1. Stanton AL, Ganz PA, Kwan L, et al. Outcomes from the Moving Beyond Cancer psychoeducational, randomized, controlled trial with breast cancer patients. J Clin Oncol. 2005;23:6009-6018.
    1. Kang JH, Kwon JH, Hui D, Yennurajalingam S, Bruera E. Changes in symptom intensity among cancer patients receiving outpatient palliative care. J Pain Symptom Manage. 2013;46:652-660.
    1. Given CW, Given B, Azzouz F, Kozachik S, Stommel M. Predictors of pain and fatigue in the year following diagnosis among elderly cancer patients. J Pain Symptom Manage. 2001;21:456-466.
    1. Dougherty P, Cata J, Cordella J, Burton A, Weng H. Taxol-induced sensory disturbance is characterized by preferential impairment of myelinated fiber function in cancer patients. Pain. 2004;109:132-142.
    1. Dupont A, Bower JE, Stanton AL, Ganz PA. Cancer-related intrusive thoughts predict behavioral symptoms following breast cancer treatment. Health Psychol. 2014;33:155-163.
    1. Mercadante S, Casuccio A, Fulfaro F. The course of symptom frequency and intensity in advanced cancer patients followed at home. J Pain Symptom Manage. 2000;20:104-112.
    1. Ganz P, Kwan L, Stanton A, Krupnick J, Rowland JH, Meyerowitz B. Quality of life at the end of primary treatment of breast cancer: first results from the Moving Beyond Cancer randomized trial. J Natl Cancer Inst. 2004;96:376-387.
    1. Owen JE, O’Carroll Bantum E, Pagano IS, Stanton A. Randomized trial of a social networking intervention for cancer-related distress. Ann Behav Med. 2017;51:661-672.
    1. Badger TA, Segrin C, Hepworth JT, Pasvogel A, Weihs K, Lopez AM. Telephone-delivered health education and interpersonal counseling improve quality of life for Latinas with breast cancer and their supportive partners. Psychooncology. 2013;22:1035-1042.
    1. Alfano CM, Smith AW, Irwin ML, et al. Physical activity, long-term symptoms, and physical health-related quality of life among breast cancer survivors: a prospective analysis. J Cancer Surviv. 2007;1:116-128.
    1. Cho MH, Dodd MJ, Cooper BA, Miaskowski C. Comparisons of exercise dose and symptom severity between exercisers and nonexercisers in women during and after cancer treatment. J Pain Symptom Manage. 2012;43:842-854.
    1. Hardcastle SJ, Maxwell-Smith C, Kamarova S, Lamb S, Millar L, Cohen PA. Factors influencing non-participation in an exercise program and attitudes towards physical activity amongst cancer survivors. Support Care Cancer. 2018;26:1289-1295.
    1. Wu S, Fisher-Hoch SP, Reininger BM, Lee M, McCormick JB. Fruit and vegetable intake is inversely associated with cancer risk in Mexican-Americans. Nutr Cancer. 2019;71:1254-1262.
    1. Wu S, Fisher-Hoch SP, Reninger B, McCormick JB. Meeting or exceeding physical activity guidelines is associated with reduced risk for cancer in Mexican-Americans. Am J Cancer Prev. 2016;4:1-7.
    1. Essue BM, Iragorri N, Fitzgerald N, de Oliveira C. The psychosocial cost burden of cancer: a systematic literature review. Psychooncology. 2020;29:1746-1760.
    1. Fitch MI, Nicoll I, Lockwood G. Exploring the impact of physical, emotional, and practical changes following treatment on the daily lives of cancer survivors. J Psychosoc Oncol. 2021;39:219-234.
    1. Zahnd WE, Murphy C, Knoll M, et al. The intersection of rural residence and minority race/ethnicity in cancer disparities in the United States. Int J Environ Res Public Health. 2021;18:1384.
    1. Kronenfeld JP, Graves KD, Penedo FJ, Yanez B. Overcoming disparities in cancer: a need for meaningful reform for Hispanic and Latino cancer survivors. Oncologist. 2021;26:443-452.
    1. Patel MI, Lopez AM, Blackstock W, et al. Cancer disparities and health equity: a policy statement from the American Society of Clinical Oncology. J Clin Oncol. 2020;38:3439-3448.
    1. Braveman P, Arkin E, Orleans T, Proctor D, Plough A. What is health equity? And what difference does a definition make?. Robert Wood Johnson Foundation; 2017.
    1. Griggs J, Maingi S, Blinder V, et al. American Society of Clinical Oncology position statement: strategies for reducing cancer health disparities among sexual and gender minority populations. J Clin Oncol. 2017;35:2203-2208.
    1. American Association for Cancer Research (AACR). AACR Cancer Disparities Progress Report 2020. Accessed March 22, 2021.
    1. Sengupta R, Honey K. AACR Cancer Disparities Progress Report 2020: achieving the bold vision of health equity for racial and ethnic minorities and other underserved populations. Cancer Epidemiol Biomarkers Prev. 2020;29:1843.
    1. American Cancer Society. Health Equity Principles. Accessed March 22, 2021.
    1. Nord M, Andrews M, Carlson S. Household Food Security in the United States, 2005. Economic Research Service, US Department of Agriculture; 2005. Accessed April 7, 2021.
    1. Economic Research Service, US Department of Agriculture. Food Insecurity and Nutrition Assistance. Economic Research Service, US Department of Agriculture; 2020. Accessed April 8, 2021.
    1. Charkhchi P, Fazeli Dehkordy S, Carlos RC. Housing and food insecurity, care access, and health status among the chronically ill: an analysis of the Behavioral Risk Factor Surveillance System. J Gen Intern Med. 2018;33:644-650.
    1. Gany F, Leng J, Ramirez J, et al. Health-related quality of life of food-insecure ethnic minority patients with cancer. J Oncol Pract. 2015;11:396-402.
    1. Banegas MP, Schneider JL, Firemark AJ, et al. The social and economic toll of cancer survivorship: a complex web of financial sacrifice. J Cancer Surviv. 2019;13:406-417.
    1. Iragorri N, de Oliveira C, Fitzgerald N, Essue B. The out-of-pocket cost burden of cancer care-a systematic literature review. Curr Oncol. 2021;28:1216-1248.
    1. Jackson I, Osaghae I, Ananaba N, Etuk A, Jackson N, Chido-Amajuoyi OG. Sources of health information among U.S. cancer survivors: results from the Health Information National Trends Survey (HINTS). AIMS Public Health. 2020;7:363-379.
    1. Johnston EA, van der Pols JC, Ekberg S. Needs, preferences, and experiences of adult cancer survivors in accessing dietary information post-treatment: a scoping review. Eur J Cancer Care (Engl). 2021;30:e13381.
    1. Sylvia Chou WY, Gaysynsky A, Cappella JN. Where we go from here: health misinformation on social media. Am J Public Health. 2020;110(S3):S273-S275.
    1. Wilner T, Holton A. Breast cancer prevention and treatment: misinformation on Pinterest, 2018. Am J Public Health. 2020;110(S3):S300-S304.
    1. Raber M, Warner E, Leroy G, Crane T, Badger T, Basen-Engquist K. Cancer-related nutrition and meal planning content on Pinterest. Poster presented at: 45th Annual Virtual Meeting of the American Society of Preventive Oncology; March 29 to April 1, 2021.
    1. Wong JN, McAuley E, Trinh L. Physical activity programming and counseling preferences among cancer survivors: a systematic review. Int J Behav Nutr Phys Act. 2018;15:48.
    1. Clark LH, Ko EM, Kernodle A, et al. Endometrial cancer survivors' perceptions of provider obesity counseling and attempted behavior change: are we seizing the moment? Int J Gynecol Cancer. 2016;26:318-324.
    1. Fisher A, Williams K, Beeken R, Wardle J. Recall of physical activity advice was associated with higher levels of physical activity in colorectal cancer patients. BMJ Open. 2015;5:e006853.
    1. Demark-Wahnefried W, Schmitz KH, Alfano CM, et al. Weight management and physical activity throughout the cancer care continuum. CA Cancer J Clin. 2018;68:64-89.
    1. Ligibel JA, Alfano CM, Courneya KS, et al. American Society of Clinical Oncology position statement on obesity and cancer. J Clin Oncol. 2014;32:3568-3574.
    1. Schmitz KH, Campbell AM, Stuiver MM, et al. Exercise is medicine in oncology: engaging clinicians to help patients move through cancer. CA Cancer J Clin. 2019;69:468-484.
    1. Trujillo EB, Claghorn K, Dixon SW, et al. Inadequate nutrition coverage in outpatient cancer centers: results of a national survey. J Oncol. 2019;2019:7462940.
    1. Centers for Medicare & Medicaid Services. Information on Essential Health Benefits (EHB) Benchmark Plans. Accessed August 3, 2021.
    1. Haas BK, Kimmel G, Hermanns M, Deal B. Community-based FitSTEPS for life exercise program for persons with cancer: 5-year evaluation. J Oncol Pract. 2012;8:320-324, 322 p following 324.
    1. Heston AH, Schwartz AL, Justice-Gardiner H, Hohman KH. Addressing physical activity needs of survivors by developing a community-based exercise program: LIVESTRONG® at the YMCA. Clin J Oncol Nurs. 2015;19:213-217.
    1. Irwin ML, Cartmel B, Harrigan M, et al. Effect of the LIVESTRONG at the YMCA exercise program on physical activity, fitness, quality of life, and fatigue in cancer survivors. Cancer. 2017;123:1249-1258.
    1. Basen-Engquist K, Alfano CM, Maitin-Shepard M, et al. Agenda for translating physical activity, nutrition, and weight management interventions for cancer survivors into clinical and community practice. Obesity (Silver Spring). 2017;25(suppl 2):S9-S22.
    1. Dossett LA, Hudson JN, Morris AM, et al. The primary care provider (PCP)-cancer specialist relationship: a systematic review and mixed-methods meta-synthesis. CA Cancer J Clin. 2017;67:156-169.
    1. Hebdon M, Fahnestock O, McComb S. Shared mental models of provider roles in cancer survivorship care. J Adv Pract Oncol. 2015;6:334-348.
    1. Rubinstein EB, Miller WL, Hudson SV, et al. Cancer survivorship care in advanced primary care practices: a qualitative study of challenges and opportunities. JAMA Intern Med. 2017;177:1726-1732.
    1. Cantwell M, Walsh D, Furlong B, et al. Healthcare professionals' knowledge and practice of physical activity promotion in cancer care: challenges and solutions. Eur J Cancer Care (Engl). 2018;27:e12795.
    1. Haggstrom DA, Arora NK, Helft P, Clayman ML, Oakley-Girvan I. Follow-up care delivery among colorectal cancer survivors most often seen by primary and subspecialty care physicians. J Gen Intern Med. 2009;24(suppl 2):S472-S479.
    1. Kenzik K, Pisu M, Fouad MN, Martin MY. Are long-term cancer survivors and physicians discussing health promotion and healthy behaviors? J Cancer Surviv. 2016;10:271-279.
    1. Zebrack B. Information and service needs for young adult cancer survivors. Support Care Cancer. 2009;17:349-357.
    1. Arem H, Duan X, Ehlers DK, Lyon ME, Rowland JH, Mama SK. Provider discussion about lifestyle by cancer history: a nationally representative survey. Cancer Epidemiol Biomarkers Prev. 2021;30:278-285.
    1. Smith TG, Strollo S, Hu X, Earle CC, Leach CR, Nekhlyudov L. Understanding long-term cancer survivors' preferences for ongoing medical care. J Gen Intern Med. 2019;34:2091-2097.
    1. Demark-Wahnefried W, Rogers LQ, Alfano CM, et al. Practical clinical interventions for diet, physical activity, and weight control in cancer survivors. CA Cancer J Clin. 2015;65:167-189.
    1. Stout NL, Brown JC, Schwartz AL, et al. An exercise oncology clinical pathway: screening and referral for personalized interventions. Cancer. 2020;126:2750-2758.
    1. Stout NL, Santa Mina D, Lyons KD, Robb K, Silver JK. A systematic review of rehabilitation and exercise recommendations in oncology guidelines. CA Cancer J Clin. 2021;71:149-175.
    1. Ligibel JA, Alfano CM, Hershman DL, et al. American Society of Clinical Oncology summit on addressing obesity through multidisciplinary provider collaboration: key findings and recommendations for action. Obesity (Silver Spring). 2017;25(suppl 2):S34-S39.
    1. Yang W, Williams JH, Hogan PF, et al. Projected supply of and demand for oncologists and radiation oncologists through 2025: an aging, better-insured population will result in shortage. J Oncol Pract. 2014;10:39-45.
    1. Stout NL, Nekhlyudov L. Cancer survivorship: broadening our workforce and extending into communities to create a system of care. Accessed August 3, 2021. 10.1200/ADN.20.200353/full/
    1. Swartz MC, Lewis ZH, Lyons EJ, et al. Effect of home- and community-based physical activity interventions on physical function among cancer survivors: a systematic review and meta-analysis. Arch Phys Med Rehabil. 2017;98:1652-1665.
    1. Westfall JM, Mold J, Fagnan L. Practice-based research-“Blue Highways” on the NIH roadmap. JAMA. 2007;297:403-406.
    1. An KY, Arthuso FZ, Kang DW, et al. Exercise and health-related fitness predictors of chemotherapy completion in breast cancer patients: pooled analysis of two multicenter trials. Breast Cancer Res Treat. 2021;188:399-407.
    1. Boyd P, Lowry M, Morris KL, et al. Health behaviors of cancer survivors and population controls from the National Health Interview Survey (2005-2015). JNCI Cancer Spectr. 2020;4:pkaa043.
    1. Tollosa DN, Tavener M, Hure A, James EL. Adherence to multiple health behaviours in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv. 2019;13:327-343.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe