Adherence to the American Cancer Society Guidelines for Cancer Survivors and Health-Related Quality of Life among Breast Cancer Survivors

Abstract

The development and validation of guidelines for breast cancer survivors are of importance due to the increased survival rate for breast cancer. In this cross-sectional study, we aimed to examine the association between adherence to the American Cancer Society (ACS) guidelines for cancer survivors and health-related quality of life (HRQoL). A total of 618 breast cancer survivors aged 30 to 81 years who had been diagnosed with stage I to III primary breast cancer and had surgery at least a year before enrollment were included. The participants completed the 36 Item Short-Form Health Survey (SF-36) to evaluate HRQoL, and adherence scores were calculated based on the Nutrition and Physical Activity Guidelines for Cancer Survivors, which were released by the ACS. Increasing adherence scores were associated with increasing scores on the physical component summary (PCS) and the physical functioning (PF), bodily pain (BP), and vitality (VT) domains (p for trend <0.001 for PCS and PF, 0.01 for BP, and 0.02 for VT); these scores were mainly driven by the associations among survivors with stage II–III cancer. Further prospective studies are needed to evaluate whether adherence to these guidelines improves HRQoL scores among breast cancer survivors.

Mediating and Moderating Factors of Adherence to Nutrition and Physical Activity Guidelines, Breastfeeding Experience, and Spousal Support on the Relationship between Stress and Quality of Life in Breast Cancer Survivors

“…ACS guideline adherence was found to have a moderating effect on both the adverse effect of stress on HRQoL and on the buffering effects of spousal support. Numbers of studies reported that adherence to the ACS guideline in the breast cancer patients reduced cancer recurrence and mortality [ 12 , 13 , 25 ]. Interestingly, an association between ACS guideline adherence and the QoL of cancer patients has been reported as well; the higher healthy daily habits scores were related to the higher HRQoL levels [ 7 , 12 , 25 ].…”

“…Adherence to the ACS guideline (2012) was estimated by the following categories: (1) achieving and maintaining a healthy body weight using body mass index, (2) engaging in regular physical activity (MET-hours/week), and (3) following the ACS guidelines for cancer prevention (including achievement of a dietary pattern that is high in vegetables, fruits, whole grains, low in processed and red meat, low alcohol intake, and non-smoking). The detailed scoring was described in a previous study by our group [ 13 ]. The score range of ACS guideline adherence was defined between 3 and 12.…”

“…A number of reports have investigated the factors associated with the improvement of HRQoL of breast cancer patients. Some studies reported that maintaining a healthy dietary habit after breast cancer diagnosis improved physical functions and HRQoL and lowered rates of cancer recurrence and mortality [ 12 , 13 ]. Interestingly, in a recent study the adherence to the American Cancer Society (ACS) nutrition and physical activity guideline for cancer survivors was found to be associated with a better HRQoL [ 13 ].…”

“…Some studies reported that maintaining a healthy dietary habit after breast cancer diagnosis improved physical functions and HRQoL and lowered rates of cancer recurrence and mortality [ 12 , 13 ]. Interestingly, in a recent study the adherence to the American Cancer Society (ACS) nutrition and physical activity guideline for cancer survivors was found to be associated with a better HRQoL [ 13 ]. The ACS gathered a group of experts in nutrition, physical activity, and cancer survivorship to evaluate the scientific evidence and best clinical practices related to optimal nutrition and physical activity for cancer survivors.…”

Diet/Nutrition: Ready to Transition from a Cancer Recurrence/Prevention Strategy to a Chronic Pain Management Modality for Cancer Survivors?

“…Furthermore, cancer survivors are advised to follow some diet recommendations from the American Cancer Society (ACS) Guideline on Diet and Physical Activity for Cancer Prevention and the World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) Cancer Prevention (Table 1). Higher diet scores were associated with many aspects, including bodily pain among breast cancer survivors with stage II-III cancer, according to a cross-sectional study that looked at whether adherence to the American Cancer Society (ACS) guidelines was associated with health-related quality of life (HRQoL) among Korean breast cancer survivors [64]. A study of Chinese patients with breast cancer who followed the WCRF/AICR guidelines (BMI, physical activity, and diet) before and after their diagnosis found that following the BMI prescription resulted in reduced pain scores while adherence to dietary recommendations, on the other hand, was not linked to pain scores [65].…”