Attention to diet, exercise, and weight in oncology care: Results of an American Society of Clinical Oncology national patient survey

Abstract

BACKGROUND:The American Society of Clinical Oncology (ASCO) surveyed cancer patients to assess practice patterns related to weight, diet, and exercise as a part of cancer care. METHODS: An online survey was distributed between March and June 2020 through ASCO channels and patient advocacy organizations. Direct email communication was sent to more than 25,000 contacts, and information about the survey was posted on Cancer.Net. Eligibility criteria included being aged at least 18 years, living in the United States, and having been diagnosed with cancer. Logistic regression was used to determine factors associated with recommendation and referral patterns. RESULTS: In total, 2419 individuals responded to the survey. Most respondents were female (60.1%), 61.1% had an early-stage malignancy, and 48.4% were currently receiving treatment. Breast cancer was the most common cancer (35.7%). The majority of resppondents consumed ≤2 servings of fruits and vegetables/d (50.5%) and exercised ≤2 times/wk (50.1%). Exercise was addressed at most or some oncology visits in 56.8% of respondents, diet in 50.1%, and weight in 28.0%. Respondents whose oncology provider provided diet and/or exercise recommendations were more likely to report changes in these behaviors vs. those whose oncology provider did not (exercise: 79.6% vs 69.0%, P < .001; diet 81.1% vs 71.3%, P < .001; weight 81.0% vs 73.3%, P = .003). CONCLUSIONS: In a national survey of oncology patients, slightly more than one-half reported attention to diet and exercise during oncology visits. Provider recommendations for diet, exercise, and weight were associated with positive changes in these behaviors, reinforcing the importance of attention to these topics as a part of oncology care.

Exercise, Diet, and Weight Management During Cancer Treatment: ASCO Guideline

“…A recent ASCO survey of 2,419 oncology patients in the United States found that almost 75% of patients reported making changes in their diet or exercise patterns after cancer diagnosis in an effort to improve outcomes. 95 The importance of regular exercise, maintaining weight in a healthy range, and consuming a high-quality diet have well-established value in decreasing risk of cardiovascular disease, metabolic disorders, and other chronic illnesses. Improving lifestyle behaviors earlier in the cancer care continuum could have longer-term benefits for patients, which are not reflected in the current literature.…”

“…A recent ASCO survey of 2,419 patients with cancer, 48% of whom were currently receiving treatment at the time of survey completion, found that 25% of survey respondents were not engaging in any regular exercise and another 25% engaged in suboptimal levels of exercise. 95 Notably, individuals whose oncology providers discussed the importance of exercise or a healthy diet as a part of cancer care reported a greater likelihood of making changes in lifestyle behaviors after cancer diagnosis, and another recent study in individuals with colon cancer in the United Kingdom found that patients who reported that their oncology providers addressed exercise during oncology visits were more likely to engage in physical activity (51% in the advice group v 42% in the no advice group; OR 1.74; 95% CI, 1.60 to 1.90; P < .001), and more likely to meet physical activity guidelines (25% v 20%; OR 1.70; 95% CI, 1.54 to 1.88; P < .001). 96 This work highlights the importance of oncology provider engagement in encouraging regular physical activity in their patients receiving cancer treatment.…”

NCCN Guidelines® Insights: Survivorship, Version 1.2022

“…[8][9][10][11][12][13][14][15][16] Results of a recent ASCO survey indicated that more than half of survivors are affected by overweight or obesity, consume #2 servings of fruits and vegetables daily, and/ or exercise #2 times each week. 17 In fact, another survey showed similar results and reported that only 7.6% of all survivors met all 6 health behavior recommendations (regarding physical activity, use of sunscreen, tobacco avoidance, minimizing alcohol, weight management, and PCP visits). 18 Analysis of data from the 2013-2017 National Health Interview Survey indicates that cancer survivors are less likely than those without a history of cancer to have a healthy body mass index (BMI; 31.6% vs 34.7%, respectively) or meet physical activity recommendations (14.2% vs 21.1%), although they are less likely to smoke (14.1% vs 16.8%) or engage in moderate/heavy drinking (18.8% vs 21.9%).…”

“…[32][33][34][35] In fact, in a recent survey, 72.8% of respondents reported changing their diet and/or exercise habits after diagnosis in hopes of improving cancer outcomes. 17 Data suggest that recommendations from the oncologist can carry significant weight for patients with cancer, yet many providers do not discuss healthy lifestyle changes with survivors. 17,32,[36][37][38] Thus, the oncology team can play a key role by providing initial advice and making referrals to programs that are grounded in theory (eg, social cognitive theory or the theory of planned behavior).…”

Studying the Implementation of Exercise Oncology Interventions: A Path Forward

“…The number of cancer survivors living in the United States is 17 million and rising (1). Exercise is an effective strategy for managing negative sequela, improving quality of life, and reduc-ing risk of cancer mortality and all-cause mortality in cancer survivors, yet most cancer survivors do not engage in regular recommended exercise (2)(3)(4)(5). Therefore, a greater focus on the dissemination and implementation of exercise oncology evidence-based interventions (EBIs) is critical (2,6).…”