Comparison of Dietary and Lifestyle Habits Among Stage III and Metastatic Colorectal Cancer Patients: Findings from CALGB 89803 and CALGB 80405

Abstract

Background Cancer patients seek information about lifestyle and dietary changes which may optimize outcomes. Using data from two large National Cancer Institute-sponsored clinical trials, we report on the dietary and lifestyle practices of patients receiving therapy for stage III colon or metastatic colorectal cancer. Methods Self-administered questionnaires were completed by patients undergoing chemotherapy for stage III colon cancer (n = 1095) and metastatic colorectal cancer (n = 875). Descriptive statistical analyses were performed to evaluate anthropometrics, diet and lifestyle in each cohort. Results Median body mass index was comparable for stage III and metastatic patients (27.3 vs. 26.5 kg/m2). Stage III patients reported a modestly higher median level of physical activity than metastatic patients (4.6 vs. 3.4 metabolic equivalent task-hours/week). Ten percent of stage III and 9% of metastatic patients reported ongoing cigarette use. Avoidance of alcohol was reported by 47% of stage III and 43% of metastatic patients. Dietary patterns for both groups were comparable with more than 80% of stage III and metastatic patients failed to meet the recommended daily intake of vegetables, fruits, and milk products. Usage of at least 2 multivitamin per week was reported by 49% of stage III and 40% of metastatic patients. Two percent of stage III and 5% of metastatic patients reported vitamin D supplement use. Conclusions We observed notable similarities in dietary and lifestyle behaviors between stage III colon and metastatic colorectal cancer patients actively receiving chemotherapy. Future research should aim to elucidate the effect of these behaviors on patient outcomes.

Associations of artificially sweetened beverage intake with disease recurrence and mortality in stage III colon cancer: Results from CALGB 89803 (Alliance)

“…Finally, randomized trials may select patients who differ from the general population. However, the pattern of dietary and lifestyle habits reported by our cohort were consistent with those of other U.S. cohorts [ 65 ]. Moreover, this large trial enrolled patients from community and academic centers throughout North America, reducing likelihood of biased sampling.…”

Colorectal cancer survivors only marginally change their overall lifestyle in the first 2 years following diagnosis

“…Several, but not all, studies suggest that CRC survivors generally improve specific health behaviors after diagnosis. Retrospective studies suggest these include eating more healthy [9–12], increasing physical activity [11], and quitting smoking [11]. Also, some prospective studies report changes in concordance with lifestyle recommendations after CRC diagnosis, including an increase in vegetable consumption [13–15], an increase in physical activity [13], a decrease in alcohol intake [14], and quitting smoking [15].…”

Association Between Serum Folate Level and Toxicity of Capecitabine During Treatment for Colorectal Cancer

“…Within China, this is of particular concern in the Southern region because the population is known to have a remarkably higher serum folate level than in Northern China, likely as a result of different dietary habits [20]. Second, it is not uncommon to note that patients take extra vitamin supplements after diagnoses of cancers [21]. Of interest, all of the nine patients in the cohort who consumed folic acid supplements prior to and during capecitabine-based treatment developed grade 2 toxicity.…”