Riding the Crest of the Teachable Moment: Promoting Long-Term Health After the Diagnosis of Cancer

Demark‐Wahnefried, Wendy; Aziz, Noreen M.; Rowland, Julia H.; Pinto, Bernardine M.

doi:10.1200/jco.2005.01.230

Cited by 1,006 publications

(879 citation statements)

References 134 publications

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“…Studies suggest that as few as 20% of providers talk to cancer survivors about health behaviors, 202 and only 10% of survivors report their physicians talking to them about smoking, exercise, and diet. 203 Similar data are lacking for HCT survivors.…”

Section: Optimal Screening and Preventative Practicesmentioning

confidence: 99%

National Institutes of Health Hematopoietic Cell Transplantation Late Effects Initiative: The Subsequent Neoplasms Working Group Report

Morton

Saber

Baker

et al. 2017

Biology of Blood and Marrow Transplantation

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Subsequent neoplasms (SN) following hematopoietic cell transplantation (HCT) cause significant patient morbidity and mortality. Risks for specific SN types vary substantially, with particularly elevated risks for post-transplant lymphoproliferative disorders, myelodysplastic syndrome/acute myeloid leukemia, and squamous cell malignancies. This consensus document provides an overview of the current state of knowledge regarding SN after HCT and recommends priorities and approaches to overcome challenges and gaps in understanding. Numerous factors have been suggested to impact risk, including patient-related (e.g., age), primary disease-related (e.g., disease type, pre-HCT therapies), and HCT-related characteristics (e.g., type and intensity of conditioning regimen, stem cell source, development of graft-versus-host disease). However, gaps in understanding remain for each of these risk factors, particularly for patients receiving HCT in the current era due to substantial advances in clinical transplantation practices. Additionally, the influence of non-transplant-related risk factors (e.g., germline genetic susceptibility, oncogenic viruses, lifestyle factors) is poorly understood. Clarification of the magnitude of SN risks and identification of etiologic factors will require large-scale, long-term, systematic follow-up of HCT survivors with detailed clinical data. Most investigations of the mechanisms of SN pathogenesis after HCT have focused on immune drivers. Expansion of our understanding in this area will require interdisciplinary laboratory collaborations utilizing measures of immune function and availability of archival tissue from SN diagnoses. Consensus-based recommendations for optimal preventative, screening, and therapeutic approaches have been developed for certain SN after HCT, whereas for other SN, general population guidelines are recommended. Further evidence is needed to specifically tailor preventative, screening, and therapeutic guidelines for SN after HCT, particularly for unique patient populations. Accomplishment of this broad research agenda will require increased investment in systematic data collection with engagement from patients, clinicians, and interdisciplinary scientists in order to reduce the burden of SN in the rapidly growing population of HCT survivors.

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Section: Optimal Screening and Preventative Practicesmentioning

confidence: 99%

National Institutes of Health Hematopoietic Cell Transplantation Late Effects Initiative: The Subsequent Neoplasms Working Group Report

Morton

Saber

Baker

et al. 2017

Biology of Blood and Marrow Transplantation

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“…Postdiagnosis lifestyle habits, including diet and alcohol consumption, have been associated with cancer prognosis, risk of recurrence or second cancer, and mortality4, 5, 6, 7 but also with quality of life 8. Tertiary prevention, by adopting and maintaining a healthy lifestyle, is crucial for reducing morbidity and mortality and improving the quality of life of cancer patients and survivors.…”

Section: Introductionmentioning

confidence: 99%

“…Overall, these studies tended to suggest an improvement in dietary behavior after cancer diagnosis, as well as a strong motivation of cancer survivors to make lifestyle changes 4. However, most of these studies were cross‐sectional and either compared survivors to cancer‐free subjects11, 13, 15, 16, 17, 18, 21, 26 or described only postdiagnosis dietary and alcohol intakes in cancer survivors 10, 12, 14, 19, 23.…”

Section: Introductionmentioning

confidence: 99%

Modifications in dietary and alcohol intakes between before and after cancer diagnosis: Results from the prospective population-based NutriNet-Santé cohort

et al. 2017

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Postdiagnosis diet and alcohol consumption may be associated with cancer prognosis, recurrence and mortality. Our aim was to investigate food, nutrient and alcohol intake variations between before and after cancer diagnosis and their determinants in a prospective cohort. Subjects (n = 696) were incident cancer cases diagnosed in the NutriNet‐Santé cohort between 2009 and 2016. Food, nutrient and alcohol intakes were prospectively collected using repeated nonconsecutive 24‐hr dietary records since subjects' inclusion (i.e. an average of 2 y before diagnosis). Mean number of dietary records per subject was 5.9 before and 8.1 after diagnosis. All dietary data before and after diagnosis were compared by mixed models. Factors associated with the main dietary changes observed were also investigated using multivariable logistic regressions. We observed a decrease in intakes of vegetables (mean decrease in intake in patients who decreased their intake=‐102.4 ± 79.8 g/d), dairy products (–93.9 ± 82.8 g/d), meat/offal (–35.5 ± 27.8/d), soy products (–85.8 ± 104.1 g/d), sweetened soft drinks (–77.9 ± 95.4 g/d), and alcoholic drinks (–92.9 ± 119.9 g/d), and an increase in broths (42.1 ± 34.9 g/d) and fats/sauces (18.0 ± 13.4 g/d). We observed a decrease in energy intake (–377.2 ± 243.5 kcal/d) and in intakes of alcohol (–7.6 ± 9.4 g/d) proteins (–17.4 ± 12.5 g/d), and several vitamins (p < 0.05) and micronutrients (p < 0.05). Conversely, lipid (19.4 ± 14.6 g/d), SFA (9.3 ± 7.0 g/d), MUFA (8.3 ± 6.3 g/d) and vitamin E (3.9 ± 3.3 mg/d) intakes increased after diagnosis. This large prospective study suggests that cancer diagnosis is a key period for nutritional changes. It highlights some healthy behaviors such as a decrease in alcohol and sweetened drink consumption, but also less favorable trends, such as a decrease in vegetable consumption and in many vitamin and mineral intakes. These results provide insights to identify and target recommendations to put forward for better nutritional care of cancer survivors.

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“…Brain cancer in younger women was associated with reduced marriage rates [15], but no marriages were observed among older female brain cancer survivors (OR<0.001). Brain cancer can be extremely debilitating and alter both physical, psychological, and social functioning [24]. It may thus significantly interfere with the ability to fill the role of a life partner.…”

Section: Discussionmentioning

confidence: 99%

Marriage after cancer in older adulthood

Syse

Bergva

2009

J Cancer Surviv

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Introduction Cancer's impact on family formation in older adulthood is not well described. Marriage rates among older adults were therefore explored. Method Data on the unmarried Norwegian population aged 45-80 in 1974-2001 (N=306 000) was retrieved from the Cancer Registry, the Central Population Register, and population censuses. Marriage rates for 27600 persons diagnosed with cancer were compared to those of the general population by means of discrete-time hazard regression models. Results Men with cancer had a similar marriage rate as cancer-free men, whereas women experienced a 25% marriage deficit after cancer. This deficit was most pronounced after ovarian (OR 0.48) and breast (OR 0.69) cancer. Marriage rates decreased with time from diagnosis. No cancer forms elevated marriage rates. Conclusion Marriage rates among older male cancer survivors are similar to those of the general population. Ovarian and breast cancer in older women was associated with pronounced marriage deficits. A possible explanation is that these gender-specific cancers relate to aspects of persons' psychological well-being, body image, and sense of femininity. Long-term adverse treatment effects are also common for the cancers in question. To explore explanations further, more details on treatment and illness progression are needed. Implications for cancer survivors Increased awareness of how ovarian and breast cancer may affect (prospects of) interpersonal relationships is valuable for cancer survivors and clinicians, and may facilitate communication of relevant, related issues during consultations. Our findings may suggest a need for more extensive psychosocial follow-up after these gender-specific cancer forms in older women, but further research is clearly warranted.

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Riding the Crest of the Teachable Moment: Promoting Long-Term Health After the Diagnosis of Cancer

Cited by 1,006 publications

References 134 publications

National Institutes of Health Hematopoietic Cell Transplantation Late Effects Initiative: The Subsequent Neoplasms Working Group Report

National Institutes of Health Hematopoietic Cell Transplantation Late Effects Initiative: The Subsequent Neoplasms Working Group Report

Modifications in dietary and alcohol intakes between before and after cancer diagnosis: Results from the prospective population-based NutriNet-Santé cohort

Marriage after cancer in older adulthood

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