Colon cancer survivors with healthier lifestyles may live longer, a recent U.S. study from the University of California at San Francisco suggests. Colon cancer patients who followed the American Cancer Society guidelines on nutrition and physical activity had a marked reduction in risk of death and recurrence.
Nutrition and Physical Activity Guidelines for Cancer Survivors were released by the American Cancer Society (ACS) in 2001. Healthy people who follow these guidelines may reduce their cancer risk, they add, and adhering to the guidelines has been linked to a better quality of life in colon cancer survivors.
To investigate whether sticking to the ACS guidelines could extend colon cancer survival, the researchers looked at 992 people participating in a clinical trial of treatment for advanced colon cancer who reported on their diet and physical activity during and after chemotherapy.
Each person was assigned a score from 0 to 6 based on their adherence to the ACS guidelines, which included recommended ranges for body mass index (BMI), physical activity, and consumption of vegetables, fruit, whole and refined grains and red or processed meat.
During an average seven years of follow-up, 335 patients had recurrence of their cancer and 299 died, including 256 who died from cancer recurrence. Twenty-six percent of the study participants had an ACS guideline score of 0-1, while only 9 percent scored 5 to 6.
People who closely followed guidelines 42% less likely to die during study
Patients who followed the guidelines most closely were 42 percent less likely to die during follow up than those with the worst adherence and had better disease-free and recurrence-free survival. Overall, people who adhered well to the guidelines were 9 percent more likely to survive for five years after diagnosis than those with worse adherence.
Healthy habits also tied to lower risk of recurrence
Patients who logged 150 minutes or more of moderate physical activity each week, such as brisk walking; ate at least five servings of fruits and vegetables a day; and chose whole over refined grains lived longer and were less likely to have cancer recurrence. Those with BMIs of 23 to 29.9, somewhat higher than the ACS guidelines recommend, also had improved survival compared to those with higher BMIs.
Low-to-moderate consumption of alcohol (no more than one drink a day for women, two a day for men) was not associated with worse survival or disease recurrence, but heavier drinking was.
Eating more red and processed meat was not associated with survival or cancer recurrence. Paying attention to carbs appears more important for colon cancer survivors, the researchers noted, because sugar-sweetened drinks, foods with a high glycemic load and other less-healthy carbs have been linked to worse outcomes.
The new study is especially valuable because it yields specifics that doctors can discuss with colorectal cancer survivors.
Source: JAMA Oncology, online April 12, 2018.
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