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Changing the
Picture for Senior Cancer Survivors
Plans to control health care
costs and improve care need to consider the growing population
of seniors who are cancer survivors. This group is not only at
risk of a secondary cancer, but also of functional decline due
to loss of strength or balance and other health conditions. Research
suggests that weight control, regular moderate physical activity
and healthy eating may reduce cancer survivors’ risk of
cancer, improve quality of life and reduce the burden of functional
decline. Now research also is identifying ways to help survivors
make healthy lifestyle changes.
Cancer survivors an at risk population:
Even cancer survivors without recurrence may experience lasting
effects of the disease and its treatment. This can include increased
risk of heart disease, high blood pressure, diabetes or osteoporosis
as well as reduced fitness and strength. |
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Overall, studies suggest that
cancer patients tend to make few if any improvements in eating
or activity habits or may make changes soon after diagnosis but
not maintain them. Yet among breast cancer survivors, those who
gain less weight show greater survival. Regular moderate physical
activity may enhance survival and help counteract the decreases
in functioning and quality of life that otherwise come with loss
of strength and fitness.
Interventions at work: Programs
to teach and support healthier lifestyles can successfully address
these problems. Researchers have been developing and testing
home-based programs delivered by mail, telephone or Internet
to improve participation by older adults. Initial studies often
showed habits improving and then reverting back to usual when
the program was over. A program from researchers at Duke University
added methods to participants’ materials to match their
readiness to change and personality. Information also included
testimonials of similar survivors who successfully made lifestyle
changes. The program is ongoing but short-term data shows increased
physical activity, improved diet and slight reduction of overweight.
Focus on function
Another recent study added efforts
to improve physical functioning among cancer survivors who were
at least 65 years old and at least five years past diagnosis.
All the participants were overweight or obese and sedentary.
This 12-month study used print materials and telephone counseling
to encourage healthier lifestyles. The goals included daily moderate
activity, eating more vegetables and fruits, eating less saturated
fat, modest weight loss, and 15 minutes of lower body strength-training
three times weekly. A "wait-list" control group made
no changes.
Participants averaged less than
half the strength-training target, but compared to the control
group who showed significant drop in a score of basic physical
function, they showed almost no detectable impact on quality
of life. Participants also made modest improvements in other
lifestyle goals, while the wait-list group made little or no
change.
We can view these results pessimistically
or optimistically. Even this well-designed, personalized program
still resulted in less than one in five participants meeting
recommended walking or vegetable and fruit consumption targets.
Although the program generally did not improve physical functioning,
it did reduce the decline in physical function often seen with
age and in many cancer survivors. Delivered at a cost of about
a thousand dollars per person, these could be dollars well spent.
We must remember that because some cancer survivors have physical
limitations, efforts to improve physical function should be evaluated
by each individual’s physician before they jump in. |
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