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Supportive Care in Cancer

, Volume 24, Issue 4, pp 1527–1536 | Cite as

Lifestyles of cancer survivors attending an inpatient educational program—a cross-sectional study

  • Gunhild M. GjersetEmail author
  • Jon H. Loge
  • Sævar B. Gudbergsson
  • Asta Bye
  • S. D. Fosså
  • Line M. Oldervoll
  • Cecilie E. Kiserud
  • Wendy Demark-Wahnefried
  • Lene Thorsen
Original Article

Abstract

Purpose

Cancer survivors have increased risk for adverse health effects, but the risk can be reduced by adopting a healthy lifestyle. Knowledge of lifestyle in terms of physical activity (PA), diet (intake of fruit and vegetables [F&V]) and smoking behaviors of cancer survivors enrolled in an inpatient educational program and identification of subgroups not meeting the lifestyle guidelines are needed to set up more targeted programs.

Methods

We invited 862 cancer survivors, ≥18 years, diagnosed within the last 10 years and about to attend a 1-week educational program, to participate in this cross-sectional study. Sixty-seven percent (n = 576) returned the questionnaire before the start of the program. PA, F&V intake (5-A-Day) and smoking behaviors were self-reported. Logistic regression analyses were used to identify the characteristics of those not meeting the guidelines.

Results

Sixty-three percent were women, median age was 60 years (range 28–83), 52 % had high education and median time since diagnosis was 12 months (range 2–119). Fifty-five percent did not meet the PA guidelines, 81 % did not meet the 5-A-Day guidelines and 12 % were current smokers. In multivariate analyses, age ≥60 years and low education were associated with not meeting the PA guidelines, and male gender and low education were associated with not meeting the 5-A-Day guidelines. Living alone was associated with smoking.

Conclusions

The majority of cancer survivors attending an educational program do not meet the public guidelines for PA and diet. Special attention should be given to those who are male, over age 60 years and with low education.

Keywords

Cancer survivors Lifestyle Educational program Rehabilitation Physical activity 

Notes

Acknowledgments

This project was funded by grant from South-Eastern Norway Regional Health Authority. The authors wish to acknowledge the work and collaboration of the staff of the Montebello-Center.

Compliance with ethical standards

The authors have no conflicts of interest to declare. Our research involves human participants. All participants have signed an informed consent.

Conflict of interest

The authors declare that they have no conflicts of interest. We also state that we have control of all primary data, and we agree to allow the journal to review the data if requested.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Ganz PA (2009) Survivorship: adult cancer survivors. Prim Care 36:721–741CrossRefPubMedGoogle Scholar
  2. 2.
    Schmitz KH, Courneya KS, Matthews C et al (2010) American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc 42:1409–1426CrossRefPubMedGoogle Scholar
  3. 3.
    Ballard-Barbash R, Friedenreich CM, Courneya KS, Siddiqi SM, McTiernan A, Alfano CM (2012) Physical activity, biomarkers, and disease outcomes in cancer survivors: a systematic review. J Natl Cancer Inst 104:815–840PubMedCentralCrossRefPubMedGoogle Scholar
  4. 4.
    Pekmezi DW, Demark-Wahnefried W (2011) Updated evidence in support of diet and exercise interventions in cancer survivors. Acta Oncol 50:167–178PubMedCentralCrossRefPubMedGoogle Scholar
  5. 5.
    Kushi LH, Doyle C, McCullough M et al (2012) American Cancer Society Guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity. CA Cancer J Clin 62:30–67CrossRefPubMedGoogle Scholar
  6. 6.
    Rock CL, Doyle C, Demark-Wahnefried W et al (2012) Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin 62:243–274CrossRefPubMedGoogle Scholar
  7. 7.
    Coups EJ, Ostroff JS (2005) A population-based estimate of the prevalence of behavioral risk factors among adult cancer survivors and noncancer controls. Prev Med 40:702–711CrossRefPubMedGoogle Scholar
  8. 8.
    Ollberding NJ, Maskarinec G, Wilkens LR, Henderson BE, Kolonel LN (2011) Comparison of modifiable health behaviours between persons with and without cancer: the multiethnic cohort. Public Health Nutr 14:1796–1804PubMedCentralCrossRefPubMedGoogle Scholar
  9. 9.
    Williams K, Steptoe A, Wardle J (2013) Is a cancer diagnosis a trigger for health behaviour change? Findings from a prospective, population-based study. Br J Cancer 108:2407–2412PubMedCentralCrossRefPubMedGoogle Scholar
  10. 10.
    Blanchard CM, Courneya KS, Stein K (2008) Cancer survivors’ adherence to lifestyle behavior recommendations and associations with health-related quality of life: results from the American Cancer Society’s SCS-II. J Clin Oncol 26:2198–2204CrossRefPubMedGoogle Scholar
  11. 11.
    Hoybye MT, Dalton SO, Christensen J et al (2008) Research in Danish cancer rehabilitation: social characteristics and late effects of cancer among participants in the FOCARE research project. Acta Oncol 47:47–55CrossRefPubMedGoogle Scholar
  12. 12.
    Ibfelt E, Rottmann N, Kjaer T et al (2011) No change in health behavior, BMI or self-rated health after a psychosocial cancer rehabilitation: results of a randomized trial. Acta Oncol 50:289–298CrossRefPubMedGoogle Scholar
  13. 13.
    Kwiatkowski F, Mouret-Reynier MA, Duclos M et al (2013) Long term improved quality of life by a 2-week group physical and educational intervention shortly after breast cancer chemotherapy completion. Results of the “Programme of Accompanying women after breast Cancer treatment completion in Thermal resorts” (PACThe) randomised clinical trial of 251 patients. Eur J Cancer 49:1530–1538CrossRefPubMedGoogle Scholar
  14. 14.
    Bertheussen GF, Kaasa S, Hokstad A, Sandmæl JA, Helbostad JL, Salvesen Ø, Oldervoll LM (2012) Feasibility and changes in symptoms and functioning following inpatient cancer rehabilitation. Acta Oncol 51:1070–1080CrossRefPubMedGoogle Scholar
  15. 15.
    Demark-Wahnefried W, Aziz NM, Rowland JH, Pinto BM (2005) Riding the crest of the teachable moment: promoting long-term health after the diagnosis of cancer. J Clin Oncol 23:5814–5830PubMedCentralCrossRefPubMedGoogle Scholar
  16. 16.
    Hawkins NA, Smith T, Zhao L, Rodriguez J, Berkowitz Z, Stein KD (2010) Health-related behavior change after cancer: results of the American Cancer Society’s studies of cancer survivors (SCS). J Cancer Surviv 4:20–32CrossRefPubMedGoogle Scholar
  17. 17.
    Kurtze N, Rangul V, Hustvedt BE, Flanders WD (2008) Reliability and validity of self-reported physical activity in the Nord-Trondelag Health Study: HUNT 1. Scand J Public Health 36:52–61CrossRefPubMedGoogle Scholar
  18. 18.
    Mosdol A (2004) Dietary assessment—the weakest link? A dissertation exploring the limitations to questionnaire based methods of dietary assessment. Dissertation, University of Oslo, NorwayGoogle Scholar
  19. 19.
    Eakin EG, Youlden DR, Baade PD, Lawer SP, Reeves MM, Heyworth JS, Fritschi L (2007) Health behaviors of cancer survivors: data from an Australian population-based survey. Cancer Causes Control 18:881–894CrossRefPubMedGoogle Scholar
  20. 20.
    Gjerset GM, Fossa SD, Courneya KS, Skovlund E, Thorsen L (2011) Exercise behavior in cancer survivors and associated factors. J Cancer Surviv 5:35–43PubMedCentralCrossRefPubMedGoogle Scholar
  21. 21.
    Hong S, Bardwell WA, Natarajan L et al (2007) Correlates of physical activity level in breast cancer survivors participating in the Women’s Healthy Eating and Living (WHEL) Study. Breast Cancer Res Treat 101:225–232CrossRefPubMedGoogle Scholar
  22. 22.
    Lynch BM, Cerin E, Newman B, Owen N (2007) Physical activity, activity change, and their correlates in a population-based sample of colorectal cancer survivors. Ann Behav Med 34:135–143CrossRefPubMedGoogle Scholar
  23. 23.
    Wang Z, McLoone P, Morrison DS (2014) Diet, exercise, obesity, smoking and alcohol consumption in cancer survivors and the general population: a comparative study of 16 282 individuals. Br J Cancer. doi: 10.1038/bjc.2014.598 Google Scholar
  24. 24.
    Harding M (2012) Health-promotion behaviors and psychological distress in cancer survivors. Oncol Nurs Forum 39:E132–E140CrossRefPubMedGoogle Scholar
  25. 25.
    Westmaas JL, Alcaraz KI, Berg CJ, Stein KD (2014) Prevalence and correlates of smoking and cessation-related behavior among survivors of ten cancers: findings from a nationwide survey nine years after diagnosis. Cancer Epidemiol Biomarkers Prev 23:1783–1792CrossRefPubMedGoogle Scholar
  26. 26.
    Spronk I, Kullen C, Burdon C, O’Connor H (2014) Relationship between nutrition knowledge and dietary intake. Br J Nutr 111:1713–1726CrossRefPubMedGoogle Scholar
  27. 27.
    Low CA, Beckjord E, Bovbjerg DH et al (2014) Correlates of positive health behaviors in cancer survivors: results from the 2010 LIVESTRONG survey. J Psychosoc Oncol 32:678–695CrossRefPubMedGoogle Scholar
  28. 28.
    Troiano RP (2007) Large-scale applications of accelerometers: new frontiers and new questions. Med Sci Sports Exerc 39:1501CrossRefPubMedGoogle Scholar
  29. 29.
    Ainsworth BE, Caspersen CJ, Matthews CE, Mâsse LC, Baranowski T, Weimo Z (2012) Recommendations to improve the accuracy of estimates of physical activity derived from self report. J Phys Act Health 9:S76–S84PubMedCentralPubMedGoogle Scholar
  30. 30.
    Wefel JS, Kesler SR, Noll KR, Schagen SB (2015) Clinical characteristics, pathophysiology, and management of noncentral nervous system cancer-related cognitive impairment in adults. CA Cancer J Clin 65:123–138PubMedCentralCrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Gunhild M. Gjerset
    • 1
    Email author
  • Jon H. Loge
    • 2
  • Sævar B. Gudbergsson
    • 3
  • Asta Bye
    • 4
  • S. D. Fosså
    • 1
  • Line M. Oldervoll
    • 5
  • Cecilie E. Kiserud
    • 1
  • Wendy Demark-Wahnefried
    • 6
  • Lene Thorsen
    • 1
  1. 1.National Advisory Unit on Late Effects after Cancer Treatment, Department of OncologyOslo University HospitalOsloNorway
  2. 2.Regional Centre for Excellence in Palliative Care, Department of Oncology, Oslo University Hospital and Institute of Basic Medical Sciences, Faculty of MedicineUniversity of OsloOsloNorway
  3. 3.Montebello-Center, The Norwegian Resource Center for Coping with CancerMesnaliNorway
  4. 4.Regional Centre for Excellence in Palliative Care, Department of Oncology, Oslo University Hospital and Department of Health, Nutrition and Management, Faculty of Health Sciences, Oslo and Akershus University College of Applied SciencesOsloNorway
  5. 5.Centre for Health Promotion and Resources, Department of Social Work and Health Science, NTNU, Trondheim and Research and Development Group, LHL ClinicsLHL ClinicsOsloNorway
  6. 6.University of Alabama at Birmingham Comprehensive Cancer CenterBirminghamUSA

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