Advertisement

Effects of Complementary and Integrative Medicine on Cancer Survivorship

  • Moshe Frenkel
  • Victor Sierpina
  • Kenneth Sapire
Integrative Care (C Lammersfeld, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Integrative Care

Abstract

Cancer survivorship has become a topic of great interest in the past few years. Unfortunately, even with successful treatment as well as good follow-up care, many patients continue to experience unmet physical, emotional, and spiritual needs as well as having an unsettling fear, fear of recurrence, a fear which most survivors share, even many years after their treatment ended. As a result, patients are continually looking for additional ways to address these needs and fears. Among the most popular approach is the use of complementary and integrative medicine (CIM). Most studies on CIM use among cancer patients and survivors concentrate on symptom improvement and improvement of quality of life and do not touch a crucial question if these therapies can affect patients’ survival in terms of prolongation of life. Interestingly, in recent years, there are a growing number of studies that suggest that approaches such as mind-body interventions, enhanced general nutrition, nutritional supplements, physical activity, and other CIM approaches may have a positive effect on survival of cancer patients. Although additional studies are needed to confirm these findings, given the low cost of these CIM interventions, their minimal risk, and the potential magnitude of their effects, these approaches might be considered as additional important tools to integrate into cancer survivorship care plans.

Keywords

Cancer survivorship Unmet needs Cancer care Complementary medicine Integrative medicine Cancer prognosis Nutrition Nutritional supplements Exercise Mind body medicine 

Notes

Compliance with Ethics Guidelines

Conflict of Interest

Moshe Frenkel, Victor Sierpina, and Kenneth Sapire declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    The Centers for Disease Control and Prevention (CDC): Basic Information about Cancer Survivorship. http://www.cdc.gov/cancer/survivorship/basic_info/ Accessed November 21, 2014.
  2. 2.
    Siegel R, DeSantis C, Virgo K, et al. Cancer treatment and survivorship statistics. CA Cancer J Clin. 2012;62(4):220–41.CrossRefPubMedGoogle Scholar
  3. 3.
    Hewitt M, Greenfield S, Stovall E. From cancer patient to cancer survivor: lost in transition. Washington: National Academies Press; 2006.Google Scholar
  4. 4.
    Mitchell GK. The role of general practice in cancer care. Aust Fam Physician. 2008;37:698–702.PubMedGoogle Scholar
  5. 5.
    Thorne SE, Stajduhar KI. Patient perceptions of communications on the threshold of cancer survivorship: implications for provider responses. J Cancer Surviv. 2012;6(2):229–37. Epub 2012 Mar 20.CrossRefPubMedGoogle Scholar
  6. 6.
    Institute of Medicine. Cancer care for the whole patient: meeting psychosocial health needs. Washington: National Academies Press; 2007.Google Scholar
  7. 7.
    Jacobs LA, Palmer S, Schwartz L, et al. Adult cancer survivorship: evolution, research, and planning care. CA Cancer J Clin. 2009;59:391–410.CrossRefPubMedGoogle Scholar
  8. 8.
    Ganz PA. The ‘three Ps’ of cancer survivorship care. BMC Med. 2011;9:14.CrossRefPubMedCentralPubMedGoogle Scholar
  9. 9.
    McCabe MS, Bhatia S, Oeffinger KC, et al. American society of clinical oncology statement: achieving high-quality cancer survivorship care. J Clin Oncol. 2013;31(5):631–40.CrossRefPubMedGoogle Scholar
  10. 10.
    MD Anderson Cancer Center. Breast Cancer Survivorship Clinic http://www.mdanderson.org/patient-and-cancer-information/cancer-information/cancer-topics/survivorship/follow-up-care/breast.html Accessed December 10, 2014.
  11. 11.
    Ganz PA, Habel LA, Weltzien EK, et al. Examining the influence of beta blockers and ACE inhibitors on the risk for breast cancer recurrence: results from the LACE cohort. Breast Cancer Res Treat. 2011;129(2):549–56.CrossRefPubMedCentralPubMedGoogle Scholar
  12. 12.
    Armes J, Crowe M, Colbourne L, et al. Patients’ supportive care needs beyond the end of cancer treatment: a prospective, longitudinal survey. J Clin Oncol. 2009;27(36):6172–9.CrossRefPubMedGoogle Scholar
  13. 13.
    Ganz PA, Rowland JH, Desmond K, Meyerowitz BE, Wyatt GE. Life after breast cancer: understanding women’s health-related quality of life and sexual functioning. J Clin Oncol. 1998;16:501–14.PubMedGoogle Scholar
  14. 14.
    Hodgkinson K, Butow P, Hunt GE, et al. Breast cancer survivors’ supportive care needs 2–10 years after diagnosis. Support Care Cancer. 2007;15(5):515–23.CrossRefPubMedGoogle Scholar
  15. 15.
    Hodgkinson K, Butow P, Fuchs A, et al. Long-term survival from gynecologic cancer: psychosocial outcomes, supportive care needs and positive outcomes. Gynecol Oncol. 2007;104(2):381–9.CrossRefPubMedGoogle Scholar
  16. 16.•
    Mao JJ, Cohen L. Advancing the science of integrative oncology to inform patient-centered care for cancer survivors. J Natl Cancer Inst Monogr. 2014;2014(50):283–4. doi: 10.1093/jncimonographs/lgu038. This is an important editorial to an issue of The Journal of National Cancer Institute that is dedicated to integrative oncology and its value to cancer survivors. This issue reflects the importance of these modalities which is gaining attention in the oncology field.CrossRefPubMedGoogle Scholar
  17. 17.
    Rowland JH, O’Mara A. Survivorship care planning: unique opportunity to champion integrative oncology. J Natl Cancer Inst Monogr. 2014;2014(50):285. doi: 10.1093/jncimonographs/lgu037.CrossRefPubMedGoogle Scholar
  18. 18.
    Briggs J. Building the evidence base for integrative approaches to care of cancer survivors. J Natl Cancer Inst Monogr. 2014;2014(50):288. doi: 10.1093/jncimonographs/lgu040.CrossRefPubMedGoogle Scholar
  19. 19.
    Frenkel M, Cohen L, Peterson N, Swint K, Palmer L, Bruera E. Integrative medicine consultation service in a Comprehensive Cancer Center: findings and outcomes. Integr Cancer Ther. 2010;9(3):276–83.CrossRefPubMedGoogle Scholar
  20. 20.
    Deng GE, Frenkel M, Cohen L, et al. Evidence-based clinical practice guidelines for integrative oncology: complementary therapies and botanicals. J Soc Integr Oncol. 2009;7(3 (Summer)):85–120.PubMedGoogle Scholar
  21. 21.
    Mao JJ, Farrar JT, Xie SX, et al. Use of complementary and alternative medicine and prayer among a national sample of cancer survivors compared to other populations without cancer. Complement Ther Med. 2007;15(1):21–9.CrossRefPubMedGoogle Scholar
  22. 22.
    Goldstein MS, Lee JH, Ballard B, et al. The use and perceived benefit of complementary and alternative medicine among Californians with cancer. Psychooncology. 2008;17(1):19–25.CrossRefPubMedGoogle Scholar
  23. 23.
    Greenlee H, Kwan ML, Ergas IJ, et al. Complementary and alternative therapy use before and after breast cancer diagnosis: the Pathways Study. Breast Cancer Res Treat. 2009;117(3):653–65.CrossRefPubMedCentralPubMedGoogle Scholar
  24. 24.
    Bright-Gbebry M, Makambi KH, Rohan JP. Use of multivitamins, folic acid and herbal supplements among breast cancer survivors: the black women’s health study. BMC Complement Altern Med. 2011;11:30.CrossRefPubMedCentralPubMedGoogle Scholar
  25. 25.
    Mao JJ, Palmer SC, Straton JB, et al. Cancer survivors with unmet needs were more likely to use complementary and alternative medicine. J Cancer Surviv. 2008;2(2):116–24.CrossRefPubMedGoogle Scholar
  26. 26.
    Mao JJ, Palmer SC, Healy KE, et al. Complementary and alternative medicine use among cancer survivors: a population-based study. J Cancer Surviv. 2011;5:8–17.CrossRefPubMedCentralPubMedGoogle Scholar
  27. 27.
    Carpenter CL, Ganz PA, Bernstein L. Complementary and alternative therapies among very long-term breast cancer survivors. Breast Cancer Res Treat. 2009;116(2):387–96.CrossRefPubMedCentralPubMedGoogle Scholar
  28. 28.
    Lawsin C, DuHamel K, Itzkowitz SH, et al. Demographic, medical, and psychosocial correlates to CAM use among survivors of colorectal cancer. Support Care Cancer. 2007;15(5):557–64.CrossRefPubMedGoogle Scholar
  29. 29.
    Frenkel M. Clinical consultation, a personal perspective: components of a successful integrative medicine clinical consultation. J Soc Integr Oncol. 2008;6:129–33.PubMedGoogle Scholar
  30. 30.
    Eisenberg DM, Kessler RC, Van Rompay MI, Kaptchuk TJ, Wilkey SA, Appel S, et al. Perceptions about complementary therapies relative to conventional therapies among adults who use both: results from a national survey. Ann Intern Med. 2001;135(5):344–51.CrossRefPubMedGoogle Scholar
  31. 31.
    Richardson MA, Masse LC, Nanny K, Sanders C. Discrepant views of oncologists and cancer patients on complementary/alternative medicine. Support Care Cancer. 2004;12(11):797–804.CrossRefPubMedGoogle Scholar
  32. 32.
    Kappauf H, Leykauf-Ammon D, Bruntsch U, Horneber M, Kaiser G, Buschel G, et al. Use of and attitudes held towards unconventional medicine by patients in a department of internal medicine/oncology and haematology. Support Care Cancer. 2000;8(4):314–22.CrossRefPubMedGoogle Scholar
  33. 33.
    Frenkel M, Ben-Arye E, Baldwin CD, Sierpina V. Approach to communicating with patients about the use of nutritional supplements in cancer care. South Med J. 2005;98(3):289–94.CrossRefPubMedGoogle Scholar
  34. 34.
    Roberts CS, Baker F, Hann D, et al. Patient-physician communication regarding use of complementary therapies during cancer treatment. J Psychosoc Oncol. 2005;23(4):35–60.CrossRefPubMedGoogle Scholar
  35. 35.
    Ben-Arye E, Frenkel M, Margalit RS. Approaching complementary and alternative medicine use in patients with cancer: questions and challenges. J Ambul Care Manage. 2004;27(1):53–62.CrossRefPubMedGoogle Scholar
  36. 36.
    Weiger WA, Smith M, Boon H, et al. Advising patients who seek complementary and alternative medical therapies for cancer. Ann Intern Med. 2002;137(11):889–903.CrossRefPubMedGoogle Scholar
  37. 37.
    Bishop FL, Yardley L, Lewith GT. Treat or treatment: a qualitative study analyzing patients’ use of complementary and alternative medicine. Am J Public Health. 2008;98(9):1700–5.CrossRefPubMedCentralPubMedGoogle Scholar
  38. 38.
    Helyer LK, Chin S, Chui BK, et al. The use of complementary and alternative medicines among patients with locally advanced breast cancer-a descriptive study. BMC Cancer. 2006;6:39.CrossRefPubMedCentralPubMedGoogle Scholar
  39. 39.
    Singh H, Maskarinec G, Shumay DM. Understanding the motivation for conventional and complementary/alternative medicine use among men with prostate cancer. Integr Cancer Ther. 2005;4(2):187–94.CrossRefPubMedGoogle Scholar
  40. 40.
    Evans M, Shaw A, Thompson EA, et al. Decisions to use complementary and alternative medicine (CAM) by male cancer patients: information-seeking roles and types of evidence used. BMC Complement Altern Med. 2007;7:25.CrossRefPubMedCentralPubMedGoogle Scholar
  41. 41.
    Seers HE, Gale N, Paterson C, Cooke HJ, Tuffrey V, Polley MJ. Individualised and complex experiences of integrative cancer support care: combining qualitative and quantitative data. Support Care Cancer. 2009;17(9):1159–67.CrossRefPubMedGoogle Scholar
  42. 42.
    Servan-Schreiber D. Anticancer—a new way of life. 2nd ed. New York: Viking Adult Press; 2010.Google Scholar
  43. 43.
    Holland JC. Psycho-oncology. 2nd ed. New York: Oxford University Press; 2010.CrossRefGoogle Scholar
  44. 44.
    Giese-Davis J, Collie K, Rancourt KM, Neri E, Kraemer HC, Spiegel D. Decrease in depression symptoms is associated with longer survival in patients with metastatic breast cancer: a secondary analysis. J Clin Oncol. 2011;29(4):413–20.CrossRefPubMedCentralPubMedGoogle Scholar
  45. 45.
    Spiegel D. Mind matters in cancer survival. JAMA. 2011;305(5):502–3.CrossRefPubMedGoogle Scholar
  46. 46.
    Thaker PH, Han LY, Kamat AA, Arevalo JM, et al. Chronic stress promotes tumor growth and angiogenesis in a mouse model of ovarian carcinoma. Nat Med. 2006;12(8):939–44.CrossRefPubMedGoogle Scholar
  47. 47.
    Sloan EK, Priceman SJ, Cox BF, et al. The sympathetic nervous system induces a metastatic switch in primary breast cancer. Cancer Res. 2010;70(18):7042–52.CrossRefPubMedCentralPubMedGoogle Scholar
  48. 48.
    Chida Y, Hamer M, Wardle J, Steptoe A. Do stress-related psychosocial factors contribute to cancer incidence and survival? Nat Clin Pract Oncol. 2008;5(8):466–75.CrossRefPubMedGoogle Scholar
  49. 49.
    Epplein M, Zheng Y, Zheng W, Chen Z, Gu K, Penson D, et al. Quality of life after breast cancer diagnosis and survival. J Clin Oncol. 2011;29(4):406–12.CrossRefPubMedCentralPubMedGoogle Scholar
  50. 50.
    Devine EC, Westlake SK. The effects of psychoeducational care provided to adults with cancer: meta-analysis of 116 studies. Oncol Nurs Forum. 1995;22(9):1369–81.PubMedGoogle Scholar
  51. 51.
    Ernst E, Pittler MH, Wider B, Boddy K. Mind-body therapies: are the trial data getting stronger? Altern Ther Health Med. 2007;13(5):62–4.PubMedGoogle Scholar
  52. 52.
    Gordon JS. Mind-body medicine and cancer. Hematol Oncol Clin North Am. 2008;22(4):683–708. 4.CrossRefPubMedGoogle Scholar
  53. 53.
    Spiegel D, Bloom JR, Kraemer HC, Gottheil E. Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet. 1989;2(8668):888–91.CrossRefPubMedGoogle Scholar
  54. 54.
    Spiegel D, Butler LD, Giese-Davis J, Koopman C, Miller E, DiMiceli S, et al. Effects of supportive-expressive group therapy on survival of patients with metastatic breast cancer: a randomized prospective trial. Cancer. 2007;110(5):1130–8.CrossRefPubMedGoogle Scholar
  55. 55.
    Fawzy FI, Fawzy NW, Hyun CS, et al. Malignant melanoma. Effects of an early structured psychiatric intervention, coping, and affective state on recurrence and survival 6 years later. Arch Gen Psychiatry. 1993;50(9):681–9.CrossRefPubMedGoogle Scholar
  56. 56.
    Fawzy FI, Canada AL, Fawzy NW. Malignant melanoma: effects of a brief, structured psychiatric intervention on survival and recurrence at 10-year follow-up. Arch Gen Psychiatry. 2003;60(1):100–3.CrossRefPubMedGoogle Scholar
  57. 57.
    Boesen EH, Boesen SH, Frederiksen K, Ross L, Dahlstrøm K, Schmidt G, et al. Survival after a psychoeducational intervention for patients with cutaneous malignant melanoma: a replication study. J Clin Oncol. 2007;25(36):5698–703.CrossRefPubMedGoogle Scholar
  58. 58.
    World Cancer Research Fund/ American Institute for Cancer Research. Food, nutrition, physical activity and the prevention of cancer: a global perspective expert report. Washington DC: AICR, 1997; 2007.Google Scholar
  59. 59.
    Pekmezi DW, Demark-Wahnefried W. Updated evidence in support of diet and exercise interventions in cancer survivors. Acta Oncol. 2011;50(2):167–78.CrossRefPubMedCentralPubMedGoogle Scholar
  60. 60.
    Meyerhardt JA, Sato K, Niedzwiecki D, et al. Dietary glycemic load and cancer recurrence and survival in patients with stage III colon cancer: findings from CALGB 89803. J Natl Cancer Inst. 2012;104(22):1702–11.CrossRefPubMedCentralPubMedGoogle Scholar
  61. 61.
    Tang L, Zirpoli GR, Guru K, et al. Intake of cruciferous vegetables modifies bladder cancer survival. Cancer Epidemiol Biomarkers Prev. 2010;19(7):1806–11.CrossRefPubMedCentralPubMedGoogle Scholar
  62. 62.
    Thomson CA, Rock CL, Thompson PA, Caan BJ, Cussler E, Flatt SW, et al. Vegetable intake is associated with reduced breast cancer recurrence in tamoxifen users: a secondary analysis from the Women’s Healthy Eating and Living Study. Breast Cancer Res Treat. 2011;125(2):519–27.CrossRefPubMedGoogle Scholar
  63. 63.
    Ghadirian P, Narod S, Fafard E, Costa M, Robidoux A, Nkondjock A. Breast cancer risk in relation to the joint effect of BRCA mutations and diet diversity. Breast Cancer Res Treat. 2009;117(2):417–22.CrossRefPubMedGoogle Scholar
  64. 64.
    American Institute of Cancer Research. Foods that fight cancer? http://www.aicr.org/foods-that-fight-cancer/ Accessed December 14, 2014.
  65. 65.
    Dorai T, Aggarwal BB. Role of chemopreventive agents in cancer therapy. Cancer Lett. 2004;215(2):129–40.CrossRefPubMedGoogle Scholar
  66. 66.
    Gullett NP, Ruhul Amin AR, Bayraktar S, et al. Cancer prevention with natural compounds. Semin Oncol. 2010;37(3):258–81.CrossRefPubMedGoogle Scholar
  67. 67.
    Aggarwal BB, Shishodia S. Molecular targets of dietary agents for prevention and therapy of cancer. Biochem Pharmacol. 2006;71(10):1397–421.CrossRefPubMedGoogle Scholar
  68. 68.
    Keum N, Giovannucci E. Vitamin D supplements and cancer incidence and mortality: a meta-analysis. Br J Cancer. 2014;111(5):976–80.CrossRefPubMedGoogle Scholar
  69. 69.
    Bell GA, Kantor ED, Lampe JW, et al. Intake of long-chain ω-3 fatty acids from diet and supplements in relation to mortality. Am J Epidemiol. 2014;179(6):710–20.CrossRefPubMedCentralPubMedGoogle Scholar
  70. 70.
    Murphy RA, Mourtzakis M, Chu QS, et al. Supplementation with fish oil increases first-line chemotherapy efficacy in patients with advanced nonsmall cell lung cancer. Cancer. 2011;117(16):3774–80.CrossRefPubMedGoogle Scholar
  71. 71.
    Ogunleye AA, Xue F, Michels KB. Green tea consumption and breast cancer risk or recurrence: a meta-analysis. Breast Cancer Res Treat. 2010;119(2):477–84.CrossRefPubMedGoogle Scholar
  72. 72.
    Cui Y, Shu XO, Gao YT, Cai H, Tao MH, Zheng W. Association of ginseng use with survival and quality of life among breast cancer patients. Am J Epidemiol. 2006;163(7):645–53.CrossRefPubMedGoogle Scholar
  73. 73.
    Matsui Y, Uhara J, Satoi S, Kaibori M, Yamada H, Kitade H, et al. Improved prognosis of postoperative hepatocellular carcinoma patients when treated with functional foods: a prospective cohort study. J Hepatol. 2002;37(1):78–86.CrossRefPubMedGoogle Scholar
  74. 74.
    Kang X, Zhang Q, Wang S, Huang X, Jin S. Effect of soy isoflavones on breast cancer recurrence and death for patients receiving adjuvant endocrine therapy. CMAJ. 2010;182(17):1857–62.CrossRefPubMedCentralPubMedGoogle Scholar
  75. 75.
    Shu XO, Zheng Y, Cai H, Gu K, Chen Z, Zheng W, et al. Soy food intake and breast cancer survival. JAMA. 2009;302(22):2437–43.CrossRefPubMedCentralPubMedGoogle Scholar
  76. 76.
    Kwan ML, Weltzien E, Kushi LH, Castillo A, Slattery ML, Caan BJ. Dietary patterns and breast cancer recurrence and survival among women with early-stage breast cancer. J Clin Oncol. 2009;27(6):919–26.CrossRefPubMedCentralPubMedGoogle Scholar
  77. 77.
    Greenlee H, Kwan ML, Kushi LH, et al. Antioxidant supplement use after breast cancer diagnosis and mortality in the Life After Cancer Epidemiology (LACE) cohort. Cancer. 2011. doi: 10.1002/cncr.26526.PubMedCentralPubMedGoogle Scholar
  78. 78.
    Skuladottir H, Tjoenneland A, Overvad K, et al. Does high intake of fruit and vegetables improve lung cancer survival? Lung Cancer. 2006;51(3):267–73.CrossRefPubMedGoogle Scholar
  79. 79.
    Holmes MD, Chen WY, Feskanich D, Kroenke CH, Colditz GA. Physical activity and survival after breast cancer diagnosis. JAMA. 2005;293(20):2479–86.CrossRefPubMedGoogle Scholar
  80. 80.
    Chen X, Lu W, Zheng W, Gu K, et al. Exercise after diagnosis of breast cancer in association with survival. Cancer Prev Res (Phila). 2011;4(9):1409–18.CrossRefGoogle Scholar
  81. 81.
    Kenfield SA, Stampfer MJ, Giovannucci E, Chan JM. Physical activity and survival after prostate cancer diagnosis in the health professionals follow-up study. J Clin Oncol. 2011;29(6):726–32.CrossRefPubMedCentralPubMedGoogle Scholar
  82. 82.
    Richman EL, Kenfield SA, Stampfer MJ, et al. Physical activity after diagnosis and risk of prostate cancer progression: data from the cancer of the prostate strategic urologic research endeavor. Cancer Res. 2011;71(11):3889–95.CrossRefPubMedCentralPubMedGoogle Scholar
  83. 83.
    Jeon J, Sato K, Niedzwiecki D, et al. Impact of physical activity after cancer diagnosis on survival in patients with recurrent colon cancer: findings from CALGB 89803/alliance. Clin Colorectal Cancer. 2013;12(4):233–8.CrossRefPubMedGoogle Scholar
  84. 84.••
    Andersen BL, Yang HC, Farrar WB, et al. Psychologic intervention improves survival for breast cancer patients: a randomized clinical trial. Cancer. 2008;113(12):3450–8. This is an important long term study which exemplifies that psychological interventions that address nutrition, stress reduction, and physical activity have a long-term positive effect on survivorship. CrossRefPubMedCentralPubMedGoogle Scholar
  85. 85.
    Andersen BL, Thornton LM, Shapiro CL, Farrar WB, Mundy BL, Yang HC, et al. Biobehavioral, immune, and health benefits following recurrence for psychological intervention participants. Clin Cancer Res. 2010;16(12):3270–8.CrossRefPubMedCentralPubMedGoogle Scholar
  86. 86.
    Gil KM, von Gruenigen VE. Physical activity and gynecologic cancer survivorship. Recent Results Cancer Res. 2011;186:305–15.CrossRefPubMedGoogle Scholar
  87. 87.
    Pierce JP, Stefanick ML, Flatt SW, Natarajan L, et al. Greater survival after breast cancer in physically active women with high vegetable-fruit intake regardless of obesity. J Clin Oncol. 2007;25(17):2345–51.CrossRefPubMedCentralPubMedGoogle Scholar
  88. 88.
    Kushi LH, Byers T, Doyle C, et al. American Cancer Society 2006 Nutrition and Physical Activity Guidelines 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. 2006;56:254–81.CrossRefPubMedGoogle Scholar
  89. 89.
    McCullough ML, Patel AV, Kushi LH, Patel R, Willett WC, Doyle C, et al. Following cancer prevention guidelines reduces risk of cancer, cardiovascular disease, and all-cause mortality. Cancer Epidemiol Biomarkers Prev. 2011;20(6):1089–97.CrossRefPubMedGoogle Scholar
  90. 90.
    Blanchard CM, Courneya KS, Stein K, American Cancer Society’s SCS-II. Cancer survivors’ adherence to lifestyle behavior recommendations and associations with health-related quality of life: results from the American Cancer Society’s SCS-II. Clin Oncol. 2008;26:2198–204.CrossRefGoogle Scholar
  91. 91.
    Knoops KT, de Groot LC, Kromhout D, Perrin AE, Moreiras-Varela O, Menotti A, et al. Mediterranean diet, lifestyle factors, and 10-year mortality in elderly European men and women: the HALE project. JAMA. 2004;292(12):1433–9.CrossRefPubMedGoogle Scholar
  92. 92.
    Ruden E, Reardon DA, Coan AD, et al. Exercise behavior, functional capacity, and survival in adults with malignant recurrent glioma. J Clin Oncol. 2011;29(21):2918–23.CrossRefPubMedCentralPubMedGoogle Scholar
  93. 93.•
    Hastert TA, Beresford SA, Patterson RE, et al. Adherence to WCRF/AICR cancer prevention recommendations and risk of post-menopausal breast cancer. Cancer Epidemiol Biomarkers Prev. 2013;22(9):1498–508. This is an important study which documents a 60 % reduction of breast cancer risk among 30000 post menopausal women who follow WCRF/AICR prevention guidelines.CrossRefPubMedCentralPubMedGoogle Scholar
  94. 94.
    Inoue-Choi M, Robien K, Lazovich D. Adherence to the WCRF/AICR guidelines for cancer prevention is associated with lower mortality among older female cancer survivors. Cancer Epidemiol Biomarkers Prev. 2013;22(5):792–802.CrossRefPubMedCentralPubMedGoogle Scholar
  95. 95.
    Vergnaud AC, Romaguera D, Peeters PH, et al. Adherence to the World Cancer Research Fund/American Institute for Cancer Research guidelines and risk of death in Europe: results from the European Prospective Investigation into Nutrition and Cancer cohort study. Am J Clin Nutr. 2013;97(5):1107–20.CrossRefPubMedGoogle Scholar
  96. 96.
    Irwin ML, McTiernan A, Manson JE, et al. Physical activity and survival in postmenopausal women with breast cancer: results from the women’s health initiative. Cancer Prev Res (Phila). 2011;4(4):522–9.CrossRefGoogle Scholar
  97. 97.•
    Aleksandrova K, Pischon T, Jenab M, et al. Combined impact of healthy lifestyle factors on colorectal cancer: a large European cohort study. BMC Med. 2014;12(1):168. One of the recent and significant studies that suggests the combined effect of nutrition, physical activity, smoking cessation, and stress reduction has on colorectal cancer survival.CrossRefPubMedCentralPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Moshe Frenkel
    • 1
    • 2
    • 4
  • Victor Sierpina
    • 1
  • Kenneth Sapire
    • 3
  1. 1.Department of Family MedicineThe University of Texas Medical Branch at GalvestonGalvestonUSA
  2. 2.Integrative Medicine UnitInstitute of Oncology Meir Medical CenterKfar SabaIsrael
  3. 3.Department of AnesthesiaThe University of Texas MD Anderson Cancer CenterHoustonUSA
  4. 4.Zichron YaacovIsrael

Personalised recommendations