Impact of Lifestyle Factors on Prognosis Among Breast Cancer Survivors in the USA

Rachel E Ellsworth; Allyson L Valente; Craig D Shriver; Barry Bittman; Darrell L Ellsworth

Disclosures

Expert Rev Pharmacoeconomics Outcomes Res. 2012;12(4):451-464. 

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Expert Commentary

As the number of breast cancer survivors increases, interest in lifestyle interventions and CAM approaches continues to grow. Although the main focus for many breast cancer survivors is prevention of disease recurrence, survivors are at increased risk for developing chronic conditions such as osteoporosis, diabetes and cardiovascular disease, as well as noncancer-related mortality.[125] Behavioral modification may provide breast cancer patients with numerous health benefits, both during and after active treatment. In addition to potential health benefits, lifestyle modification may provide patients with feelings of control and self-determination because they become active participants in managing their own health.

Between September 2006 and February 2007, the US President's Cancer Panel examined current evidence regarding the effects of lifestyle behaviors on cancer risk, as well as ways to reduce the national cancer burden by promoting healthy lifestyles.[207] The panel recommended that: healthcare providers coordinate and integrate education and prevention messages related to healthy lifestyles with other chronic diseases to promote common risk reduction strategies; and individuals assume personal responsibility for learning about cancer risk and making healthy lifestyle choices. Research has shown that breast cancer patients who receive healthy lifestyle recommendations, such as a recommendation to exercise, from their oncologist actually participate in these behaviors significantly more than patients following standard treatment;[126] however, only about 25% of patients report actually receiving dietary or physical activity recommendations from their primary care physicians.[127] Healthcare providers must become more involved in recommending (and monitoring implementation of) healthy lifestyle behaviors for their cancer patients. Similarly, breast cancer survivors must be proactive in learning about options for healthier lifestyles and integrating appropriate behaviors into their daily routine.

Despite the large number of studies investigating the effects of lifestyle modification on breast cancer survivorship, few definitive conclusions have emerged. Many lifestyle behaviors may individually affect prognosis, but it is unlikely that a single comprehensive 'lifestyle modification package' is appropriate for all survivors. Patients should consider general 'common-sense' recommendations such as maintaining a healthy weight by consuming a diet rich in plant-based foods and limiting alcohol, being physically active and minimizing stress. Survivors should strive to incorporate as many healthy behaviors as possible, given their individual physical, emotional and financial constraints.

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