
Colon cancer improved 5-year survival rates – A study published in JAMA Oncology on April 12 confirmed that colon cancer patients who adhere to the American Cancer Society Nutrition and Physical Activity Guidelines have improved 5-year survival rates. Previous studies conducted have looked at diet or exercise or weight on an individual basis, but this is the first study to look at the combination of recommendations by the ACS.
All of us who are in treatment or in post-treatment for colon cancer or rectal cancer want to do everything possible to enhance our treatment, prevent recurrence and improve our quality of life. This study provides solid evidence that the American Cancer Society’s Nutrition and Physical Activity Guidelines provides colorectal cancer survivors with a blueprint for survival strategies that work.
Previous studies found that adherence to the ACS Guidelines improved quality of life, but no study had been conducted to investigate whether following these guidelines affected survival. This study involved 992 Stage III colon cancer patients who had been enrolled in the CALGB 89803 adjuvant chemotherapy trial in the years 1999 through 2001. The patients were followed for a median 7-year follow-up. The data was analyzed from November 2016 through December 2017.
Every patient enrolled in the study was assigned a numerical score (from a low of 0 to a high of 6 based on compliance to the ACS guidelines) based on their personal characteristics, including body mass index, diet and level of physical activity. Patients who followed the ACS recommendations more strictly had a 5-year survival probability of 85 percent in comparison with a 76 percent likelihood for the least compliant patients.
While that 9 percent absolute risk reduction may not seem like that much, when adjusted for multiple variables, high compliance to the American Cancer Society’s Guidelines for Nutrition and Physical Activity correlated to a 42 percent lower risk of death during the study.
So what does this mean to me?
What can I do to improve my chances? How much do I have to change my lifestyle? Let’s look at the real numbers to gain an understanding of how attainable compliance with the ACS standards is.
- High compliance patients. 91 patients had the highest compliance. Most had a BMI of less than 23. They exercised an equivalent of 30 metabolic equivalent task hours (also called MET-hours) weekly. They ate more than 3 servings of fruits and vegetables and usually ate whole grain bread and pasta.
- Low compliance patients. 262 patients had very low compliance rates. For example, their average BMI was 33. They were extremely sedentary, racking up only a median of 2 metabolic equivalent task hours weekly. Their diet contained less than 2 servings of vegetables and fruits daily. They ate refined grains.
Real Life Recommendations
We don’t have to become Olympic athletes. We don’t have to become vegans. Nor do we have to get skinny. We, as colorectal cancer survivors, need to make conscious decisions daily as we develop new habits.
The researchers learned that making relatively easy decisions about exercise, weight and eating can result in profound differences in survival for the 1.3 million U.S. colorectal cancer survivors. Simply put, here’s what we need to aim for:
- A BMI of between 23 and 29.9.
- 150 minutes of moderate exercise weekly.
- 5 servings of fruits and vegetables daily.
- Choose whole grains over refined grains.
The Rest of the Story
The ACS Guidelines suggest limited red and processed meats, but the study did not show that this behavior provided any additional protective factor. The study suggests that cancer survivors may actually need higher protein intake.
The ACS Guidelines suggest limited red and processed meats, but the study did not show that this behavior provided any additional protective factor. The study suggests that cancer survivors may actually need higher protein intake.
Get Started
Whether we are a patient in active treatment or have finished our treatment, we can begin making small lifestyle changes to improve our survival chances. Check with your healthcare team before beginning a weight loss program or exercise program.
First, we should determine our BMI by utilizing an online BMI calculator. That’s our starting point. Next, use this weight loss calculator to determine the number of calories required to lose a pound a week. We don’t need to go overboard and lose weight too quickly. Our goal is a lifestyle change to obtain and sustain a healthy BMI.
Now we need to look at increasing our activity. Whether we are couch potatoes or only walk to the mailbox and back, we can become more active. A great place to begin is to find a cancer wellness program. Almost 700-YMCA’s across the country in partnership with LIVESTRONG offer a cancer wellness program. Google cancer wellness program and the city name for other options. Older cancer survivors may find a Silver Sneakers (https://www.silversneakers.com/) program near them (over 13,000 locations nationwide). Women may feel more comfortable in a women’s only fitness center like Curves (https://www.curves.com/). Local hospitals often offer fitness programs.
Are we eating enough fruits and vegetables? Keep a food diary. It can be as simple as a notebook. Eat different colors of fruits and vegetables to get the vitamins and minerals we need. Add red bell peppers to stir-fry dishes. Eat green kiwi. Add a red sweet potato weekly. Choose different kinds of melons. Oven roast Brussel sprouts or broccoli. When we make a commitment to eat a wider variety of fruits and veggies, we’re likely to be more successful.
Our stores are full of whole grain products that are delicious. We win when we step out of our comfort zone and try new foods like spouted grain bread, 12-grain bread, ancient grain pasta, barley and quinoa.
Slow and steady lifestyle changes incorporating the ACS guidelines for nutrition and physical activity for colorectal cancer survivors will not only improve our quality of life but extend our lives significantly.
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