Are physicians helping cancer survivors live healthy lives?

A recent study indicates that certain physicians who care for patients with cancer do not often promote healthy lifestyle changes to cancer survivors, and they may fear that providing such advice would distress or overwhelm patients. Published early online in Cancer, a peer-reviewed journal of the American Cancer Society, the findings are noteworthy because maintaining a healthy lifestyle is especially important to the long-term well-being of cancer survivors.

Cancer survivors face increased risks of cardiovascular disease and other conditions, and guidelines advise physicians—including oncologists—to encourage cancer survivors to adopt healthy lifestyles to help protect their long-term health.

To investigate the extent to which physicians follow these recommendations, a team led by Tammy Stump, Ph.D., and Bonnie Spring, Ph.D., faculty at the Northwestern University Feinberg School of Medicine in Chicago, surveyed 91 physicians: 30 primary care physicians; 30 oncologists; and 31 specialists (urologists, gynecologists, and dermatologists) who treat survivors of prostate cancer, breast cancer, and melanoma, respectively. Interviews also were conducted with 12 of the oncologists who were sent the survey.

Among primary care physicians, 90 percent reported recommending health promotion such as weight loss and smoking cessation to at least some cancer survivors. However, only 26.7 percent of oncologists and 9.7 percent of specialists said they ever did so.

In interviews, oncologists expressed fear that promoting healthy lifestyle changes would distress or overwhelm patients. They also noted that they often lack the time and training to make such recommendations to patients. Most physicians believed that at least half of cancer survivors would take their medications properly to prevent cancer recurrence, but they believed that patients would not do so if they were also trying to lose weight

"Even though oncologists clearly believe that cancer survivors should adopt a healthy lifestyle, they don't have the time to address more than cancer care—that's their expertise," said Dr. Stump. "Ultimately, we believe that healthy lifestyle support can be provided to cancer survivors most effectively as part of integrated survivorship care delivered by health promotionists trained in nutrition, physical activity, and behavioral coaching in a program designed with the input of oncologists to meet the specific needs of cancer survivors," added Dr. Spring.