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Health
Choices predict Cancer Survival
Newswise — Head and neck cancer patients who
smoked, drank, didn’t exercise or didn’t eat
enough fruit when they were diagnosed had
worse survival outcomes than those with
better health habits, according to a new
study from the University of Michigan
Comprehensive Cancer Center.
“While there has been a recent emphasis on
biomarkers and genes that might be linked to
cancer survival, the health habits a person
has at diagnosis play a major role in his or
her survival,” says study author Sonia
Duffy, Ph.D., R.N., associate professor of
nursing at the U-M School of Nursing,
research assistant professor of
otolaryngology at the U-M Medical School,
and research scientist at the VA Ann Arbor
Healthcare System.
Each of the factors was independently
associated with survival. Results of the
study appear online in the Journal of
Clinical Oncology.
The researchers surveyed 504 head and neck
cancer patients about five health behaviors:
smoking, alcohol use, diet, exercise and
sleep.
Patients were surveyed every three months
for two years then yearly after that.
Smoking was the biggest predictor of
survival, with current smokers having the
shortest survival.
Problem drinking and low fruit intake were
also associated with worse survival,
although vegetable intake was not. Lack of
exercise also appears to decrease survival.
“Health behaviors are only sporadically
addressed in busy oncology clinics where the
major focus is on surgery, chemotherapy or
radiation.
Addressing health behaviors may enhance the
survival advantage offered by these
treatments,” says Duffy, a U-M Cancer Center
investigator.
Complicating matters is that many of these
health behaviors are inter-related. For
example, smokers might also be heavy
drinkers, making it more difficult to quit.
It’s not enough, Duffy points out, to refer
someone to a smoking cessation program if
alcohol is a major underlying problem.
In addition, previous research has
associated many of these health behaviors
with preventing cancer.
In the current study, a third of the
patients reported eating fewer than four
servings of fruit per month. Nutrition
experts recommend two servings of fruit per
day.
“Eating fruits and vegetables, not smoking
and drinking in moderation can have a big
impact on a person’s risk of getting cancer
in the first place.
"Now
it appears that these factors also impact
survival after diagnosis,” Duffy says.
The next step for the researchers is to look
at behavior changes over time to determine
if changing health habits when a person is
diagnosed can impact survival.
That will help determine what types of
interventions or services should be offered
to patients in the clinic.
Head and neck cancer statistics: 35,310
Americans will be diagnosed with head and
neck cancers this year and 7,590 will die
from the disease, according to the American
Cancer Society
Additional authors: David L. Ronis, Ph.D.,
associate research scientist, U-M School of
Nursing; Scott McLean, M.D., Ph.D., Henry
Ford Health System; Karen E. Fowler, U-M
research associate; Stephen B. Gruber, M.D.,
Ph.D., M.P.H., associate professor of
internal medicine, human genetics and
epidemiology, U-M Medical School and U-M
School of Public Health; Gregory T. Wolf,
M.D., professor of otolaryngology, U-M
Medical School; and Jeffrey E. Terrell,
M.D., associate professor of otolaryngology,
U-M Medical School.
Funding: National Institutes of Health, Head
and Neck Cancer Specialized Program of
Research Excellence (SPORE) grant
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