Why Oncologists Avoid Discussing Lifestyle Changes With Cancer Survivors

By | September 24, 2019

Survivors, take note: Now that you’re in remission, embracing a healthier lifestyle can help you feel more in control and may one day save your life. Many cancer survivors, for example, face an increased risk for cardiovascular events posttreatment, so paying attention to healthier habits is particularly important.

But you probably won’t hear about it from your oncologist. 

According to a new study, few oncologists discuss changes such as smoking cessation and weight loss with their patients in recovery. A new study published in Cancer, the journal of the American Cancer Society, investigates why and encourages doctors to promote healthy habits to their patients post-therapy.

Conducted by researchers at Northwestern University’s Feinberg School of Medicine, the research surveyed 91 doctors who treat survivors of three common types of cancer in the United States: breast cancer, prostate cancer and melanoma. Of these providers, 30 were primary care providers, 30 were oncologists and 31 were specialists (urologists, dermatologists, ob-gyns).

Only 9.7% of specialists and just 26.7% of oncologists recommended healthy habits to their patients in remission. In contrast, 90% of primary care providers took these steps, counseling patients to quit smoking and lose weight to improve their long-term health.

Why do oncologists avoid bringing up lifestyle changes? In interviews, many said they feared that emphasizing a healthy lifestyle soon after treatment might “distress” their patients. Others said they didn’t have the time or training to make such recommendations. Many also cited concerns that patients might be less likely to adhere to medications to prevent cancer recurrence if they were focused on, say, losing weight.

To be clear: No research thus far suggests that suggesting healthier lifestyle changes makes cancer survivors any less adherent to their medications. What’s more, study authors said counseling patients in these areas could help significantly improve their long-term mental and physical health.

“Making healthy lifestyle changes is a great way for a cancer survivor to feel more in control of his or her health,” said study coauthor Bonnie Spring, PhD, director of the Institute of Public Health and Medicine at Northwestern University in a recent interview with Florence Health, a website for health professionals.

Spring recommended that oncologists interested in counseling their patients do so gradually—for example, by encouraging someone with a weight-related cancer to try an app that monitors what they eat or how much they exercise before pushing them toward a more intensive weight-loss regimen. 

Study authors also said it was important that more oncologists and specialists encourage any patients who smoke to quit, regardless of their cancer history.

To read the full study in Cancer, click here.

For further reading, check out “What Should Cancer Patients Do After Treatment Ends?


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