Nutrition and Physical Activity Guideline for Cancer Survivors

Abstract

There are nearly 17 million cancer survivors living in the United States. Research suggests that lifestyle factors, such as a person's body weight, how physically active they are, what they eat, and whether they drink alcohol, may affect their survival and wellness following a cancer diagnosis. The American Cancer Society (ACS) recently reviewed the research on how these factors may influence cancer outcomes and published a detailed update of its Nutrition and Physical Activity Guideline for Cancer Survivors. Here is a summary of the guideline's evidence-based advice about these lifestyle factors for cancer survivors and their families as well as some related tips from experts at the ACS.

Your outlook for survival and for a return to good health after being diagnosed with cancer depends on many factors. The type of cancer you have, how advanced it is, what treatments you get, and whether you have any other health problems can all affect your outlook.

There is also growing evidence that diet, physical activity, and related factors can help some cancer survivors live longer, lower their risk of the cancer returning (or of a new cancer developing), and limit some side effects of treatment. It can also lower their risk of developing some other serious diseases and improve their overall health and wellness.

There is no guarantee that following the advice in this guideline will achieve all of these benefits for every cancer survivor. If you have questions about how lifestyle factors might affect you as an individual, speak with your cancer doctor or other members of your cancer care team.

Eating nutritious foods can help cancer survivors manage their energy levels, feel better, and stay stronger. The nutritional needs of cancer patients during treatment depend on the type of cancer they have, which treatments they get, and what side effects they have.

Patients getting cancer treatment may face eating challenges, such as poor appetite; having problems chewing, swallowing, or digesting; and feeling very tired from the treatment or cancer, all of which can affect their nutritional status.

The ACS recommends that nutrition screening, assessment, and counseling begin as soon as possible after cancer is diagnosed:

The goal is to prevent or resolve nutrient deficiencies, preserve muscle mass, and manage side effects of treatment that may cause problems with eating.

If your health care team determines that you're at risk for malnutrition or have other diet-related issues that could affect your nutritional status, they should refer you to a Registered Dietitian Nutritionist (RDN) or Registered Dietitian (RD) for personalized nutritional counseling.

Being physically active after a cancer diagnosis can help improve survival for breast, colorectal, and prostate cancer survivors, and evidence is growing that it can be helpful for some other cancer types as well. Physical activity can also help reduce anxiety, depression, fatigue, and lymphedema, as well as improving health-related quality of life, bone health, and sleep.

Because of the many benefits of physical activity, the ACS recommends that physical activity assessment and counseling begin as soon as possible after cancer is diagnosed. Being physically active is safe for most people getting cancer treatment. However, it's still important for people to check with their care team before starting any exercise program for advice on choosing a program that is safe and effective for them.

Survivors who want to exercise to help with specific cancer-related effects, such as fatigue, anxiety, or depression, should visit the Moving Through Cancer website from the American College of Sports Medicine for specific physical activity recommendations for those symptoms.

People with overweight or obesity have a higher risk of developing several types of cancer. However, the role of body weight in cancer outcomes, such as recurrence and survival, is less well understood. For example, research suggests that women with obesity have a higher risk of recurrence and death from breast cancer, but whether obesity is related to these outcomes for other cancers is less clear.

During cancer treatment, try to focus on maintaining (or even increasing) your muscle mass through diet and physical activity. Side effects of cancer treatment that cause changes in taste and smell, reduce appetite, or cause digestive disturbances can lead to weight loss, loss of muscle mass, and poor nutritional status. Patients getting cancer treatments that affect the digestive tract are most at risk for weight loss. Getting enough calories to prevent malnutrition and maintain healthy body weight and strength can improve your cancer recovery journey.

After treatment, survivors with overweight or obesity may consider trying to lose weight to improve their overall health, reduce the chances of getting another cancer, and possibly reduce their risk of recurrence and improve survival for some cancer types. If you are interested in losing weight, talk to your health care provider about your options.

Among cancer survivors, the impact of drinking alcohol on cancer recurrence and survival isn't clear for most cancer types. Studies of people with head and neck cancer and liver cancer show that those who drink alcohol do not live as long as those who do not. The link with other cancer types is less clear.

During cancer treatment, it may be best for patients to avoid or limit alcohol, especially if they are starting treatment that will put them at risk for mouth sores, such as head and neck radiation or many types of chemotherapy. If alcohol is consumed during treatment, it should be limited to prevent interactions with chemotherapy and avoid aggravating treatment areas during radiation therapy. Talk to your health care provider about whether it's safe to drink alcohol during your treatment.

American Cancer Society Recommendations for Cancer Survivors

This information is based on the 2022 ACS Nutrition and Physical Activity Guideline for Cancer Survivors. Additional resources may be found online in the Supporting Information section at the end of the guideline article.

See also Article, pages 000–000.