Healthy Diet and Exercise to Extend Survival in Colon Cancer

On 12 April, JAMA Oncologypublished an observational study finding that good dietary and exercise habits help extend survival in people with colon cancer as a beneficial lifestyle approach.

Stage 3 colon cancer patients making healthy diet and exercise part of their lifestyle had a %42 lower death rate.

This new study allows researchers to clarifypreviously somewhat uncertain recommendations: 5-6 portions of fruit and vegetables daily and at least 150 minutes of exercise weekly. They describe this as a special cancer-control secret.

The study originated in the Cancer and Leukemia Group B (CALGB) trial begun approximately 20 years earlier. That clinical trial included colon cancer patients receiving irinotecan chemotherapy. Lifestyle questionnaires were administered during and after chemotherapy. This observational analysis included 992 eligible patients.

Over seven years of follow-up, 335 recurrences and 299 deaths occurred, including 43 without recurrence-related death. Patients following American Cancer Society healthy diet and exercise guidelines had a %42 lower death rate and significantly higher 5-year survival than those without these habits.

Although most patients have no valid reason to postpone healthy living, they often hesitate, especially during treatment.

Patients with cancer, including colon cancer, frequently ask lifestyle questions such as “What should I eat? What exercise should I do? ” Our following articles address these questions:

• The Healthiest Diet Programs of 2018 — Where Do Well-Known Diets Rank?
• The Most Concrete Study Showing How Exercise Reduces Cancer Growth

Study Details

To assess lifestyle-related outcomes in colon cancer, researchers evaluated factors including body mass index, physical activity and consumption of vegetables, fruit, whole grains, red and processed meat for each patient using the American Cancer Society guideline scoring system.

Scores ranged from 0 to 6, with higher scores representing healthier choices.

• Patients with body mass index 25.0 – 29.9 had lower mortality risk than those above 30.
• Frequent drinkers had increased mortality risk compared with nondrinkers, although not statistically significant. Low or moderate alcohol consumption did not significantly reduce mortality risk.
• Alcohol Consumption Clearly Shown to Increase Cancer Risk
• Eating 5 or more daily portions of fruit and vegetables was beneficial, whereas red and processed meat increased mortality risk. Processed Meat Consumption Increases Colon Cancer Risk as is known, but the relationship between red meat and cancer is unclear. More comprehensive studies specifically addressing this are needed.
• Red Meat: Pros and Cons

Strengths include many patients, standardized cancer treatment, repeated lifestyle assessments and complete follow-up. There are also weaknesses: for example, we cannot conclude that prediagnosis lifestyle or postdiagnosis behavioral changes did not affect observed outcomes.

In conclusion, this study associates healthy body weight, physical activity and a diet rich in vegetables, fruit and whole grains after stage III colon cancer diagnosis with longer survival.

RELATED TOPICS

• What You Need to Know About Colon and Rectal Cancer
• Innovations in Colon and Rectal Cancer Treatment — 2017 and 2018