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Finally the ACS steps up, anyone want to pat Pete on the back?

son of hal
Posts: 117
Joined: Mar 2011

Cancer survivors urged to eat better, exercise
Published - Apr 26 2012 12:34PM EST

MIKE STOBBE, AP Medical Writer

ATLANTA (AP) — A cancer diagnosis often inspires people to exercise and eat healthier. Now the experts say there's strong evidence that both habits may help prevent the disease from coming back.

New guidelines issued Thursday by the American Cancer Society urge doctors to talk to their cancer patients about eating right, exercising and slimming down if they're too heavy.

That's not something most doctors do, said Dr. Omer Kucuk, an Emory University oncologist who has researched the effect of nutrition on prostate cancer. They're focused on surgery, chemotherapy or other treatments for their patients, he added.

"Usually the last thing on their mind is to talk about diet and exercise," Kucuk said.

Cancer society officials have long encouraged healthy eating and exercise as a way to prevent certain cancers. They and others have tried to spread that gospel to cancer survivors as well. Indeed, the cancer society has a certification program for fitness professionals who work with cancer survivors.

But until now, the group didn't think there was enough research to support a strong statement for cancer survivors.

Hastine Reese, a breast cancer survivor, says she began to exercise because her husband — not her doctor — pushed her. Besides being good for her health, he thought it might help pull her out of the depression that followed her diagnosis and double-mastectomy.

"When you're first diagnosed with cancer, you go into a dark place," said Reese, as she finished a one-hour exercise class this week at DeKalb Medical Center in Decatur, Ga.

Exercise has changed that. "I'm coming into the light, and it's getting brighter and brighter," she said.

Being overweight or obese has long been tied to an increased risk of several types of cancer, including cancers of the colon, esophagus, kidney, pancreas and — in postmenopausal women — breast. But there hadn't been much evidence on the effects of diet and exercise for people who had had cancer.

The last five years saw more than 100 studies involving cancer survivors, many of them showing that exercise and/or a healthy diet was associated with lower cancer recurrence rates and longer survival.

Most of the research was on breast, prostate and colorectal cancer. The evidence is more meager when it comes to other cancers, including the deadliest kind, lung cancer. Also, most of the work involved observational studies, which can't prove a cause and effect. Still, the volume of research was compelling.

"We've got enough data now to make these recommendations," said Colleen Doyle, the organization's director of nutrition and physical activity.

At least two other medical groups have strongly recommended exercise and healthier eating for cancer survivors, but the cancer society's new guidelines are expected to have much greater impact. It's the nation's largest cancer charity in both donations and the number of volunteers, and it funds more cancer research than any other non-governmental agency.

There was a time when cancer patients were thought of as gaunt and dying souls. Many cancers were diagnosed at a late stage, after the disease had ravaged the body and caused weight loss.

But better screening and treatment has made early diagnosis of cancer more common and survival more likely. Today, more than two-thirds of cancer patients live at least five years. The ranks of cancer survivors have grown, with more than 12 million Americans identified as cancer survivors.

Meanwhile, obesity has boomed. More than two-thirds of U.S. adults are now considered overweight or obese.

The guidelines recognize that for some people just eating enough food is a priority, and that diet advice can vary during treatment. The cancer society also notes that some people may be too weak at times for vigorous exercise. But experts say that even modest activities, like lifting soup cans while watching TV, can help.

Women seem to take to exercise and diet recommendations more readily than men, or to push their spouses to follow the advice, some doctors said. Most of Reese's classmates were women.

"I find women to be very, very proactive," said Dr. Allen Lawhead, a gynecologic oncologist at DeKalb Medical Center. "Men, we traditionally go back into our man cave and hide."

Lawrence Genter, a survivor of non-Hodgkin's lymphoma, was one of three men in Reese's class of about a dozen. "I'm here because of my wife," he said.

For another cancer survivor, exercise came easy but eating healthy was a challenge. During chemotherapy, nausea is common and food can seem unappetizing.

"The key thing is to eat period — whatever you can get down and keep down," said Bob Falkenberg of Alpharetta, Ga., who was a marathoner and long-distance cyclist before he was diagnosed with leukemia.

What did he eat during chemo? Mexican food. Hamburgers.

"I had people bring in pizza at one point," he laughed.

___

Online:

American Cancer Society: http://www.cancer.org/

Way to go Pete!!!!

herdizziness's picture
herdizziness
Posts: 3642
Joined: Apr 2010

I believe most of the people on this board feel the same way about exercise and eating right, I know NanaB and many, many others do so and encourage everyone else to do so. It's common sense, unfortunately enough of us don't have the common sense. LOL (me being one of those). So Kudos to ALL who eat the right stuff and exercise!!!!!
Winter Marie

plh4gail's picture
plh4gail
Posts: 1238
Joined: Oct 2010

I looked and looked for Petes name in that article. Did I miss it?

I know of several people on here (and some who used to be) who live healthy, eat healthy, and share their journey with others. And then there are those that seek out help, asking question about making changes, looking for healthy approaches.

Me...I am working on it as well.

Way to go to all who survive!.... even if we choose do so without pooping via enema in the ocean (EW). That still grosses me out!

herdizziness's picture
herdizziness
Posts: 3642
Joined: Apr 2010

I was going to put more names down but the darn chemo fog came into play, and I couldn't remember anyone's name, but yes, you are another that encourages and shares your journey of healthiness, things that we all can do and see reason in, I'm hoping one day, it'll sink into reality for me some day due to your all's encouragements!!!! (I now eat broccoli and asparagus, a small change, but nonetheless a change in the right direction)Way to Go Gail, and all the others!!! We do appreciate you!!!
Winter Marie

PhillieG's picture
PhillieG
Posts: 4912
Joined: May 2005

How quickly some forget...
P.S. I'm staying in my pool this summer...

son of hal
Posts: 117
Joined: Mar 2011

I'll give you a pat too, Gail.... And since you're bowling and not playing baseball, I'll keep it above the waist... :)

plh4gail's picture
plh4gail
Posts: 1238
Joined: Oct 2010

I was not personally looking for your pat.

son of hal
Posts: 117
Joined: Mar 2011

OK then....
Please, don't act as if I just tried to buy you a drink in a night club. It was just an off-the-cuff comment. Lighten up....

joemetz's picture
joemetz
Posts: 493
Joined: Nov 2011

i really enjoyed this article... i was also looking for Pete's name in there. and others from here... but it's really good.

I have a quesiton for others who might have the colostomy bag... I was told by my docs and the things that i read that salads, brocilli and other vegies are gasy and don't process well... i've finally started to eat a bit of salad the other day so i am experimenting more.... but has anyone had any problems with salads with a bag? or should i say it the other way... should i eat salads and other veggies?

right now, i'm like the last paragraph in the article... I eat what i can when i can, and it seems that pizza, subway sandwiches, and mac & cheeze and PBJ sandwiches on toast... and i also eat a good amount of fish. but i truly miss salads and would love to just chow on a big spinich salad or a salmon ceaser salad. I have taken out almost all red meet. Maybe a small burger once a week to take away hunger pains or to fight off the hangover feeling... but just curious for help regarding salads/veggies and the colostomy bag.

thanks

Joe

coloCan
Posts: 1956
Joined: Oct 2009

consumer.healthday.com/Article.asp?AID=664171
(if you didn't already practice this)

pete43lost_at_sea's picture
pete43lost_at_sea
Posts: 3908
Joined: Nov 2010

It's another bittersweet day, another Friend up in the stars.

But this news should give us all hope. The acs conquered diet and exercise.

I have been blessed in many ways to have patient doctors and Naturopath and friends.
to educate,care and support me.

On our little forum we share our journey.

I did feel foolish posting on our exercise post sometimes.
So many here replied on the walking posts, especially pepe.

Whatever health I have I owe to you guys.

But it's never stopped me before, I say embarrassing this in real life as well.

The science behind diet and exercise I find compelling, I suspect my quality and quantity
Depends on it.

This acs initiative is so positive, the whole cancer world just changed.
now we have permission to pursue health.
It's easier for overworked onc's to say go for a walk.

I wonder if my onc will put up the exercise poster I asked along time ago.

Maybe our wife's, kids and friends can come on a walk with us.

It's amazing to think we can pursue health and be a good role model.
Our families and communities need this message yesterday.

Tomorrow is my last day in this hardcore vegan health retreat, I will share this great news with them

I will spring out of bed at tomorrow for my interval training .

Hugs,
Pete

Ps I am grateful for the post son of Hal, I will share this with my family, I am just glad exercise just got easier for us all.

smokeyjoe
Posts: 1428
Joined: Feb 2011

I know with my own onc. I asked him about diet anything I should or shouldn't be eating....he looked at me bewildered and just said "eat healthy"...left it wide open. I asked about supplements vitamins....he said not to take folic acid, because of the folinic acid in the chemo mix. His nurse encouraged me to get out and continue riding my bike or get some exercise because it showed it made cancer patients "feel better". This all was mentioned once and one time only. There is a "clinical trial" being conducted here in Ontario on the effects of exercise....stage 1V are excluded....Have Undergone Treatment for High-Risk Stage II or Stage III Colon Cancer

SummaryTrial DetailsEligibilityCentres / ContactsOfficial Title
A Phase III Study of the Impact of a Physical Activity Program on Disease-Free Survival in Patients With High Risk Stage II or Stage III Colon Cancer: A Randomized Controlled Trial (CHALLENGE)

Summary:
RATIONALE: Participating in a physical activity program designed to increase free time physical activity and receiving written health education materials may influence the chance of cancer recurring as well as impact on physical fitness, psychological well-being and the quality of life of patients who have undergone surgery and chemotherapy for colon cancer. It is not yet known whether giving a physical activity program together with health education materials is more effective than giving health education materials alone for patients who have undergone colon cancer treatment. PURPOSE: This randomized phase III trial is studying a physical activity program given together with health education materials to see how well it works compared with giving health education materials alone for patients who have undergone treatment for high-risk stage II or stage III colon cancer.

Trial Description
Primary Outcome:

•Disease-free survival
Secondary Outcome:

•Overall survival
•Patient-reported outcomes, including quality of life, using SF-36, FACIT-F, PSQI, and HADS questionnaires
•Objective markers of physical fitness (i.e., body mass index, hip and waist circumference, cardiovascular fitness, and physical function)
•Physical activity behaviour as assessed by TPAQ
•Safety profile according to NCI CTCAE version 3.0
•Correlative biological markers including biochemical and molecular markers associated with insulin-related growth factor and cytokines associated with the mechanisms of fatigue
•Economic evaluations including cost-effective analysis and cost utility analysis
•Predictors of physical activity adherence as assessed by Social Cognitive Determinants of Exercise questionnaire
OBJECTIVES:
Primary
•To compare the disease-free survival (DFS) of medically fit patients who have completed surgical resection and adjuvant chemotherapy for high-risk stage II or stage III colon cancer when administered a physical activity program with general health education materials vs general health education materials alone. Secondary
•To compare the two intervention arms with respect to overall survival (OS); patient-reported outcomes using the SF-36, FACIT-F, PSQI, and HADS questionnaires; objective markers of physical fitness using body mass index, hip and waist circumference, submaximal exercise testing, and the Seniors' Fitness Test; physical activity behaviour using the Total Physical Activity Questionnaire (TPAQ); safety profile as assessed by NCI CTCAE version 3.0; serum levels of insulin (i.e., IGF-1, IGF-2, and IGFBP3); cytokine levels (i.e., IL-1β, IL-6, IL-2, IL-4, IL-8, IL-10, IL-12, TNF-α, IFN-γ, and GM-CSF) and C-reactive protein levels; economic evaluations including cost-effective and cost-utility analyses; and predictors of physical activity adherence using the Social-Cognitive Determinants of Exercise Measure questionnaire.
•To evaluate the potential prognostic associations of the serum levels of insulin, IGF-1, IGF-2, IGFBP3, blood glucose, cytokines (i.e., IL- 1β, IL-6, IL-2, IL-4, IL-8, IL-10, IL-12, TNF-α, IFN-γ, and GM-CSF), and C-reactive protein with DFS, OS, level of physical activity, and level of fatigue in these patients.
•To evaluate the potential prognostic associations of age, gender, country, incremental increase in physical activity, and change in cardiovascular fitness with DFS, OS, level of fatigue, and quality of life in these patients.
OUTLINE:

This is a multicentre study. Patients are stratified according to disease stage (II vs III), participating centre, body mass index (≤ 27.5 vs > 27.5), and ECOG performance status (0 vs 1). Patients are randomized to 1 of 2 treatment interventions. •Arm I: Patients receive general health education materials regarding nutrition and physical activity and undergo the Colon Health And Life Long Exercise Change (CHALLENGE) physical activity program consisting of behaviour-support sessions and supervised physical activity sessions with a physical activity consultant.
•Part I (intensive intervention for 6 months): Patients undergo 12 mandatory biweekly face-to-face behaviour support sessions combined with 12 mandatory supervised physical activity sessions to increase their physical activity goal by 10 metabolic equivalent task (MET) hours/week. Twelve supervised physical activity sessions and also recommended on alternate weeks.
•Part II (reduced intervention for months 6-12): Patients undergo 12 mandatory biweekly face-to-face or telephone behaviour support sessions combined with 12 recommended supervised physical activity sessions to increase their physical activity goal by 20 MET hours/week.
•Part III (minimal intervention for months 12-36): Patients undergo mandatory monthly face-to-face or telephone behaviour support sessions combined with recommended supervised physical activity sessions to increase their physical activity goal to a maximum total of 27 MET hours/week.
•Arm II: Patients receive general health education materials regarding nutrition and physical activity. Patients complete the Total Physical Activity Questionnaire (TPAQ) to assess exercise participation and undergo fitness testing periodically by the submaximal exercise test and Seniors' Fitness Test (SFT). Patients complete the SF-36, FACT-F, Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale (HADS), and Social Cognitive Determinants of Exercise Measure questionnaires periodically. Patients also complete a 30-day resource use diary and undergo a health economics analysis by the Work Productivity and Activity Impairment (WPAI) questionnaire. Blood samples are collected periodically for correlative studies and fasting glucose. Samples are analyzed for markers of insulin level, IGF-1, IGF-2, and IGFBP3, cytokine levels (i.e., IL-1β, IL-6, IL-2, IL-4, IL-8, IL-10, IL-12, TNF-α, IFN-γ, and GM-CSF), and C-reactive protein levels. During the 3 year intervention period, patients are followed every 6 months for 3 years and then annually for 4-10 years.

plh4gail's picture
plh4gail
Posts: 1238
Joined: Oct 2010

I guess my point wasn't taken.

PhillieG's picture
PhillieG
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Joined: May 2005

It's too bad those who were possibly the two biggest promoters of a healthy diet and lifestyle changes in the fight against cancer left the site rather than put up with the ______ they had to hear about Diet & Exercise.
The irony is amazing...

I'm certainly not knocking your contributions to the cause Pete, I think it's great all of the things you're trying.
Whatever works/helps...
-p

Minnesotagirl
Posts: 141
Joined: Sep 2011

Yes,
I agree with you Phil on your last statement. I have been trying to follow many of the old threads (previous to my joining this board) for information on healthy diet and exercise. I have always wondered why people who are trying to help here on this board get jumped on and make others like myself reluctant to post sometimes...I didn't follow or post for about 3 weeks because of previous statements that really bothered me.

I like to follow Pete's storyline...can't always understand it but I really see he is trying to make a difference for all of us. I appreciate his effort!

I, for one, would like all people to feel comfortable here to comment on anything that they think may help another person...just like you said "whatever works/helps..."

"Minnie"

PhillieG's picture
PhillieG
Posts: 4912
Joined: May 2005

I've wondered that too Minnie. It's not like we're dealing with gravity (on earth*) so when you drop something it always falls to the ground.

There are probably as many ways to treat cancer as there are ways to get cancer.
No two people are the same. Yet, gang mentality exists at times because of what some proclaim is
The Right Way to  insert hot topic here .

Cancer's been around for a long time and no one figured it all out and probably never will.
There are ancient methods like TCM that have been effective for some,
there are nutritional methods that have been effective for some,
and there are chemo methods that have been effective for some.
One Size Does NOT Fit All.

There's probably a good chance that the solution may lie with All of The Above.
They all have pluses and minuses and they all aren't effective for everyone.
Cancer is one tricky SOB...
-phil

*The disclaimer since I know that someone would comment "well there's no gravity in outer space..." :-)

pepebcn's picture
pepebcn
Posts: 6352
Joined: Aug 2010

to convince this board and help us to maintain a healthy life after cancer, got all my support!
Hugs my friend.

steved
Posts: 835
Joined: Apr 2004

It is amazing how complex this topic really is when you see the range of reactions it can promote and just shows how hard it is to provide appropriate advice for people around health. None of us should be surprised eating well and doing exercise is good for our health- whether we have/ have had cancer or not. The difficulty is we are all individual and this advise needs to come with a health warning that will cause feelings of guilt and anxiety.

We must all be allowed to find the right way to live our lives especially when that life may be limited in qauntity or quality. For some juicing and enbarking on marathons is the right thing while for others beers and burgers are the right thing.

I'm personally a lifelong moderate- love some exercise, enjoy healthy food as well as slothing on the sofa with the wife drinking too much wine with a curry. Where ever you fall on the spectrum of all this we all have in common a desire to enjoy our lives so find what makes you happy and stick to it.

steve

PhillieG's picture
PhillieG
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Joined: May 2005

We'll hear that smoking is bad for you and causes cancer...

herdizziness's picture
herdizziness
Posts: 3642
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That's exactly what I thought when I saw this post. The cancer society told us something we all knew long ago. LOL.
Winter Marie

tommycat's picture
tommycat
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Brilliant....Thank you Steved. I feel exactly the same way.
Thanks~

plh4gail's picture
plh4gail
Posts: 1238
Joined: Oct 2010

Thank you steved!

smokeyjoe
Posts: 1428
Joined: Feb 2011

Phil I really miss those two....reading their posts really gave me inspiration, as do the other long time survivors.

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maglets
Posts: 2596
Joined: Jun 2006

surely we have a moral obligation to our family and friends to continue to be contributing members of the group despite and in spite of our cancer.

I do eat very well and I do exercise but I never want to feel that I sacrifice my family on the altar of cancer. They support me and care for me with great devotion during times of surgery and chemo. I try to relieve them of this burden when I am not in care....by living a life as close to normal as possible and I also like to enjoy myself. Perhaps some people derive pure pleasure from different things....I am sure they do and we are all different....but Steve kicking back on the couch with some wine and a curry sounds like fun to me too

maggie

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herdizziness
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Joined: Apr 2010

You said it so well!!!
Winter Marie

Erinb
Posts: 295
Joined: Apr 2010

I didn't know Emily and Scouty were not posting any longer. Their stories were inspirational to me, and I always enjoyed reading their posts.
Erin

son of hal
Posts: 117
Joined: Mar 2011

Wow, didn't expect this much traffic on the topic. First off, I'm not trying to exclude anyone or imply that no one else advocates exercise and good health but Pete has clearly been the most (shall we say,) enthusiastic, of our current bunch. His recurring exercise thread and his willingness to share everything he tries set him apart a bit. Clearly I would have mentioned the most influencial members on the topic (Emily and Scouty) if they were still here. I realize several members, including myself, advocate for nutrition but typically only on another thread or just occassionaly. Pete stands out as one who is trying to encourage us all and that takes effort. Secondly, while the ACS has had a position of encouraging nutrition and exercise to individualls, they have refrained from recommending oncologists do the same. THAT is the point of this article. When I was diagnosed 2 1/2 years ago I proudly stated all my positive lifestyle changes to my onc. and he stated, in a condescending tone, "there is no proof that diet and exercise have any effect on outcomes, but if you want to see a nutritionist we can arrange something." Hopefully, THAT attitude will change now and the ACS has the power to do it.
Anyway, just to clear it up, I thank all the members on here for their contributions. Even the ones I dissagree with sometimes. If everyone had the same opinions, they would not BE opinions nothing would ever change and we might as well be robots.
Take care, CJ

PhillieG's picture
PhillieG
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Joined: May 2005

A lot can happen in 8 hours!
It is sad how infrequently doctors consider diet. It's really kind of crazy.
Then again, "More doctors smoke Camels than any other cigarette," so it kind of makes sense in a bizarre way.

I didn't feel that you were giving Pete all the credit. He does stand out on the forum.
Timing IS everything it seems. Em & Scouty did so much over such a long period of time to help promote a healthier lifestyle.
They posted some GREAT nutritional information that was easy to understand. They may not be active on here but they still matter to many of us on the site and are dearly missed. It's not like they're Voldermort...

I agree with your comment about hoping that since there is now ACS backing of the concept that being healthy is good that hopefully more doctors will push patients to eat better and to exercise.
-p

maglets's picture
maglets
Posts: 2596
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I really think you have to consider some sort of base line when talking about food and eating. Forgive me...I know this topic has been hot....but when you say you should improve your eating habits this is going to be so totally variable for every person here. For instance when I say i will improve i might be coming from a base of quinoa and bulghur 7 times a week and wish to improve this. Someone else might dine at at MCd's and wish to move from there...

and you say Phil and also Steved....sooooo variable....

mags

lauragb
Posts: 370
Joined: Aug 2011

I wish the other folks were back on here too. I only got to see a couple of postings before there was a "rift". And yeah, healthy habits are healthy. I agree that I wish more doctors were knowledgable about diet and exercise. Nutrition isn't a big focus in a lot of medical schools. Anyway, I've asked about supplements too to no avail. That's another reason forums are important to me to get the input of a lot of people and see what's up in the real world of cancer survival outside the doctor's office.

son of hal
Posts: 117
Joined: Mar 2011

Hey Phil- Great comments (as usual). That cracked me up, Voldemort.....
But seriously, I really do miss those two on here. As well as many others...

Nana b's picture
Nana b
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Joined: May 2009

Great to read this news.... My ONC supports healthy eating and exercise 101%. I'm eating breakfast rights now, vegan apple sage sausage, two boiled eggs, sauteed mushrooms and spinach. Then I will enjoy my hot cup of matcha tea with a teaspoon of honey and take my supplements. I keep telling my sister it's not a diet, it's a change of life style. I have entered this food into my husband's meals gradually and he doesn't even think of them as healthy anymore, just food. I'm not deprived at all. It's funny because I would fix his meals and mine, and he would end up eating half of my plate or just picking here and there tasting, now I mix his and mine on his plate and my food is growing on his plate. I still give him some beef now and then but I make it strips or cubes like the Japanese do, not a whole steak. My biggest thing is I liked the healthy frozen entrees for my lunch at work, but that is processed food so I miss that convenience, but the smoothies with my protein powdered have now replaced my lunch at work. Amazing that they fill me up. I can make one in my Bullet in less then 5 minutes. Berries, apples, banana, spinach and a handful of mixed greens with a scoop of my protein drink. With my boiled eggs, smoothies and veggie dinner, it's hard to fit in the juicing but I need to. I need to get up earlier and make that my first drink; I know that my body would just soak it up and my liver would love it. This change of eating has not happened over night, it has revolved itself in the past 3.6 years.

Also, I just bought the health master, it makes me a quick soup in no time. Throw in your veggies, organic broth and your hot water, mix and voila, you have soup. I love doing this with tomatoes. I was also very surprised that organic veggies at whole Foods are not that expensive.

Excuse my carrying on... ;)

Nana b's picture
Nana b
Posts: 3045
Joined: May 2009

ps, I do enjoy my wine too, as long as it's Red! LOL

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