Breast cancer survivors change lifestyle after diagnosis

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"We found that breast cancer survivors who believed that an unhealthy behavior-such as consuming an unhealthy diet, contributed to their cancer-were more likely to say that they had changed that behavior since their diagnosis," says lead author Carolyn Rabin, PhD, a psychologist at The Miriam Hospital's Centers for Behavioral and Preventive Medicine. "Likewise, breast cancer survivors who believed that a healthy behavior- such as consuming a healthy diet, could ward off a cancer recurrence-were more likely to say that they had adopted that behavior since their diagnosis."

Due to advances in detection and treatment, there are now more than 10 million Americans who are cancer survivors, according to the American Cancer Society. However, researchers have not yet determined why some cancer survivors are motivated by a cancer diagnosis to make healthy lifestyle changes, while others are not. This question prompted the study by researchers at The Miriam Hospital and Brown Medical School.

The researchers cite evidence from past studies indicating that many cancer survivors are not leading healthy lifestyles �'{ 50 percent of breast cancer survivors consume fewer than the recommended five servings of fruits and vegetables per day, 23 percent consume more than 30 percent of their calories from fat, and 28 to 43 percent lead sedentary lifestyles. In addition, more than 50 percent of cancer survivors who smoked prior to diagnosis continue to smoke.

"Adopting a healthy lifestyle is an important strategy for cancer survivors since, in addition to a cancer recurrence, they may be at increased risk for the developing other medical problems, such as cardiac or pulmonary disease, as a result of their cancer treatment. The goal of this study was to develop a better understanding of why a cancer diagnosis appears to serve as an impetus for some survivors to adopt healthy behaviors, while others do not," says Rabin.

Researchers assessed breast cancer survivors within three months of the survivor completing all surgery, chemotherapy, and/or radiation treatment for cancer and a second time three months later. Study participants completed measures assessing beliefs about the cause of their cancer; beliefs about behavioral strategies that may reduce the chance of cancer recurrence; diet, exercise, smoking, and alcohol consumption; and any changes in health practices since their cancer diagnosis.

Findings indicated that survivors who believed that unhealthy diet, insufficient exercise or alcohol consumption contributed to their cancer were more likely to modify the relevant behavior. The most robust relationship between beliefs and behavior change was found for changes in diet.

"This study suggests that cancer survivors develop their own understanding of the causes of their cancer and the behavior changes that may prevent recurrence, and then take an active problem-solving approach to help reduce risk of a future cancer," says co-author Bernardine Pinto, PhD, a psychologist at The Miriam Hospital's Centers for Behavioral and Preventive Medicine.

Given the role of health behavior changes in reducing medical risks, these findings have important implications for maintaining the health of cancer survivors. The authors note, however, that even though survivors' beliefs about what caused their cancer may prompt healthy lifestyle changes, these beliefs may not be accurate.

"This research highlights the important role that survivors' beliefs about their disease have in their life post-cancer diagnosis. Ultimately, we hope that cancer survivors will take a holistic approach to maintaining their health so that they do not dismiss an opportunity to make a healthy lifestyle change. Behavior modification may not impact their chance of a cancer recurrence, but can help reduce other serious medical risks," says Rabin.

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