Weekly Newsletter

THURSDAY, April 26 (HealthDay News) -- A healthy lifestyle -- including eating right, exercising and maintaining normal weight -- can boost the odds of long-term cancer survival, especially for breast, colorectal or prostate cancer, according to new recommendations from the American Cancer Society.

About one in 25 Americans is a cancer survivor. "Many ask, 'How can I keep the cancer from coming back?' " said Colleen Doyle, the cancer society's director of nutrition and physical activity.

Cancer survivors often are advised to adopt healthy behaviors, including eating lots of fruits, vegetables, whole grains and lean protein; fitting in walking or other aerobic activity most days of the week; and keeping weight within a normal range, Doyle said.

Research has shown that those steps can help prevent cancer, but there was little research showing that a healthy lifestyle could keep cancer from recurring, or could prevent cancer survivors from getting a new type of cancer, she said.

But a review of recent scientific evidence allowed a panel of cancer experts to conclude that such measures help ward off cancer's return.

"The last time we published recommendations for survivors in 2006, we didn't feel there was enough evidence to say clearly that watching your weight, being active and eating a healthy diet can reduce risk of recurrence," said Doyle, a co-author of the guidelines. "Since that time, 100 studies have looked at the impact of weight, diet or a combination of those things, and those studies have clearly formed a foundation for us being able to make these very solid recommendations that adopting a healthy lifestyle is one of the most important things cancer survivors can do for themselves."

The recommendations were published online April 26 in CA: A Cancer Journal for Clinicians.

Among the recommendations:

• Losing weight if you're overweight or obese may help prevent recurrence and development of new cancers. Obesity is associated with multiple types of cancer, including breast, colorectal and gallbladder malignancies.
• Exercise is "safe and feasible" during cancer treatment, and it also can improve physical functioning, fatigue and quality of life. People undergoing chemotherapy or radiation may need to reduce the intensity, but should strive to maintain physical activity to the extent possible. People who were sedentary before the diagnosis can begin low-intensity exercises such as stretching or brief, slow walks.
• Results from observational studies suggest that diet may affect cancer progression, risk of recurrence and survival in individuals treated for cancer. A diet high in fruits, vegetables, whole grains, poultry and fish was found to be associated with reduced mortality compared to a diet high in refined grains, processed and red meats, desserts and high-fat dairy products.
• No evidence shows that supplements benefit cancer survivors, and there is some evidence that certain supplements may cause harm.

Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York City, said the guidelines support what oncologists have told patients for years, and the American Cancer Society's endorsement of that advice is an important step.

After a cancer diagnosis, adopting a healthy lifestyle also can help people regain a sense of control, Bernik added.

"When you have cancer, it takes control of your life. You have to go through the treatment and you feel it's ruling your life," she said. "After it's over, it's good when you feel you can take control."

Nothing is a sure thing, though, "and we have to tell them that," Bernik said. "But it helps emotionally knowing that they're doing something to prevent the cancer from recurring."

People diagnosed with cancer are at a significantly higher risk of developing other cancers, and may be at higher risk of developing other chronic diseases such as cardiovascular disease, diabetes and osteoporosis, said Nagi Kumar, director of cancer chemoprevention at Moffitt Cancer Center in Tampa, Fla.

"Many survivors are not going to die of cancer anymore," Kumar said. "They are going to have problems with obesity, metabolic syndrome and other diseases that are very common in the U.S. anyway, and this is a little bit more vulnerable group."

After months of treatment, it's important for cancer survivors to work to get their strength back and improve their aerobic capacity.

"It's really important to be obsessive about what they do for themselves," Nagi said. "Give it your all: do yoga, get more flexible, walk, eat right. Become very obsessive about what you're putting in your body."

More information

The U.S. National Cancer Institute has more on how lifestyle can help prevent cancer.

TUESDAY, April 24 (HealthDay News) -- In 2008, the U.S. Preventive Services Task Force recommended against testing for prostate cancer in men aged 75 and older, but new research finds that almost 44 percent of these men are still being screened.

Before the 2008 guidelines were set, about 43 percent of men in this age group opted for prostate-specific antigen (PSA) tests, but the task force found that testing had no effect on longevity and could result in overtreatment with adverse consequences. Meanwhile, the task force drafted a new set of guidelines last October that are even more critical of PSA testing, suggesting it may not have any value for men of any age.

"Patients and providers did not adjust their screening behavior following the last major United States Preventive Services Task Force recommendation, and the effect of the upcoming guideline needs to be monitored," said study author Dr. Sandip Prasad, a urologic oncology research fellow at the University of Chicago Medical Center.

"Many physicians and patients continue to have confidence in PSA screening to prevent death from prostate cancer, and it is incumbent upon the medical community to refine the use of this screening test to minimize overdiagnosis and overtreatment of prostate cancer without losing ground on the progress we have made against the disease," he added.

The findings were published in a letter in the April 25 issue of the Journal of the American Medical Association.

Prasad's team found that the number of older men receiving PSA tests had actually increased to 43.9 percent by 2010. That's more screening than in men in their 40s and 50s (12.5 percent and 33.2 percent, respectively) who are the ones most likely to benefit from early diagnosis and treatment, the researchers said.

Only men aged 60 to 74 were more likely to get a PSA test (51.2 percent), they noted.

To gather the data, the researchers used the 2005 and 2010 Cancer Control Supplements, which are part of the annual National Health Interview Survey.

Because patient data is self-reported, the results likely underestimate the actual number of men getting PSA screening, the researchers noted.

The U.S. Preventive Services Task Force is on the verge of issuing new PSA testing guidelines and, based on early recommendations, the task force now believes the PSA test is ineffective for men of any age.

"Prostate-specific antigen-based screening results in small or no reduction in prostate cancer-specific mortality," the early recommendations conclude, and is associated with "harms related to subsequent evaluation and treatments, some of which may be unnecessary."

Given that the initial public recommendation against routine PSA-based screening generated significant controversy in the fall of 2011, "it is unclear what, if any, changes in PSA screening will result if this recommendation is made final," Prasad said.

Dr. Anthony D'Amico, chief of radiation oncology at Brigham and Women's Hospital in Boston, doesn't think that age is a good indicator of when PSA screening is appropriate.

"I'll make the same comment for Warren Buffet who is 81 and diagnosed with prostate cancer," he said. "I don't look at 75, I don't look at 50, I look at the person. People's age doesn't tell you about their life expectancy -- on average it does, but not everyone," D'Amico explained.

"We should look at an individual's life expectancy, and if it's more than 10 years that's a person who should be screened," he said.

However, the reason the rate of screening has remained the same is because of confusion, D'Amico said.

"Doctors and patients don't know what to think, because there is evidence that PSA works in one study and that it doesn't in another, so rather than change they do what they have been doing all along," he noted.

More information

For more on prostate cancer, visit the U.S. National Cancer Institute.

MONDAY, April 23 (HealthDay News) -- The stress of caring for a wife with breast cancer can harm a man's health, and this effect can continue for years after her treatment ends, new research says.

The Ohio State University study of 32 men found that those who had the highest levels of stress related to their wives' cancer were most likely to have physical symptoms -- such as headaches and abdominal pain -- and weaker immune responses.

Previous research has suggested that people with weakened immune systems are more susceptible to infection and might not respond well to vaccines.

The median age of the men in the study was 58, and they had been married for an average of 26 years.

"Guilt, depression, fear of loss -- all of those things are stressful. And this is not an acute stressor that lasts a few weeks; it's a chronic stress that lasts for years," study co-author Kristen Carpenter, a postdoctoral researcher in psychology, said in a university news release.

The findings, published in the journal Brain, Behavior and Immunity, suggest that doctors caring for breast cancer patients could help their patients by considering their caregivers' health, too, the researchers said.

This could include screening caregivers for stress symptoms and encouraging them to participate in stress management, relaxation or other self-care therapies.

"If you care for the caregiver, your patient gets better care too," Carpenter said.

"Caregivers are called hidden patients because when they go in for appointments with their spouses, very few people ask how the caregiver is doing," study author Sharla Wells-Di Gregorio, an assistant professor of psychiatry and psychology, said in the news release. "These men are experiencing significant distress and physical complaints, but often do not seek medical care for themselves due to their focus on their wives' illness."

More information

Men Against Breast Cancer provides resources for men caring for women with breast cancer.

FRIDAY, April 20 (HealthDay News) -- Adults who were obese as children are at increased risk for liver cancer, a new study suggests.

Researchers looked at the birth weight and body-mass index (a measurement of body fat based on height and weight commonly called BMI) of more than 165,000 men and 160,000 women in Denmark born between 1930 and 1989.

Of those participants, 252 developed hepatocellular carcinoma, the most common form of liver cancer in adulthood.

The study authors calculated that at age 7, the risk of developing hepatocellular carcinoma increased by 12 percent for every one-point increase in BMI. By age 13, that risk increased to 25 percent. Therefore, as units of BMI increased into adulthood, so did the risk of developing hepatocellular carcinoma. This was consistently similar across both genders and all ages.

Other factors associated with liver cancer include alcoholism, infection by hepatitis B and C, and other liver diseases. But the study results did not change when participants with these factors were removed from the study, which indicates that childhood obesity was the major factor in the development of hepatocellular carcinoma, the researchers said.

The study was slated for presentation Thursday at the International Liver Congress in Barcelona.

"Childhood obesity not only leads to the development of many adverse metabolic conditions -- such as type 2 diabetes and heart disease -- but also fatty liver disease, which may subsequently result in liver cancer," Dr. Frank Lammert, a scientific committee member of the European Association for the Study of the Liver, said in an association news release.

"The importance of maintaining a healthy childhood BMI cannot be underestimated," Lammert said in the release. "These alarming study results point to a potential correlation between childhood obesity and development of liver cancer in adulthood."

Data and conclusions presented at meetings should be considered preliminary until published in a peer-reviewed medical journal.

More information

The American Liver Foundation has more about liver cancer.