LITTLE FALLS, N.J., May 12 — Implementing a home-based diet and exercise program could slow functional decline in long-term cancer survivors.

A telephone-based intervention significantly halted functional decline compared with no intervention, Miriam C. Morey, Ph.D., of Duke University, and colleagues reported in the May 12 issue of the Journal of the American Medical Association.

“Even with modest change, [patients in the intervention] experienced clinically meaningful improvements in both physical function and other health-related quality-of-life domains,” the researchers said.

• Explain that a telephone-based intervention significantly slowed functional decline in patients who’d been cancer-free for more than five years.
• Note that long-term survival rates for many cancers are increasing, although patients are at risk for accelerated functional decline.

Long-term survival rates for many early-stage cancer patients exceed 90% and are increasing. However, these patients are at risk for accelerated functional decline.

Lifestyle interventions have benefited younger cancer survivors with more recent diagnoses, but Dr. Morey’s group wanted to know whether they’d help long-term, older cancer survivors whose diagnoses are in the distant past.

So, to determine whether a telephone counseling diet and exercise intervention is effective, the researchers randomized 641 overweight (BMI >25 and <40), long-term (> 5 years) cancer survivors ages 65 to 91 to an intervention group or a control group with no intervention.

The Reach out to Enhance Wellness (RENEW) intervention lasted 12 months over a period from July 1, 2005, to May 17, 2007.

The program consisted of a tailored workbook and a series of quarterly newsletters along with 15 sessions of telephone counseling, each 15 to 30 minutes long.

The researchers found that mean function scores declined less rapidly in the intervention group compared with the control group (-2.15 versus -4.84, P=0.03).

“A decline of 6.5 points over a four-year period is associated with a 10% higher mortality risk within a subsequent three-year window,” the researchers said. “A decline of two points is considered too small to be clinically detectable.”

Basic lower extremity function — going up and down stairs, using a step stool — changed negligibly in the intervention group. The control group, on the other hand, showed a decrease in scores (0.34 versus -1.89, P=0.005).

Advanced lower extremity function — walking a mile, running a short distance to catch a bus — followed a similar pattern, the researchers said, but didn’t reach statistical significance.

Also, there was significantly greater weight loss in the intervention group than in the control group (2.06 kg versus 0.92 kg, P<0.001).

And physical activity and dietary behaviors increased significantly in the intervention group (P<0.001). Quality-of-life scores decreased for control patients, but were sustained in the intervention group.

The researchers noted that the study was limited by self-report, and that the intervention, according to their demographics, was most likely delivered to highly motivated patients.

Still, they said the findings suggest that further efforts should be made to promote such programs among older cancer survivors, “not only in those who are well beyond their diagnosis, but also in those who are more newly diagnosed.”

The study was supported by grants from the NIH and from Veterans Affairs Research and Development. The researchers reported no conflicts of interest.

Primary source: Journal of the American Medical Association

Source reference:

Morey MC, et al “Effects of home-based diet and exercise on functional outcomes among older, overweight long-term cancer survivors” JAMA 2009; 301(18): 1883-91.

Ex-smokers are overwhelmingly happier after quitting according to a new Cancer Research UK study published in Nicotine and Tobacco Research*.

Researchers studied the responses of 879 adults who had stopped smoking. More than two thirds (69.3 per cent) said that they feel happier now than when they were smoking and only one in thirty (3.3 per cent) felt less happy. Around a quarter (26.6 per cent) said they felt the same.

The length of time since quitting affected the level of happiness. Ex-smokers who had stopped more than a year ago reported feeling happier than ex-smokers who had stopped within the last year. Even among ex-smokers who had recently stopped a large majority felt happier than when they smoked.

Younger ex-smokers were also more likely to report feeling happier than older ex-smoker.

There was no difference in the level of happiness between ex-smokers who smoked heavily or those who smoked fewer cigarettes irrespective of age, sex, social group and time since giving up smoking.

Cancer Research UK’s Dr Lion Shahab, lead researcher based at the UCL Health Behaviour Research Centre , said: “There may be many reasons why ex-smokers say they’re happier now than when they were smokers, including self-justification. These results provide reassurance to would-be quitters that they will not only improve their physical health but that their quality of life is also likely to improve if they succeed in stopping smoking.”

“Most smokers would like to give up if they could. But for some, stopping isn’t simple. Previous research has shown that it generally takes more than one attempt to successfully quit. The important thing is that people keep trying.”

Elspeth Lee, Cancer Research UK’s head of tobacco control, said: “Smoking is very expensive. At today’s rates, smoking around twenty cigarettes a day for the next twenty years would cost over £40,000 - that’s over £2,000 from a smoker’s annual income. So giving up smoking makes you wealthier as well as healthier.

“But tobacco is a deadly addiction that costs smokers more than just money. Half of all long term smokers will die from the addiction, so quitting is one of the most important steps a smoker can take to improve their health.

“Preventing children from starting smoking is vital also. Putting tobacco out of sight in shops, getting rid of vending machines and wrapping cigarettes in plain packaging will all help to protect young people from the devastating influence of tobacco marketing. We’re calling on parliament to adopt these measures in the current Health Bill.”

* Do ex-smokers report feeling happier following cessation? Evidence from a cross-sectional survey

Smoking status was assessed by asking participants if they (a) smoked cigarettes (including hand-rolled) every day; (b) smoked cigarettes (including hand-rolled) but not every day; (c) did not smoke cigarettes at all but did smoke tobacco of some kind (e.g. pipe or cigar); (d) had stopped smoking completely in the last year; (e) had stopped smoking completely more than a year ago; or (f) had never been a smoker (i.e. smoked for a year or more).

Those participants who responded ‘yes’ to (d) or (e) were further asked which of the following statements best applied to them: ‘I feel happier now than when I was smoking’; ‘I feel about the same now as when I was smoking’; ‘I feel less happy now than when I was smoking’.

There are a lot of good reasons to quit smoking, whatever your age.

Giving up smoking at any age will increase life expectancy, provided you stop before you develop cancer or another serious disease.

The sooner you give up smoking the better. After:

- 20 minutes - your blood pressure and pulse return to normal
- 8 hours - nicotine, carbon monoxide and oxygen levels in your blood begin to return to normal
- 2 days - your lungs start to clear and your sense of taste and smell begin to return
- 3 days - breathing is easier and your energy levels increase
- 2-12 weeks - circulation improves and exercise gets easier
- 3-9 months - breathing problems, coughing, shortness of breath and wheezing improve
- 5 years - risk of having a heart attack falls to about half that of a smoker
- 10 years - risk of lung cancer falls to about half that of a smoker. You have the same risk of a heart attack as someone who has never smoked.

Source
Cancer Research UK

As the credit crunch continues to hit UK adults hard in the pocket, a new survey, released by Cancer Research UK to raise awareness of its annual skin cancer by more than half.

The survey found that overall, a third (34 per cent) of UK adults are less likely to go on a sunny summer holiday this year due to the recession. At the same time, almost one in three (29 per cent) said they would be disappointed if they did not get a tan this summer, with 46 per cent believing a tan makes them look healthier and 22 per cent thinking they will be more attractive if they have a tan.

Katy Scammell, SunSmart campaign manager at Cancer Research UK, said: “As the recession takes its toll on people’s holiday plans, what is clear is that a tan is still something that many people value and aspire to. Using a sunbed may seem like a cheap, quick fix to achieve that summer glow, yet while the process may only take a few moments, the damage can last a lifetime.

“With all the evidence linking over-exposure to UV radiation with skin cancer, it’s surprising that so many people are still putting their health at risk by using sunbeds. Exposure to these harmful rays increases your risk of melanoma, the most dangerous form of skin cancer. Not only do the harmful rays increase your risk of skin cancer, but they also lead to premature ageing and the appearance of lines, wrinkles and coarse, leathery skin.

“If you really can’t do without a tan this summer, then the best option is to fake it.”

Don’t let sunburn catch you out this year. Use shade, clothing and sunscreen to protect yourself.

For further information about Cancer Research UK’s SunSmart campaign, visit http://www.sunsmart.org.uk

About SunSmart

It is the seventh year of the SunSmart campaign, commissioned by the UK’s Department of Health, which aims to raise awareness of the importance of sun protection and early detection against skin cancer. Cancer Research UK’s SunSmart campaign is funded by UK Health Departments and launched in March 2003

About the survey

Two surveys were carried out, and all figures, unless otherwise stated, are from YouGov Plc. Survey 1: Total sample size was 2182 adults. Fieldwork was undertaken between 17th - 20th April 2009. The survey was carried out online. The figures have been weighted and are representative of all UK adults (aged 18+). Survey 2: Total sample size was 2276 adults. Fieldwork was undertaken between 24th - 27th April 2009. The survey was carried out online. The figures have been weighted and are representative of all UK adults (aged 18+).

About Cancer Research UK

- Together with its partners and supporters, Cancer Research UK’s vision is to beat cancer.
- Cancer Research UK carries out world-class research to improve understanding of the disease and find out how to prevent, diagnose and treat different kinds of cancer.
- Cancer Research UK ensures that its findings are used to improve the lives of all cancer patients.
- Cancer Research UK helps people to understand cancer, the progress that is being made and the choices each person can make.
- Cancer Research UK works in partnership with others to achieve the greatest impact in the global fight against cancer.

Confidence intervals

14.3% - 24.7% - the confidence interval for the statistic ‘19% of sunbed users are planning to increase their sunbed usage because they cannot afford to go on a summer holiday’.

Source
Cancer Research UK