Dr. Hudis said helping obese patients lose excess weight as part of their treatment plan may help improve responses to local and systemic treatment modalities. He also noted that obese patients are at increased risk of surgical complications and tend to have delayed wound healing after surgery. Explaining these risk factors to patients may be key to motivating them to improve their diet and to exercise more. “Patients are interested in anything they can do and this is one of the things they can do. The patients are more motivated and it can be a teachable moment,” Dr. Hudis said in an interview with CancerTherapyAdvisor.com.
Tending the Garden
Researchers at UAB recently conducted a year-long study and found that a vegetable gardening intervention could improve fruit and vegetable consumption, physical activity, and physical function in patients with cancer.4 The pilot study paired 12 adult and child cancer survivors with Master Gardeners. The researchers examined the effects of a gardening intervention on fruit and vegetable intake, physical activity, quality of life, and physical function. They found that a gardening intervention was feasible and well-received and there were measurable improvements in objective measures of strength, agility, and endurance in 90% of patients.
In the pilot program, the patients with cancer were provided with gardening tools and seedlings. They were also given a raised bed for their yard or EarthBoxes (large gardening containers on wheels) that could be kept on a porch or patio. A Master Gardener conducted a monthly visit for 12 months and offered advice and answered questions for each survivor.
“Our findings suggest that this intervention works,” said Dr. Demark-Wahnefried.
Forty percent of the participants in this study ended up eating one or more servings of a fruit or vegetable a day compared with baseline and 60% ended up increasing their physical activity level to 30 minutes or more a day. Dr. Demark-Wahnefried explained that increasing physical activity and fruit and vegetable consumption are both associated with improved outcomes in patients with cancer.
The UAB researchers call their intervention “Harvest for Health” and it was undertaken in Jefferson County, Alabama, in 2011. The study has since been expanded to many counties surrounding Birmingham with support from the National Cancer Institute. Dr. Demark-Wahnefried hopes to launch a multicenter trial across the United States. She said that this is a program that could be put in place on a national level since two-thirds of the country has at least two growing seasons.
“Studies are now looking at whether a weight-loss intervention has an impact on disease right before surgery and after a diagnosis of cancer,” said Dr. Demark-Wahnefried in an interview with CancerTherapyAdvisor.com. “Helping patients improve their physical strength and fruit and vegetable intake through a gardening intervention could affect outcomes and help improve quality of life.”
- Calle EE, Rodriguez C, Walker-Thurmond K, Thun M. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med. 2003;348(17):1625-1638.
- Casagrande DS, Rosa DD, Umpierre D, et al. Incidence of cancer following bariatric surgery: systematic review and meta-analysis. Obes Surg. 2014 May 12. [Epub ahead of print]
- Heymach JV, Shackleford TJ, Tran HT, et al. Effect of low-fat diet on plasma levels of NF-kB-regulated inflammatory cytokines and angiogenic factors in men with prostate cancer. Cancer Prev Res (Phila). 2011;4(10):1590-1598.
- Blair CK, Madan-Swain A, Locher JL, et al. Harvest for health gardening feasibility study in cancer survivors. Acta Oncol. 2013;52(6):1110-1118.