Cancer survivors experience significant ongoing health problems compared to the general population. Problems include: fatigue, pain, loss of function (musculoskeletal, cardiovascular, cardiopulmonary), infection, lymphoedema, diarrhoea, reduction in bone mass, body composition changes and neuropathy. Many cancer survivors gain weight due to adjuvant cancer therapies and supportive care medications, coupled with decreased physical activity during cancer treatment. Obesity and sedentary lifestyle are risk factors for cancer recurrence.
Adult patients with localised cancer (breast, colorectal and haematological [commenced May 2014]) after completion of primary treatments (surgery, chemotherapy and/or radiotherapy) are referred. At the initial visit patients see a multi-disciplinary team including: oncologist/haematologist, cancer nurse, dietitian, psychologist and exercise physiologist. Patients complete questionnaires assessing distress, exercise, diet and quality of life prior to attending clinic. Weight history is collected including pre-treatment, post-treatment, and at the clinic visit.
92 patients have attended the clinic; 78% female. Cancer diagnoses represented: breast 50%, colorectal 38%, haematological 12%. Median age 54 (range 23-80) years. 68 patients completed the Distress Thermometer (mean score 3.1/10; range 0-10); 28% scored >4, indicating distress requiring further assessment. Mean body mass index (BMI) pre- and post-treatment was 26.9kg/m2 (range15-53kg/m2) and 27.8kg/m2 (range 17-59kg/m2) respectively; >50% were overweight or obese; 76% gained weight between diagnosis and attendance at survivorship clinic (mean 3.1kg,SD4.3). Median time spent walking at time of first clinic was 180min/week, mean of 49min/week of moderate intensity PA (range 0-330min). Median weekday sitting time was 315min/day (range 60-870min).
More than half the patients are overweight before starting treatment and three quarters gain weight throughout treatment. The majority of patients are not meeting recommended guidelines for moderate intensity PA and spend an average of 6 hours/day sitting. A quarter report psychological distress. The Survivorship Clinic has the potential to identify and address important lifestyle concerns for cancer survivors.