A US study found that head and neck cancer patients who drank alcohol, smoked, didn’t eat enough fruit, and didn’t exercise, had poorer survival than patients with healthier lifestyles.
The study was the work of Dr Sonia Duffy, associate professor of nursing at the University of Michigan (U-M) School of Nursing and colleagues, and is published in the Journal of Clinical Oncology. Duffy is also research assistant professor of otolaryngology at the U-M Medical School, and research scientist at the VA Ann Arbor Healthcare System.
Duffy and colleagues had already been researching links between healthy living habits and quality of life among head and neck cancer patients, but apart from smoking, there was no clear evidence of a link between healthy living and survival.
The American Cancer Society estimates that over 35,000 Americans will be diagnosed with head and neck cancers this year, while over 7,500 will die from one of these diseases.
For the prospective study, the researchers looked at five lifestyle habits (smoking, alcohol consumption, diet, physical activity, and sleep), assessing them before treatment began and then every three months for two years, then once a year, among 504 head and neck cancer patients.
The results showed that each of the factors was independently linked to survival: smoking showed the strongest link with poor survival, and current smokers fared the worst.
Problem drinking and not eating much fruit were also linked with worse survival, but vegetable intake was not. Lack of exercise was also linked to poor survival.
The researchers concluded that:
“Variation in selected pretreatment health behaviors (eg, smoking, fruit intake, and physical activity) in this population is associated with variation in survival.”
Duffy told the press that while eating fruit and vegetables, not smoking and drinking only moderate amounts of alcohol can significantly lessen a person’s risk of getting cancer, it appears that these factors are also beneficial to survival.
“While there has been a recent emphasis on biomarkers and genes that might be linked to cancer survival, the health habits a person has at diagnosis play a major role in his or her survival,” she explained.
Duffy also said that oncology clinics don’t have time to look at health behaviours, where the focus is on surgery, chemotherapy and radiation.
“Addressing health behaviors may enhance the survival advantage offered by these treatments,” she added.
She pointed out that helping people change their habits is not easy: many of the factors are inter-related. For example heavy smokers might also be heavy drinkers and referring them for smoking cessation probably won’t work if the underlying problem is the alcohol.
The researchers also noted that a third of the patients taking part in this study ate very little fruit: fewer than four servings a month. The national recommendation is for people to eat at least two servings of fruit per day.
Duffy and colleagues’ next project is to look at whether changing health habits after diagnosis changes their survival outcomes. This could be valuable information for designing interventions and treatments for patients.
The research was sponsored by a National Institutes of Health, Head and Neck Cancer Specialized Program of Research Excellence (SPORE) grant. “Pretreatment Health Behaviors Predict Survival Among Patients With Head and Neck