Putting the life in lifestyle: Lifestyle choices after a diagnosis of cancer predicts overall survival

摘要

Background The aim of this study was to examine predictors of health behaviors over time and the link between health behaviors and survival after a diagnosis of advanced cancer. Methods Patients with a diagnosis of advanced cancer were administered a battery of questionnaires measuring optimism, depressive symptoms, physical activity, intake of fruits and vegetables, and alcohol and tobacco use over an 18‐month period. Analyses included generalized linear mixed models and Cox regression survival analyses. Results Of the 334 patients enrolled in the study, the mean age at cancer diagnosis was 62 years; the majority were male (62.3%) and white (91%). Twenty percent of the patients reported using alcohol, 19% reported using tobacco, 19% reported eating fewer fruits and vegetables than recommended by the Centers for Disease Control and Prevention and 28% reported physical inactivity after the diagnosis of advanced cancer. Clinical levels of depressive symptoms were associated with lower intake of fruits and vegetables ( t ?=?2.67, P ?=?.007) and physical inactivity ( t ?=?2.11, P ?=?.035). Dispositional optimism was positively associated with physical activity ( t ?=?–2.16, P ?=?.031) and a lower frequency of tobacco use ( Z ?=?–2.42, P ?=?.015). Multivariate analyses revealed that after adjusting for demographic variables (age and sex), depressive symptoms, and disease‐specific factors (diagnosis, tumor size, cirrhosis, vascular invasion, and number of lesions), alcohol use (χ 2 ?=?4.1186, P ?=?.042) and physical inactivity (χ 2 ?=?5.6050, P ?=?.018) were linked to an poorer survival. Conclusions Greater dissemination and implementation of effective interventions to reduce alcohol use and increase physical activity in cancer patients are recommended.