Mary Elizabeth Williams 

Yes, I’ve had cancer, but no, I’m not going to live like a Puritan

A new study shows that cancer vets don’t take much more care over their lifestyles than anyone else. That’s because we’re only human
  
  

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Cancer survivors are what we always have been: ordinary, fallible human beings. Photograph: Clara Molden/PA

This shouldn’t come as a great surprise to those of us who’ve experienced cancer or know someone close who has, but new research on “lifestyle behaviors among US cancer survivors” appears to confirm it anyway: the side effects of surviving the disease do not include suddenly picking up a whole slew of positive new habits.

The expansive University of Oklahoma study, published in the Journal of Cancer Survivorship, drew upon 47,139 adult cancer survivors and 407,191 individuals with no cancer history, from every part of the country. The findings conclude that “US cancer survivors are not more likely than the general population to engage in … healthy lifestyle behaviors.”

In other words, don’t look to us to be your role models. We are not – with the exception of a few prominent new age hucksters – lifestyle gurus. We are instead for the most part what we’ve always been: ordinary, fallible human beings.

As a nation overall, there’s plenty of room for improvement in the areas the the study examines: smoking, physical activity, alcohol consumption and nutrition. But there are compelling reasons for people who’ve experienced cancer in particular to raise the bar and make lifestyle adjustments. As the study’s authors report, “smoking cessation post-cancer treatment has been linked to a reduction in the risk of cancer progression among lung cancer survivors; a healthy, non-overweight, body mass index has been associated with improved survival among colorectal cancer patients.” Physical activity and other adjustments are associated with “improved health-related quality of life” for breast, prostate and colorectal cancer survivors.

Yet roughly two thirds of the respondents, regardless of cancer history, were overweight or obese, and more than 80% of people in both groups said they consume fewer than the American Cancer Society’s recommended five daily servings of fruits and vegetables. And while the cancer survivors binge drink less than their counterparts, 4% more female survivors smoke than women who haven’t had cancer.

So why don’t people who’ve faced cancer do more to improve their odds? The study’s four authors don’t have easy answers, though they vaguely note “opportunities exist for clinicians to promote lifestyle changes that may improve the length and quality of life of their patients”. I’d wager some of the blame rests in basic human nature, and more in our culture, which focuses on fixing illness rather than establishing wellness.

Lasting positive lifestyle habits are difficult to achieve – especially when, unlike while we’re in cancer treatment, we rarely have a supportive team of doctors and nurses to guide us on the journey. It’s also no doubt significant that fewer than 14% of the the cancer survivors surveyed were under age 44 – and half were age 65 or older. As a friend recently recalled about her partner’s late mother, “When I met her she had two great loves: gardening and smoking. By the time she died of lung cancer, it was just smoking.”

The study, too, notably omits people who’ve had skin cancers from its findings. It also only asks respondents to identify as cancer survivors, not distinguishing the type or severity of the disease. Yet as a Stage 4 melanoma veteran who regularly forgets to wear a hat and is lax about reapplying sunscreen, I could have told you that surviving even a very serious cancer diagnosis doesn’t bestow a halo of optimal decision making on a person. I lead a pretty healthy lifestyle that features plenty of seasonal produce, but I no doubt fail the “five servings of fresh fruits and vegetables every single day” test.

Cancer is not a standalone teachable moment. So it’s unsurprising that without education and reinforcement, people don’t readjust their behaviors.

With more and more of us who’ve had cancer living longer past our initial diagnoses, we need to get real and face that we can be more vulnerable to future – and sometimes preventable – issues than non-survivors. But our current, deeply flawed healthcare system rarely takes into account the lives we lead outside of our hospitals. Our cancers are frequently regarded as finite and distinct experiences, rather than the start of a new way of living that requires consistent management.

And while the default public discourse around cancer tends to incorrectly frame treating the disease as the “battle,” oftentimes, the more challenging health struggles are the same day-to-day ones we’ve always had, now with a sense that life is too brief to eschew treasured vices.

 

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