Demark-Wahnefried Wendy, Pinto Bernardine M, Gritz Ellen R
Duke University Medical Center, School of Nursing & Department of Surgery, Durham, NC 27710, USA.
J Clin Oncol. 2006 Nov 10;24(32):5125-31. doi: 10.1200/JCO.2006.06.6175.
Cancer survivors are at increased risk, not only for progressive and recurrent disease, but also other cancers, cardiovascular disease, diabetes, osteoporosis, and functional decline. Lifestyle interventions to improve dietary and physical activity behaviors, and smoking cessation, have the potential to improve the overall health and quality of life of this vulnerable population. Studies on overall health and physical function from 1966 and beyond regarding the impact of behavioral interventions that used randomized and controlled designs were identified through MEDLINE and PubMed searches. Published reports currently exist for 22 exercise interventions, 11 diet-related interventions (excluding those limited to dietary supplements or single nutrients), two diet and exercise interventions, and 10 behavioral-based smoking cessation interventions. Although many interventions have been successful in promoting behavioral change and have resulted in improvements in various health-related outcomes, more research is needed to determine the key components of interventions that are able to produce the greatest behavioral change and the most favorable health-related benefits. The oncology care provider can play a pivotal role in improving the long-term health of cancer survivors by (1) being aware of opportunities to encourage healthful behaviors (ie, smoking cessation, weight control, and increased physical activity); (2) vigilantly tracking long-term effects among cancer survivors and exploring whether they are amenable to intervention; (3) staying abreast of current health behavior guidelines for cancer survivors and existing resources for professional and patient education; and (4) supporting and contributing to efforts aimed at primary and tertiary prevention research.
癌症幸存者面临的风险增加，不仅有疾病进展和复发的风险，还有患其他癌症、心血管疾病、糖尿病、骨质疏松症以及身体机能衰退的风险。改善饮食和身体活动行为以及戒烟的生活方式干预措施，有可能改善这一弱势群体的整体健康状况和生活质量。通过检索MEDLINE和PubMed数据库，确定了1966年及以后有关采用随机对照设计的行为干预影响的整体健康和身体机能的研究。目前已发表的报告包括22项运动干预、11项饮食相关干预（不包括仅限于膳食补充剂或单一营养素的干预）、2项饮食和运动干预以及10项基于行为的戒烟干预。尽管许多干预措施在促进行为改变方面取得了成功，并在各种与健康相关的结果方面有所改善，但仍需要更多研究来确定能够产生最大行为改变和最有利健康相关益处的干预措施的关键组成部分。肿瘤护理提供者可以通过以下方式在改善癌症幸存者的长期健康方面发挥关键作用：（1）意识到鼓励健康行为（即戒烟、体重控制和增加身体活动）的机会；（2）密切跟踪癌症幸存者的长期影响，并探索他们是否适合接受干预；（3）了解癌症幸存者当前的健康行为指南以及专业和患者教育的现有资源；（4）支持并参与旨在进行一级和三级预防研究的工作。
