A new study from the University of Michigan Comprehensive Cancer Center has found that head and neck cancer patients who smoke, drink, don't exercise or don't eat enough fruit have worse survival outcomes than those with better health habits.
"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," said study author Sonia Duffy, Ph.D., R.N., associate professor of nursing at the U-M School of Nursing, research assistant professor of otolaryngology at the U-M Medical School, and research scientist at the VA Ann Arbor Healthcare System.
Each of the factors was independently associated with survival.
For the study, the researchers surveyed 504 head and neck cancer patients about five health behaviours: smoking, alcohol use, diet, exercise and sleep. Patients were surveyed every three months for two years then yearly after that.
They found that smoking was the biggest predictor of survival, with current smokers having the shortest survival.
Problem drinking and low fruit intake were also linked to worse survival, although vegetable intake was not. Lack of exercise also appears to decrease survival.
"Health behaviours are only sporadically addressed in busy oncology clinics where the major focus is on surgery, chemotherapy or radiation. Addressing health behaviours may enhance the survival advantage offered by these treatments," said Duffy.
Complicating matters is that many of these health behaviours are inter-related. For example, smokers might also be heavy drinkers, making it more difficult to quit. Duffy points out that it's not enough to refer someone to a smoking cessation program if alcohol is a major underlying problem.
Also, previous research has linked many of these health behaviours with preventing cancer.
In the current study, a third of the patients reported eating fewer than four servings of fruit per month. Nutrition experts recommend two servings of fruit per day.
"Eating fruits and vegetables, not smoking and drinking in moderation can have a big impact on a person's risk of getting cancer in the first place. Now it appears that these factors also impact survival after diagnosis," Duffy said.
Results of the study appear online in the Journal of Clinical Oncology.