After the Bell: Lifestyle Transformation After Cancer Treatment

There are many traditions on the last day of chemotherapy. It is often a happy time when patients have pictures taken with their oncology nurses and ring the bell as they leave the infusion area. For many, the bell is symbolic of the completion of cancer treatment and the beginning of the rest of their lives as cancer survivors. After the bell, survivors often go home wondering what they can do to be healthier and reduce their risk of recurrence.

We are now seeing the results of cancer screening programs and innovative treatments with earlier detection of cancers and a growing population of long-term survivors. There are now more than 14.5 million cancer survivors in the United States (American Cancer Society, 2016). People with a previous cancer diagnosis are now living longer, aging, and living with or developing other chronic health problems. Although we cannot change the aging process, we can address lifestyle factors that may cause chronic health problems, such as cardiovascular disease and diabetes. In addition, many of these same factors, such as obesity and tobacco use, may be associated with cancer development, cancer recurrence, and even second cancers in cancer survivors. What can cancer survivors do to reduce their risk for cancer recurrence and other chronic health problems? How can oncology nurses help survivors adopt healthier lifestyles?

A cancer diagnosis is often a teachable moment for people with cancer and their families. Many people describe their cancer diagnosis as a wake-up call and try to revamp their diet or begin fitness regimens. However, these attempts often are short-lived as the cancer experience recedes into the background. More structured, long-term programs may help survivors learn new behaviors and improve their overall health.

One such program, the Anticancer Lifestyle Program (ACLP), was designed to empower cancer survivors to make an investment in long-term health. The ACLP was inspired by the research and principles outlined in a book, Anticancer: A New Way of Life (Servan-Schreiber, 2011), and was developed by the Anticancer Lifestyle Foundation, in collaboration with the Payson Center for Cancer Care at Concord Hospital in New Hampshire. This evidence-based lifestyle transformation program provides cancer survivors with the necessary tools and information to make sustainable changes in the areas of diet, fitness, stress management, and exposure to toxins in daily life.

The program is initially 12 weeks, followed by three monthly maintenance sessions. Content experts in each of the course pillars—diet, exercise, mindset, and environment—rotate according to the subject being covered at the session. For example, the diet session may be taught by a registered dietitian and the exercise session by a physical therapist. A course facilitator, usually a social worker, is present at each session (Anticancer Lifestyle Foundation, 2016).

Since the ACLP launched in 2011, about 250 survivors have participated in New Hampshire and other communities in the United States and Canada. The ACLP has been well received by both cancer survivors and oncology clinicians. Referrals come from all members of a patient’s multidisciplinary team, and discussion of the program is often included during a patient’s end-of-treatment visit and before they ring the bell.

Oncology nurses are in a pivotal position to explore patients’ readiness for change after a cancer diagnosis. They often develop close, long-term relationships with their patients and are well positioned to identify those patients who are interested and able to make the commitment to a structured program for lifestyle transformation. Many survivors are seeking the best path to change their lifestyle and improve their overall health, as well as decrease their risk of cancer recurrence. With educational programs, they learn that many of these healthy behaviors can also decrease their risks of chronic conditions such as heart disease and diabetes. Structured programs, such as the ACLP, can empower cancer survivors to take control of their lives after treatment and improve overall health and quality of life. As oncology nurses, we can empower our patients and cancer survivors to be active in transforming their lifestyle.

As one cancer survivor who attended the ACLP said, “Everything else has been done to us. This is something we get to do for ourselves.” So, how can you empower your patients to make positive lifestyle changes? Please share your innovative approaches at CJONEditor@ons.org. Let us make these unique programs commonplace, thereby increasing our patients’ quality of life.

References

American Cancer Society. (2016). Cancer facts and figures, 2016. Atlanta, GA: Author.

Anticancer Lifestyle Foundation. (2016). Anticancer lifestyle program. Retrieved from http://bit.ly/2bhVpDa

Servan-Schreiber, D. (2011). Anticancer: A new way of life. London, UK: Penguin Random House.

About the Author(s)

Nancy Kane, MS, RN, AOCN®, is the executive director of the Anticancer Lifestyle Foundation in Concord and Lisa Kennedy Sheldon, PhD, ANP-BC, AOCNP®, is an oncology nurse practitioner in the Cancer Center at St. Joseph Hospital in Nashua, both in New Hampshire. The authors take full responsibility for the content of the article. No financial relationships relevant to the content of this article have been disclosed by the editorial staff. Kane can be reached at nancy@anticancerfoundation.info, with copy to editor at CJONEditor@ons.org.