Age-Informed Nutrition and Intervention Strategies for Cancer Patients Across All Ages
What are nutrition and intervention strategies for age-inclusive cancer survivorship? Oncology dietitian Dr. Cynthia Thomson from the University of Arizona discusses cancer research studies on diet and exercise behaviors, strategies to make studies more age-inclusive, and ways to increase self-determination in cancer survivorship.
Related Resources:
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Nutritional Essentials: Supporting Behavior Change During Cancer Treatment |
Transcript:
Lisa Hatfield:
Navigating cancer treatment is challenging at any age. How can age-specific strategies support better outcomes for cancer patients? I’m getting insightful answers from a leading expert in this edition of the Patient Empowerment Network RESTORE program.
Dr. Thomson, your study suggests that age at diagnosis was not a significant effect modifier. What implications does this have for designing interventions that address diet and physical activity behaviors across different age groups?
Dr. Cynthia Thomson:
Yes, I think it’s really important when we think about designing studies that we think about what is best for the individual patient, right? And, unfortunately, when we’re designing trials and we’re trying to evaluate diet and physical activity, we have to keep what’s called treatment fidelity. We have to kind of give everyone the same package, right? Because we want to know if this package works.
On the other hand, we know that patients do best when we individualize that care. And so it’s kind of a dance that we do as researchers to make sure patients get what they need, but also are relatively adherent to a plan that we’re testing with hypotheses. And so I would say that in some of my research, age has not been an effect modifier. In others, it has. And it really comes down to two things, I think. One is in individual studies, the age range may be very narrow, right? A lot of times when we go to do exercise and diet studies, we focus on, oh, we don’t want anyone who has heart disease, or we don’t want anyone who might fall, or we don’t want anyone who’s, we’re going to drive up their blood pressure.
And so in order to keep things safe, we may develop an age range for enrollment in our trial that kind of excludes people at either end. And so that lack of significance as an effect modifier may just reflect that it was a pretty narrow age range. The other thing is I always tell people when I hang up my flyer and say, come join my diet and physical activity study, cancer survivor, we need you. It attracts the people who are already walking, the people who go, well, I’m a vegetarian, I’d be great for this study. And so one of the things that we really need to do in research is to be more inclusive and to get those different age groups into different studies. And we are starting to do that. I think there are more and more studies that are reaching higher and higher age groups, younger age groups, trying to be more inclusive.
Lisa Hatfield:
Okay, thank you. And then considering that health behaviors and beliefs among adolescent and young adults and adults or older cancer survivors were found to be similar, how should this influence the way that we approach the development of age-inclusive survivorship care plans?
Dr. Cynthia Thomson:
Yeah, so care plans I think are imperative to really help people kind of have that self-determination about where they’re going during and after their cancer journey. And I think it’s important to think about age. I think it’s also important to think about race, ethnicity, resources that individuals have. We need to think about the individual overall and adapt our care plans to meet individual goals and individual needs. Even things like language, preferable language, many times are not addressed during cancer care or survivorship. And so we really have to get back to that and make sure that we’re meeting all of those needs across the spectrum of cancer survivors that we treat.
Lisa Hatfield:
Okay, thank you. And I just want to clarify a little bit the word or the term survivorship care plan. What exactly is that and what would that include for people who are wondering, hmm, I don’t have, I’m a cancer patient, but I don’t have a survivorship care plan. What might you tell them about that?
Dr. Cynthia Thomson:
Usually it’s the nurses that really take charge of helping patients develop their survivorship care plan. And really, this is a written plan that goes within your medical record that really details, what your current health status is, what your goals are as a cancer survivor. It may even detail different resources, different providers you need to meet with, the frequency that you need to follow up on your survivorship care. And so diet and physical activity should be part of that survivorship care plan, but those plans are much broader. They’re really addressing all of the healthcare needs that a cancer patient will need to tap into both immediately and long-term.
Lisa Hatfield: Okay, thank you for explaining that. You heard it here directly from Dr. Cynthia Thompson. Thanks for joining this RESTORE program. I’m your host, Lisa Hatfield.
