Part 3 of 3
AICR Recommendations Fit in Clinical Care
Cancer risk and survivorship aren’t concerns you can address in a vacuum. Many people have, or are at risk of, heart disease, diabetes or other health problems. Health-care professionals and health coaches like those attending the workshop need to know how to incorporate cancer prevention recommendations into overall clinical care.
That’s where I came in as a presenter in the workshop. As a registered dietitian nutritionist who focuses on translating nutrition research in cancer, heart health and their intersection (cardio-oncology), I was thrilled to contribute to this workshop.
Body composition, especially metabolic obesity, is related not only to cancer risk and cancer outcomes, but also to risk and management of chronic diseases like heart disease and diabetes. Excess body fat, especially visceral fat deep in the abdomen, can occur even in people with a BMI (body mass index) categorized as healthy. In the workshop, we talked about ways to assess this.
People are often surprised to learn that a relatively small amount of weight loss can significantly reduce visceral fat and improve metabolic markers of inflammation and insulin resistance. If weight loss may be helpful, health-care professionals need to clarify that the goal is not getting down to some “ideal” weight target from decades ago (or never).
Also, especially during and after cancer treatment, weight loss that includes loss of lean muscle tissue is associated with poor health outcomes . . . even in people with overweight or obesity. So unintentional or unexpected weight loss is different than small, slow weight loss from changes like healthier food choices, fewer sugar-sweetened drinks and more walking.
Heart health and cancer risk reduction and survivorship can fit hand-in-hand. Some people with cancer already have heart disease or risk factors when they’re diagnosed with cancer. Some develop them during cancer treatment. The diet and lifestyle choices highlighted in the AICR Recommendations promote overall health, too.
Messages need to be framed to address barriers and misinformation. When whole grains, beans and green vegetables, for example, are unfamiliar to people, that’s a barrier to including them as a major part of eating habits. But other barriers come in the form of false and confusing information people see about what is and isn’t a healthy diet. In the workshop, we talked about how to help people with misunderstandings about topics like soy foods, supplements and alcohol choices.
Brainstorming: AICR Resources Fit Throughout the Health-care Spectrum
In the final portion of the workshop, participants gathered in small groups to share how they are now or would like to build AICR’s Cancer Prevention Recommendations and resources into the work they do. After all they learned about the strength of the evidence behind the Recommendations, these professionals were thrilled that they don’t have to reinvent the wheel to share them. Our review of the free AICR programs and tools had many attendees excited to get up and running when they returned home.
- Cancer HealthCheck will be a sound and engaging introduction to talking about cancer risk for those involved in hospital, community or corporate wellness programs.
- The Healthy10 Challenge will provide pre-planned, accessible weekly content for cancer survivorship programs.
- Recipes in the Healthy10 Challenge and on the AICR website can be prepared in a group setting in programs with a culinary component. And in other settings, a recipe can be selected for people to prepare at home and discuss at a follow-up session. These taste-testing opportunities, with group members providing tips and encouragement to one another, can help people overcome the barrier of reluctance to try unfamiliar foods.
Here are some ways health professionals are using AICR’s materials, programs and resources
At the VCU Massey Cancer Center, RD Allie Farley shares that AICR’s New American Plate grocery list, meal plan and One Pot Meals brochure are favorites with patients. Along with a fresh produce program at Massey, the information in the brochures has helped patients put the research into action
RDN Judy Donnelly describes how AICR’s resources and tools enhance her work with patients. “I frequently refer my clients to AICR’s Foods that Fight Cancer resources to help them get a sense for what foods potentially help reduce risk of cancer and other chronic diseases.
“For folks in survivorship, I refer them to AICR’s Healthy10 Challenge. I share my computer screen with the participants and together we visit various parts of AICR’s website, including the Healthy10 Challenge.”
Javin Brita, PA-C, MPAS, Physician Assistant in Survivorship, Oncology Services at Smilow Cancer Hospital at Yale New Haven Health
“We provide our cancer patients with a folder at their initial visit with us. This folder has resources on psychosocial well-being, integrative medicine, exercise, nutrition and more—many of the resources are from AICR.
“We receive outstanding feedback on the resources from AICR. For example, AICR’s magnets that people can place on their refrigerator at home are some of the most popular nutrition resources we have.
“The magnets are a reminder that encourages patients to reference other AICR materials that make it easy for survivors to develop healthy eating habits and motivate people to sustain these healthy lifestyle behaviors.”
Dr. Amy Commander, Director of Breast Oncology and Survivorship at Mass General Cancer Center in Waltham and at Newton-Wellesley Hospital and Medical Director at Mass General Cancer Center in Waltham.
“Participants in the PAVING program are highly motivated to learn about lifestyle medicine, and I refer them to the AICR website because AICR compiles the latest scientific research from around the world on the role of lifestyle factors in cancer outcomes. My patients have benefited from AICR’s materials on a wide range of topics, including the role of exercise during treatment and how to manage treatment-related side effects. AICR also provides information about the role of diet, weight management and physical activity for cancer survivors. This information helps individuals make informed lifestyle choices to reduce their risk of cancer recurrence.”
All in all, the workshop provided a deep dive to help these health-care professionals and health educators with the roadmap they needed to strengthen their knowledge of the evidence, see how cancer risk reduction and survivorship fit into clinical care and identify resources to put it all into action.