ALBANY, N.Y., Jan. 25 (UPI) -- Many -- especially those in healthcare -- believe that once a person has survived cancer he or she adopts a healthier lifestyle, but that isn't always the case.
A significant number of young survivors of childhood cancers smoke, are physically inactive and/or don't use sunscreen, according to researchers at the Lombardi Comprehensive Cancer Center in Washington.
While these behaviors can be a future cancer risk to adolescents who have not had cancer, they can pose special peril to those who have been treated for the disease, says lead author Kenneth Tercyak, assistant professor of oncology and pediatrics at the Lombardi Center, part of Georgetown University Medical Center and Georgetown University Hospital.
"For those of us in the field working on these issues, I think what's most striking is how vulnerable and susceptible young survivors are to all of the same lifestyle risks as children and teens who have not been treated for cancer," Tercyak told UPI's Caregiving.
"In many ways, survivors' health behaviors closely resemble those of their peer group. However, survivors are a special population due to their medical involvement -- they've already been touched by cancer and have lived through it. Their cancer could return, and smoking might prompt another bout with cancer or other smoking-related illnesses.
"Cancer survivors are at increased risk for developing cancer for specific reasons -- for example, skin and lung cancer risk increases if a patient has been treated with radiation, and certain treatments, such as chemotherapy, can weaken lungs, making them more susceptible to future disease.
"We should try our best to make sure that young survivors have access to all of the information, counseling and support they need to avoid making poor lifestyle choices such as smoking."
Tercyak's study, published recently in Pediatric Blood & Cancer, samples 75 adolescent cancer survivors whose average age was 14. It finds 28 percent reported one of the three risk factors of smoking, lack of exercise or not using sunscreen -- 12 percent reported two of the three, and 7 percent reported all three. This is among the first studies to look at multiple behavioral risk factors among adolescent cancer survivors, says Tercyak.
Tercyak surveyed patients between ages 11 to 21 who were one or more years from treatment and were cancer-free for one or more years. More than half of respondents were girls who had been treated for leukemia, and most were white, living in dual-parent households in areas with upper-middle-class incomes, reportedly earning As and Bs in school.
The study finds that 15 percent of the patients had a history of cigarette use, 20 percent engaged in insufficient physical activity, and 37 percent did not use sun protection as recommended.
Some of these youths may be especially "stress prone," and thus more likely to have difficulty protecting their health, Tercyak says.
"We have looked within a group of survivors to better understand what might lead some survivors toward risky behaviors, and we find that older children and those with more personal and family stress appear to be at greatest risk," he says.
Childhood cancer cure rates are better now than at any other point in history. The five-year childhood cancer survival rates, depending on the type of cancer, now range between 70 percent and 92 percent, with the 10-year survival rate at 75 percent, according to the Centers for Disease Control and Prevention in Atlanta and the National Cancer Institute.
Dr. Larry Lachman, a licensed clinical psychologist at Chapman University in Monterey, Calif., who is a cancer survivor himself, treats cancer survivors and leads cancer support groups, says the study results are not surprising.
"Experimenting with smoking, drinking, staying out late, not getting enough sleep and sexual experimentation to some degree is absolutely normal and age-appropriate for adolescents who are trying to form their own individual identity apart from their parents, instead of ending up with role confusion of who they are," Lachman told Caregiving.
"Stress does play a factor," he said. "We all end up falling back on the coping behaviors that were modeled by our parents and uncles and aunts and grandparents; and if that includes smoking, drinking, etc., then that increases the chance of the teenager following suit."
I think there is something else involved here. My father was diagnosed with bladder cancer in 1973 at age 61. He was in remission and diagnosed with colon cancer in 1983. He had been a career officer in the Air Force and was highly decorated after his actions during World War II. He had seen a lot of combat.
He had a lifetime behind him before he had to deal with cancer. He was a strong man most people did not mess with, but his cancer surgeries were very difficult -- he nearly died after each of his six surgeries -- as were the yearly cancer tests.
I can't imagine a teenager going through anything similar. My father didn't have to deal with peer pressure. Many of his friends were also battling cancer in the 1970s. Despite progress, there is still a stigma to cancer and I can understand how a teenager or young adult might feel he or she might "fit in" more if they smoke or get a tan.
Next: The emotional toll of cancer.
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Alex Cukan is an award-winning journalist, but she always has considered caregiving her real work. UPI welcomes comments and questions about this column. E-mail: [email protected]
