Conclusion
Diet and PA play a vital role in the development of adolescents with cancer or those who have been treated for cancer during their youth. Educating survivors on the importance of these behaviors, both for their typical development and in the context of their cancer diagnosis and treatment, is important and may help prevent both acute and late effects related to the cancer journey. While several interventions aimed at increasing diet and PA in this population have been successful, more research is needed to evaluate the long-term maintenance of health behaviors, as well as the impact these behavioral changes have on adolescents as they continue into adulthood. Future interventions should incorporate key elements of adolescent development, including individualized and specific intervention components, and peer and family support, to increase saliency and long-term commitment. Finally, collaborative efforts in the development, implementation, and evaluation of these interventions should be coordinated within the childhood cancer professional community to ensure that the greatest numbers of patients are reached with the highest impact possible.
Disclosure
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This work has been supported in part by the National Cancer Institute-sponsored Cancer Prevention and Control Training Program (R25 CA047888). Ms Barnes and Dr Demark-Wahnefried have no financial interests or potential conflicts of interest to report in relation to this work.
References
1. National Cancer Institute (NCI). State cancer profiles [web page on the Internet]. Bethesda, MD: NCI; nd. Available from: http://statecancerprofiles.cancer.gov/cgi-bin/quickprofiles/profile.pl?00&515. Accessed February 12, 2014.
2. Eiser C, Eiser JR, Stride CB. Quality of life in children newly diagnosed with cancer and their mothers. Health Qual Life Outcomes. 2005;3:29.
3. Penn A, Lowis SP, Stevens MC, et al. Family, demographic and illness-related determinants of HRQL in children with brain tumours in the first year after diagnosis. Pediatr Blood Cancer. 2009;53(6):1092–1099.
4. Mertens AC, Lui Q, Neglia JP, et al. Cause-specific late mortality among 5-year survivors of childhood cancer: the Childhood Cancer Survivor Study. J Natl Cancer Inst. 2008;100(19):1368–1379.
5. Hewitt M, Weiner SL, Simone JV, editors; National Cancer Policy Board; Institute of Medicine (IOM); National Research Council. Childhood Cancer Survivorship: Improving Care and Quality of Life. Washington DC: National Academics Press; 2003.
6. Agricultural Research Service, US Department of Agriculture, US Department of Health and Human Services. Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 2010: to the Secretary of Agriculture and the Secretary of Health and Human Services. Washington DC: US Department of Agriculture; 2010. Available from: www.cnpp.usda.gov/publications/dietaryguidelines/2010/dgac/report/2010dgacreport-camera-ready-jan11-11.pdf. Accessed April 16, 2014.
7. Paxton RJ, Jones LW, Rosoff PM, Bonner M, Ater JL, Demark-Wahnefried W. Associations between leisure-time physical activity and health-related quality of life among adolescent and adult survivors of childhood cancers. Psychooncology. 2010;19(9):997–1003.
8. Keats MR, Culos-Reed N. A theory-driven approach to encourage physical activity in pediatric cancer survivors: a pilot study. J Sport Exerc Psychol. 2009;31(2):267–283.
9. San Juan AF, Fleck SJ, Chamorro-Viña C, et al. Effects of an intrahospital exercise program intervention for children with leukemia. Med Sci Sports Exercise. 2007;39(1):13–21.
10. Steinberg L. Adolescence. 8th ed. New York, NY: McGraw-Hill; 2008.
11. Peterson A, Taylor B. The biological approach to adolescence: biological change and psychological adaptation. In: Adelson J, editor. Handbook of Adolescent Psychology. New York, NY: Wiley; 1980:117–155.
12. Susman EJ, Rogol A. Puberty and psychological development. In: Lerner RM, Steinberg L, editors. Handbook of Adolescent Psychology. 2nd ed. New York, NY: Wiley; 2004:15–44.
13. Sallis JF, Patrick K. Physical activity guidelines for adolescents: consensus statement. Pediatr Exerc Sci. 1994;6(4):302–314.
14. Story M. Nutritional requirements during adolescence. In: McAnarney ER, Kreipe RE, Orr DE, Comerci GD, editors. Textbook of Adolescent Medicine. Philadelphia, PA: WB Saunders; 1992:75–84.
15. Bechard LJ, Duggan C. Cancer treatment. In: Walker WA, Watkins JB, Duggan C, editors. Nutrition in Pediatrics: Basic Science, Clinical Applications. 4th ed. Hamilton, Ontario: BC Decker; 2008:607–616.
16. Love E, Schneiderman JE, Stephens D, et al. A cross-sectional study of overweight in pediatric survivors of acute lymphoblastic leukemia (ALL). Pediatr Blood Cancer. 2011;57(7):1204–1209.
17. Fuemmeler BF, Pendzich MK, Clark K, et al. Diet, physical activity, and body composition changes during the first year of treatment for childhood acute leukemia and lymphoma. J Pediatr Hematol Oncol. 2013;35(6):437–443.
18. Lek N, Prentice P, Williams RM, Ong KK, Burke GA, Acerini CL. Risk factors for obesity in childhood survivors of suprasellar brain tumours: a retrospective study. Acta Paediatr. 2010;99(10):1522–1526.
19. Steinberger J, Sinaiko AR, Kelly AS, et al. Cardiovascular risk and insulin resistance in childhood cancer survivors. J Pediatrics. 2012;160(3):494–499.
20. Tai E, Buchanan N, Townsend J, Fairley T, Moore A, Richardson LC. Health status of adolescent and young adult cancer survivors. Cancer. 2012;118(19):4884–4890.
21. Badr H, Chandra J, Paxton R, et al. Health-related quality of life, lifestyle behaviors, and intervention preferences of survivors of childhood cancer. J Cancer Surviv. 2013;7(4):523–534.
22. Bilariki K, Anagnostou E, Masse V, et al. Low bone mineral density and high incidences of fractures and vitamin D deficiency in 52 pediatric cancer survivors. Horm Res Pediatric. 2010;74(5):319–327.
23. Cohen J, Wakefield CE, Fleming CA, Gawthorne R, Tapsell LC, Cohn RJ. Dietary intake after treatment in child cancer survivors. Pediatr Blood Cancer. 2012;58(5):752–757.
24. Stolley MR, Restrepo J, Sharp LK. Diet and physical activity in childhood cancer survivors: a review of the literature. Ann Behav Med. 2010;39(3):232–249.
25. Demark-Wahnefried W, Werner C, Clipp EC, et al. Survivors of childhood cancer and their guardians. Cancer. 2005;103(10):2171–2180.
26. San Juan AF, Wolin K, Lucía A. Physical activity and pediatric cancer survivorship. Recent Results Cancer Res. 2011;186:319–347.
27. Winter C, Müller C, Hoffmann C, Boos J, Rosenbaum D. Physical activity and childhood cancer. Pediatr Blood Cancer. 2010;54(4):501–510.
28. Haskell WL, Lee I, Pate RR, et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sport Exer. 2007;39(8):1423–1434.
29. Mays D, Gerfen E, Mosher RB, Shad AT, Tercyak KP. Validation of a milk consumption stage of change algorithm among adolescent survivors of childhood cancer. J Nutr Educ Behav. 2012;44(5):464–468.
30. Cox CL, McLaughlin RA, Rai SN, Steen BD, Hudson MM. Adolescent survivors: a secondary analysis of a clinical trial targeting behavior change. Pediatr Blood Cancer. 2005;45(2):144–154.
31. Hudson MM, Tyc VL, Srivastava DK, et al. Multi-component behavioral intervention to promote health protective behaviors in childhood cancer survivors: the protect study. Med Pediatr Oncol. 2002;39(1):2–10; discussion 2.
32. Gilliam MB, Ross K, Walsh A, et al. Healthy Heroes: a token economy to increase adherence with a community-based exercise intervention for childhood cancer survivors. Rehab Oncol. 2011;29:16–22.
33. Järvelä LS, Kemppainen J, Niinikoski H, et al. Effects of a home-based exercise program on metabolic risk factors and fitness in long-term survivors of childhood acute lymphoblastic leukemia. Pediatr Blood Cancer. 2012;59(1):155–160.
34. Li W, Chung OKJ, Ho KY, Chiu SY, Lopez V. Effectiveness of an integrated adventure-based training and health education program in promoting regular physical activity among childhood cancer survivors. Psychooncology. 2013;22(11):2601–2610.
35. Keats MR, Culos-Reed SN. A community-based physical activity program for adolescents with cancer (project TREK): program feasibility and preliminary findings. J Pediatr Hematol Oncol. 2008;30(4): 272–280.
36. Hartman A, te Winkel ML, van Beek RD, et al. A randomized trial investigating an exercise program to prevent reduction of bone mineral density and impairment of motor performance during treatment for childhood acute lymphoblastic leukemia. Pediatr Blood Cancer. 2009;53(1):64–71.
37. Gilliam MB, Madan-Swain A, Whelan K, Tucker DC, Demark-Wahnefried W, Schwebel DC. Social, demographic, and medical influences on physical activity in child and adolescent cancer survivors. J Pediatr Psychol. 2012;37(22):198–208.
38. Children’s Oncology Group. About us [web page on the Internet]. Monrovia, CA: Children’s Oncology Group. Available from: http://www.childrensoncologygroup.org/index.php/about-us. Accessed January 24, 2014.
Source: Dove Press.