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癌症诊断不会促进明显的行为改变，需要以族群基础生活型态介入帮助癌症存活者增加运动和维持健康体重。
以上是一篇加拿大研究的结论，显示癌症存活者运动程度低且肥胖程度高，和对一般族群的研究发现略有不同；该研究登载于4月21日的Cancer期刊，即将在6月1日印刷出版。
主要作者、Alberta大学之加拿大癌症与体能活动研究主席Kerry Courneya博士向Medscape肿瘤学表示，癌症病患须有运动与饮食谘商。
Courneya博士建议，我们实际做了一些研究，显示大部分的肿瘤科医师未对其癌症病患提供有关运动或体重控制的谘商，我们相当鼓励他们提供运动与饮食谘商，这是让他们有具体的特定利益，而不只是说说“运动对你有好处”而已；如果有运动谘商更好，可以提供病患参考。
【增加对重要风险因素的体认】
作者写道，肥胖与没有运动是癌症存活者预后不佳的重要风险因素；该研究首次以加拿大族群基础，进行癌症存活者与非癌症对照组之间有关这两个风险因素的比较，资料来自2005年的加拿大社区健康调查（Canadian Community Health Survey），以电脑辅助访视了114,355 名成人；作者指出，研究限制之一就是采自我报告型式。
不到22%的癌症存活者有积极运动，超过18%是肥胖(身体质量指数 ≧30 kg/m2)，其他有34%过重 (BMI 25–30 kg/m2)，这些比率和最近美国两篇族群基础研究中有关癌症存活者的结果类似。
【不同癌症存活者之间的变化】
除了三组特定病患之外，加拿大癌症存活者的运动及肥胖比率与一般族群类似。
前列腺癌存活者运动最积极且最少肥胖；作者指出，事实上，前列腺癌存活者也比一般族群更积极运动；他们估计这是受到一篇2003年的研究影响，该研究显示阻力运动可明显改善接受雄性素去除疗法之前列腺癌存活者的肌肉强度、疲劳与生活品质(J Clin Oncol. 2003;21:1653-1659)。
皮肤癌存活者(黑色素细胞瘤和非黑色素细胞瘤)，特别是男性，比较有积极运动；作者写道，这可能有取样偏差；最近的研究显示，积极运动的人比较有可能发生原发皮肤癌，因为经常于户外运动而曝露于太阳下，因此，这些人可能只是继续其诊断前的运动习惯。
和其他无癌症病史的女性相比，肥胖的乳癌存活者较不运动；因此，作者认为，需更关注肥胖乳癌存活者的运动。
在各种癌症存活者中，大肠直肠癌存活者的运动程度最少；作者认为，这相当引人关心，因为最近的两篇研究显示，这类病患若有较高的运动程度，可以有比较好的疾病控制。
Cancer. 2008年4月21日线上发表。
Little Physical Activity and H
By Zosia Chustecka
Medscape Medical News
A diagnosis of cancer does not appear to be prompting significant behavior changes, and population-based lifestyle interventions to increase physical activity and maintain a healthy body weight in cancer survivors are warranted.
This is the conclusion from a Canadian study showing that cancer survivors have low levels of physical activity and high levels of obesity, with little difference from those found in the general population. The study was published online April 21 in Cancer, and is scheduled to appear in print in the June 1 issue.
Lead author Kerry Courneya, PhD, who holds the Canada Research Chair in Physical Activity and Cancer at the University of Alberta, in Edmonton, told Medscape Oncology that cancer patients should be counseled about both exercise and diet.
"We have actually done some studies showing that the majority of oncologists do not counsel their cancer patients about exercise or weight control. We would certainly encourage them to do so," Dr. Courneya commented. "It would be good to frame it in terms of specific benefits to them, rather than a generic 'exercise is good for you.' It would also be great if they had an exercise consultant that they could refer their patients to."
Increasingly Recognized as Important Risk Factors
Obesity and physical inactivity are increasingly being recognized as important risk factors for poorer outcomes in cancer survivors, the authors write. The study provides the first Canadian population-based data comparing cancer survivors with noncancer controls on these 2 risk factors. The data were obtained from the 2005 Canadian Community Health Survey, which consists of computer-assisted interviews of 114,355 adults. This self-reporting is one of the main limitations of this study, the authors note.
Fewer than 22% of the cancer survivors were physically active, over 18% were obese (body mass index ≥ 30 kg/m2), and another 34% were overweight (BMI 25–30 kg/m2). These rates are similar to those reported for cancer survivors in the United States in 2 recent population-based studies, the authors comment.
Variations Among the Different Cancer-Survivor Groups
The rates of activity and obesity in Canadian cancer survivors were similar to those in the general population, with the exception of 3 specific patient groups.
Prostate cancer survivors were more likely to be active and less likely to be obese. In fact, prostate cancer survivors were significantly more active than the general population, the authors noted. They speculate that this behavior was influenced by a 2003 Canadian study that showed that resistance training significantly improved muscular strength, fatigue, and quality of life in prostate cancer survivors receiving androgen deprivation therapy (J Clin Oncol. 2003;21:1653-1659).
Skin cancer survivors (melanoma and nonmelanoma), especially men, were more likely to be active. This could be the result of selection bias, the authors write; recent studies have shown that physically active people have a higher risk of developing primary skin cancer, likely resulting from greater exposure to the sun during outdoor activities. Hence, it could be that these individuals were just continuing with their prediagnosis (higher) level of physical activity.
Obese breast cancer survivors were less likely to be physically active than obese women who had no history of cancer. "This finding is cause for concern because physical activity may be particularly important for obese breast cancer survivors," the authors comment.
Among all the different cancer-survivor groups, it was patients with colorectal cancer who reported the least physical activity. "This finding is particularly concerning, given that 2 recent studies showed that higher physical-activity levels may result in better disease control in this group," the authors comment.
Cancer. Published online before print April 21, 2008.