The long-term wellbeing of survivors of childhood cancer is being significantly boosted by projects managed by Dr Jennifer Cohen and her team.
It’s not immediately obvious how a better survival rate across most kids’ cancers, as we’ve seen during the last several decades, could also present an entirely new problem. But a landmark research paper from 2006, called Chronic health conditions in adult survivors of childhood cancer, made clear the “incidence and severity of chronic health conditions in adult survivors”.
The research, part of the Childhood Cancer Survivor Study conducted by St Jude Children’s Research Hospital in Memphis, calculated conditions in 10,397 survivors and revealed that 62.3 per cent had at least one chronic condition, and that 27.5 per cent had a severe or life-threatening condition.
The study findings state, “Among survivors, the cumulative incidence of a chronic health condition reached 73.4 per cent … 30 years after the cancer diagnosis, with a cumulative incidence of 42.4 per cent … for severe, disabling, or life-threatening conditions or death due to a chronic condition.”
These conditions included heart disease, Type 2 diabetes and obesity-related issues. For a long time, medical professionals had realised the importance of diet and nutrition during treatment but following this study the significance of off-treatment nutrition was better appreciated.
“We hadn’t previously been looking so much at what was happening off treatment, and that’s how my research started coming about,” says paediatric nutritionist and recipient of a grant from The Kids’ Cancer Project, Dr Jennifer Cohen.
Read more: Reboot-Kids | A randomised controlled trial of a behavioural medicine intervention to prevent obesity and metabolic complications in young cancer survivors recently off treatment.
We have always believed in the role of nutrition for prevention of under-weight during treatment. But now we’re doing just as much work on how treatment affects the health and wellbeing of long-term survivors.”
In the past, when patients came off cancer treatment, Jennifer says, it was not unusual for them to develop poor nutrition habits. This put them at greater risk of lifestyle diseases as they entered adulthood.
“We saw that into adulthood, survivors of childhood cancer had diets that weren’t going to help them to have healthier lifestyles,” Jennifer, Senior Paediatric Dietitian at the Kids Cancer Centre at Sydney Children's Hospital, explains.
“We needed to know what was happening really early off-treatment. And in the last couple of years we’ve been starting to take this knowledge and re-focus what’s happening during treatment.”
“We used to say, ‘Just don’t lose weight’, but now we focus more closely on good nutrition during treatment,” she says.
Current studies in adult cancer patients are starting to investigate how specific types of diets might affect the efficacy of cancer treatments.
It has long been known that dramatic weight loss is not good, but researchers are now discovering the very best way to remain at a healthy weight during cancer treatment is through maintaining a good diet and exercise.
Jennifer prefaces all of her recommendations with a note that there is no such thing as perfect nutrition during cancer treatment. There is a lot going on, she says, so much nausea and vomiting during the treatment period that medical experts, patients and their families are simply doing all they can to ensure young cancer patients don’t lose too much weight.
But for those children who are able to eat during their cancer treatment, she has this advice.
“For these patients, what we want to say is that they should try to stick to the eating habits their family already has,” Jennifer says.
“As much as possible it’s about continuing the healthy eating habits they had before they were diagnosed, and not letting the child eat whatever they want. Consider what you would normally eat as a family and stick with that.”
“Of course, you’ll have to distinguish between hospital eating and home eating. Sometimes in hospital the child is just so sick they can’t eat anything. Sometimes the thought of eating vegetables is absurd. But what I sometimes say is, when you’re at home, try to keep those usual family food practises as normal as you can. Try not to change things too much.”
“A normal, healthy diet means lots of fruits and vegetables, lots of whole grains, and reduced red meat intake. Also, lots of good fats from olive oil, nuts, seeds, avocado etc., because these foods are nutritious, are high in antioxidants and can help prevent weight loss, but they also have antioxidants and polyphenols, which is something we’re beginning to think might help with improving how chemotherapy works.”
"Through Reboot-Kids, the study funded by The Kids’ Cancer Project," says Jennifer, "We hope to get more evidence to support these theories and create an online coaching platform that families can easily follow so children diagnosed with cancer can have the best chance of a healthy life after treatment.”