Many Physicians Not Following Guideline Recommendations to Discuss Healthy Lifestyle Choices With Cancer Survivors

Few physicians discuss healthy lifestyle modifications with cancer survivors due to a lack of time, resources, and expertise, according to a study published in Cancer.

Cancer survivors often face increased risks for other conditions, and guidelines advise physicians to encourage the adoption of healthy lifestyles for long-term health benefits.

Researchers used a mixed‐method survey on 91 physicians, including 30 primary care physicians (PCPs), 30 oncologists, and 31 specialists (urologists, dermatologists, and gynecologists). They also conducted interviews with 12 oncologists.

Most PCPs (90%) said they recommend health promotion, including weight loss and smoking cessation, to at least some cancer survivors, while few oncologists (26.7%) and specialists (9.7%) said they did so (P<0.001).

When presented with a hypothetical situation in which a physician had two minutes left during a regular follow-up visit with a patient, 8.8% said they would use the time to address health promotion topics, and PCPs were significantly more likely to allocate this time to health promotion (odds ratio [OR] = 7.37; 95% CI, 1.39-39.14) than oncologists and specialists (OR=1.03; 95% CI, 0.06-17.33).

Most PCPs (96.7%) said they would refer cancer survivors to a health-promotion counseling service compared with about half of oncologists and specialists (P<0.01).

Barriers to healthy lifestyle promotion

Although most physicians believed that at least 50% of cancer survivors would be adherent to medication regimens to prevent cancer recurrence, they also believed that, if patients were trying to lose weight, they would not remain adherent to their medication.

In interviews, oncologists feared that providing healthy lifestyle advice would distress or overwhelm patients. Additional barriers included identifying cancer as oncologists’ focal concern, time pressure, insufficient behavior change training, and care coordination challenges.

“Research is needed to evaluate whether health‐promotion efforts compromise medical regimen adherence, as physicians’ responses suggest,” the researchers concluded.