Patients with bladder cancer who live a healthy life have a quarter less chance of the disease returning, according to a study by Radboudumc, in which almost 900 patients were followed for years using questionnaires. The total package of a healthy weight, sufficient exercise and good nutrition, as advised by the World Cancer Research Fund (WKOF), was examined.
For the first time, the effect of a healthy lifestyle after diagnosis on the recurrence of bladder cancer has been investigated. Previous research has already shown that healthy living reduces the risk of cancer, but this is one of the first studies to specifically look at recurrence of disease. ‘Bladder cancer recurs very often after the first operation, in about half of all patients,’ says nutrition and cancer epidemiologist Alina Vrieling. ‘Patients therefore receive many check-ups and often new treatments. That is an intensive process.’
Score for healthy living
The researchers wondered whether a healthy lifestyle can reduce the risk of disease recurrence. They therefore followed 885 patients from 22 Dutch hospitals for an average of 3.5 years. They had bladder cancer that had not yet grown into the bladder muscle, about three quarters of all bladder cancers. ‘These people completed questionnaires about their lifestyle before the diagnosis and three months afterwards,’ says researcher Moniek van Zutphen. ‘In addition, they gave us permission to access their medical data.’
The researchers converted the results of the questionnaires into a score for healthy living. They used the recommendations for a healthy lifestyle from the WKOF. These are about weight, exercise and nutrition. They recommend lots of vegetables, fruit and whole grain products, and little alcohol, red and processed meat, ultra-processed products and sugary drinks. Van Zutphen: ‘We included the entire package of recommendations in the score. Smoking was not part of this score, but we corrected for it. We know that smoking increases the risk of cancer recurrence.’
Do something yourself
Based on the score for healthy living, the researchers made three groups. Did bladder cancer recur less often in the healthiest group? ‘Yes’, answers Van Zutphen. ‘We saw 26% less disease recurrence in the group that scored highest on healthy living compared to the least healthy living group. In addition, a healthier lifestyle turned out to be associated with a better quality of life.’
Patients currently receive hardly any lifestyle advice when diagnosed with bladder cancer. ‘At most, the urologist advises to stop smoking and drink plenty of fluids,’ explains Vrieling. ‘While many people after a diagnosis of cancer ask their doctor what they can do themselves. In our study we see a positive effect of a healthy lifestyle. We need more studies confirming our findings before we can provide well-founded advice. But living a little healthier is always a good idea.’
About the publications
The results of this study have been published:
– In the American Journal for Clinical Nutrition: Adherence to lifestyle recommendations after non-muscle invasive bladder cancer diagnosis and risk of recurrence. Moniek van Zutphen, Jasper P Hof, Katja KH Aben, Ellen Kampman, J Alfred Witjes, Lambertus ALM Kiemeney, Alina Vrieling.
– In the International Journal of Cancer: Longitudinal associations of adherence to lifestyle recommendations and health-related quality of life in patients with non-muscle invasive bladder cancer. Short title: Lifestyle and quality of life after NMIBC. Nikoletta Vidra, Ivy Beeren, Moniek van Zutphen, Katja K. Aben, Ellen Kampman, J. Alfred Witjes, Antoine G. van der Heijden, Lambertus A. Kiemeney and Alina Vrieling.
This study was carried out with funding from KWF and World Cancer Research Fund.