Health Link

Healthy living after treatment of childhood, adolescent, and young adult cancer

Staying Healthy through Nutrition and Physical Activity
Good nutrition and regular exercise offer many benefits to childhood cancer survivors. These include:•

Promoting healing of tissues and organs affected by cancer and its treatment•

Building strength and endurance•

Reducing the risk of certain types of adult cancers and other diseases suc as diabetes, high blood pressure, andobesity•Decreasing stress and providing a feeling of well-being

Impact of Childhood Cancer on Nutrition and Physical Activity
The effects of childhood cancer on nutrition and physical activity will be different for each survivor. Cancer affects
nutrition in several ways. Some survivors may have difficulty gaining weight, while others may have problems withgaining too much weight. Physical activity is an important factor in maintaining a healthy body weight. There are manyfactors that can influence a survivor’s ability to be physically active; however, childhood cancer and its treatment should
not be used as an excuse for not eating a healthy diet or staying physically active. Many survivors, just like many people
who have never experienced cancer, have poor health habits. Now is a good time to begin making healthy choices about
what you eat and stay active. These choices can have a positive effect on your health for many years to come.
Developing a Healthy Nutrition Plan
Suggestions for good nutrition include:•Choosing a variety of foods from all the food groups. Use the interactive
customized guide at www.choosemyplate.gov to help develop a well-balanced
diet and activity plan.

•Eating five or more servings a day of fruits and vegetables, including citrus fruits
and dark-green and deep-yellow vegetables.

•Limiting juice to 4 ounces of 100% fruit or vegetable juice per day.

•Eating plenty of high-fiber foods, such as whole grain breads, rice, pasta, and cereals.

•Limiting refined carbohydrates, including pastries, sweetened cereals, soft drinks, and sugars.

•Decreasing the amount of fat in your meals by baking, broiling or boiling foods.

•Limiting intake of red meat and eating fish, poultry, or beans instead. When eating meat, select leaner and smaller
portions.

•Limiting fried and high-fat foods, such as fries, snack chips, cheeseburgers, and pizza.

•Choosing low-fat milk and dairy products.

•Avoiding salt-cured, smoked, charbroiled, and pickled foods.

•For adults, limiting alcoholic drinks to less than two a day for men and one for women.

If you need to lose or gain weight, consult with your health care team and/or a nutritionist to develop a nutrition plan.
Herbal or dietary supplements should be discussed with your team. There are several questions you should ask yourself
to make sure your nutrition plan will be effective.
•Do you have a realistic, achievable weight goal?

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Healthy living after treatment of childhood, adolescent, and young adult cancer•

Does your plan include foods that you will enjoy eating for the rest of your life, not just a few weeks or months?

•Does your plan include a variety of foods?

•Are foods on your plan easily available at your supermarket?

•Does your plan fit into your lifestyle, daily schedule and budget?

•Does your plan include lifestyle changes that will help you maintain your weight change?

Developing a Healthy Exercise Plan
Check with your healthcare team before starting an exercise plan or taking part in new sports and recreational
activities. Your healthcare provider can make you aware of the activities that you can safely take part in and those you
should avoid.
When choosing an exercise plan, ask yourself these questions:•Do you have reasonable goals based on your present strength and endurance?

•

Is the activity safe for you to perform?

•Does the plan fit into your lifestyle and schedule?

•

Does the activity require special equipment or protective gear and will your budget cover the expense?

•

Do you need to make changes in the sport or activity based on a special need?

•Do you enjoy doing the sport or activity?

Here are a few helpful suggestions when implementing your exercise plan:•

Start out slow. Don’t try activities that are too strenuous or put you at risk for muscle strain.

•Begin your exercise plan with a warm-up program and end with a cool-down activity, such as stretching andslow easy movements.

•Use correct posture when exercising.

•Exercise until you are tired, but not in pain.

•Identify the muscles you want to strengthen and choose exercises that work on those muscles.

•

Alternate exercises to work different muscles and different parts of your body.

•To avoid injury, use the right equipment and shoes. Avoid running, jogging, or aerobic dancing on hard surfaces
such as asphalt or concrete.

The American Cancer Society recommends having a physically active lifestyle. Adults should get at least 150 minutesof moderate physical activity (brisk walking, bicycling, vacuuming, gardening), or 75 minutes of vigorous physicalactivity (running, aerobics, heavy yard work), or a combination of these each week, preferably spread throughout
the week. Children and adolescents should engage in at least 60 minutes each day of moderate to vigorous physicalactivity each day (running, aerobics, heavy yard work), with vigorous activity at least 3 days each week. Here are some
practical suggestions to try to work physical activity into your daily schedule.
•Park a good distance from your place of work and walk the extra distance each day.

•Set aside 30 minutes a day to take a brisk walk.

•Take the stairs instead of the elevator.

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Healthy living after treatment of childhood, adolescent, and young adult cancer•If you have a sit-down job, get up and stretch your muscles every hour and take a walk during your lunch orbreak.

•Ride a bike to work or for running errands.

•If you have a dog, take him/her on a brisk walk every day.

•Plant a garden, wash your car, mow the lawn, paint furniture, clean out the garage and catch up on all thosechores you have been meaning to do—instead of watching TV or playing on the computer.

•Keep your body moving while watching TV or reading the newspaper on a stationary bike or treadmill.

•Plan active outings with family or friends.

•Exercise with a partner.

•Join a sports team.

Physical Activity for Survivors with Special Needs
Survivors who have special needs can take part in most activities, but the help of a physical or occupational therapist
may be needed to adapt the activity for success. A social worker may be able to help find insurance coverage or otherresources for special equipment. Specialized programs for individuals with special needs, organizations and otherresources are often available through your healthcare center, in your local community, and at www.ncpad.org.
Adapted by Sharon A. Frierdich, RN, MS, CPNP, University of Wisconsin Hospital and Clinics, Madison, WI, from “Staying PhysicallyHealthy, Play Safely, Play Well,” St. Jude Children’s Research Hospital, used with permission.
Reviewed by Linda Rivard, RN, BSN, CPON®; Christine S. Yun, MSN, PNP, CPON®; and Kayla L. Foster, MD, MPH.

Additional health information for childhood cancer survivors is available atwww.survivorshipguidelines.org
Note: Throughout this Health Links series, the term “childhood cancer” is used to designate pediatric cancers that may occur during childhood, adolescence, or young adulthood.
Health Links are designed to provide health information for survivors of pediatric cancer, regardless of whether the cancer occurred during childhood, adolescence, or youngadulthood.
Disclaimer and Notice of Proprietary Rights
Introduction to Late Effects Guidelines and Health Links: The Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancers and accompanying Health
Links were developed by the Children’s Oncology Group as a collaborative effort of the Late Effects Committee and Nursing Discipline and are maintained and updated by the Children’s
Oncology Group’s Long-Term Follow-Up Guidelines Core Committee and its associated Task Forces.
To cancer patients (if children, their parents or legal guardians): Please seek the advice of a physician or other qualified health provider with any questions you may have regarding a
medical condition and do not rely on the Informational Content. The Children’s Oncology Group is a research organization and does not provide individualized medical care or treatment.
To physicians and other healthcare providers: The Informational Content is not intended to replace your independent clinical judgment, medical advice, or to exclude other legitimate
criteria for screening, health counseling, or intervention for specific complications of childhood cancer treatment. Neither is the Informational Content intended to exclude other reasonable
alternative follow-up procedures. The Informational Content is provided as a courtesy, but not intended as a sole source of guidance in the evaluation of childhood cancer survivors. The
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