Importance of lifestyle modification in cervical cancer survivors.

Abstract

e15521 Background: With the introduction of multimodality therapy for cervical cancer many women will be long-term survivors in need of comprehensive postsurveillance care. Lifestyle modifications are critical components of such care. Our goal was to evaluate patterns of obesity and smoking in a cohort of cervical cancer survivors. Methods: We reviewed the records of patients treated for invasive cervical cancer at our institution from 2000-2003 who were NED ≥ 3 years. Demographic and clinical information was collected, including smoking history and anthropometric measurements. BMI was categorized according to WHO criteria. Logistic regression, Wilcoxon-signed rank test, and chi-square analyses were performed. Results: Of the101 women with complete follow-up data at 3 years, median age at diagnosis was 44.4 yrs (mean 45.2; range, 23.9-75.7). 68% were White; 16% were Hispanic; 14% were Black. At diagnosis, 38% had a normal BMI, 22% were overweight, and 41% were obese compared with 35%, 20%, and 46% at 3 years, respectively. Of the 21 women whose BMI categorization changed, only 15 had weight gain, and 6 lost weight. By paired analysis, increase in BMI was significant over the 3-year interval (n = 65) (p < 0.01). There was a trend for more psychiatric consults in obese women (p = 0.1), and only 7 had nutrition consults. 50 patients were nonsmokers; 25 formerly smoked, and 26 actively smoked at diagnosis. Smoking cessation was discussed with 15 patients and 1 patient accepted referral. Compared with nonsmokers, ever smokers were more likely to experience treatment complications (OR 2.6; 95%CI [1.2, 5.8]) and have consults by the pain service (p = 0.01). Current smokers also appeared to be at greater risk for radiation cystitis (OR 3.2, p = 0.1). Median time to GU consult for ever smokers was less than never smokers (11 vs. 51 mos). Conclusions: Obesity and smoking may significantly complicate care in cervical cancer patients during the survivorship phase of the cancer continuum. It is crucial for oncologists and primary care physicians to reinforce healthy lifestyle changes in these women. In 2008, our institution began offering comprehensive services in the GYN Survivorship Clinic, a major aim of which is to provide patients with lifestyle management strategies. No significant financial relationships to disclose.