Work area: Cancer survivors

One of our research goals – and key work areas – in the Global Cancer Update Programme (CUP Global) is cancer survivors.

On this page:

> Survivors of childhood cancers
> Survivors of adult cancers

The cancer survivors work encompasses reviews of adult cancer survivors and childhood cancer survivors. Every 2-3 years a data prioritisation exercise will determine when evidence could be/needs to be updated in the area of cancer survivorship (both for medical outcomes such as mortality and quality of life outcomes, covering evidence around specific exposures, eg physical activity, body weight).

Survivors of childhood cancers

Aims: Determining the impact of diet, nutrition and physical activity on children from diagnosis and into adult life

Benefits of approach

  • Development of evidence-based recommendations for survivors of childhood cancers that maximise treatment efficacy, minimise treatment-related toxicity and promote long and healthy survivorship
  • Improved research methods- eg developing a paediatric acute leukaemia systematic review protocol and criteria for judging the evidence on medical and quality of life outcomes for childhood cancer survivors
  • Ability to address critical research questions – eg evaluating role of diet, nutrition and physical activity across the spectrum of childhood cancer types

This is a new area for WCRF and the Transition Panel identified it as having particular importance since the CUP Global process offers a unique and efficient approach to synthesising available evidence and establishing evidence based conclusions/ recommendations for survivors of childhood cancer.

Survival for those diagnosed with cancer in childhood (<21 years of age) has improved dramatically in recent decades, but survivors of childhood cancer are at risk of developing an array of adverse health-related complications from aggressive, yet increasingly successful, curative therapy.

There’s demand from clinicians, families, and patients for evidence-based advice on the role of diet, nutrition and physical activity to enhance the efficacy of therapy and reduce the severity of treatment-related toxicity, over both the short- and long-term.

A comprehensive analysis of the existing published literature on diet, nutrition, and physical activity in childhood cancer survivors, using rigorous methodology, has not yet been done. Such an analysis would provide a foundation for diet, nutrition and physical activity recommendations that can be integrated into current care.

It will also define critical gaps in research and knowledge, suggesting opportunities for research on these topics and incentivising incorporation of diet, nutrition and physical activity assessment into ongoing and future clinical therapeutic trials.

Developing a paediatric acute leukaemia systematic review protocol and criteria for judging the evidence for medical and quality of life outcomes for childhood cancer survivors will form part of future CUP Global work. Paediatric acute leukaemia has been prioritised as it is the most common childhood cancer, with the most evidence to date.

Survivors of adult cancers

Aims: Identifying the impact of diet, nutrition and physical activity following a cancer diagnosis

Benefits of approach

  • More specific and stronger recommendations for cancer survivors
  • Improved research methods eg development of systematic review protocols for prostate and colorectal cancer (medical outcomes), and for assessment of quality of life outcomes
  • Identification of topics to pursue in future research eg evaluating role of diet, nutrition and physical activity in survivors of different cancer types

The aspiration to build the knowledge base for cancer survivors started in the previous CUP, with breast cancer survivors the first cancer type reviewed. Despite the enormous demand for reliable estimates and advice from the lay, medical and research worlds, the availability and quality of evidence has so far been insufficient to support robust, evidence-based diet, nutrition and physical activity recommendations that are specific for cancer survivors overall, or for survivors of specific types of cancer.

In recent years there has been a substantial growth in the volume of research among survivors of breast and other common cancers, especially colorectal and prostate cancers. This provides an opportunity to augment the previous analyses for breast cancer survivors by applying a similar approach to prostate and colorectal cancer survivors.

The workstream developed detailed protocols to allow for systematic analysis of colorectal and prostate cancer studies in the first instance. These systematic reviews, being implemented as part of CUP Global, will provide our first evidence conclusions and recommendations based on comprehensive syntheses of evidence concerning the role of diet, nutrition and physical activity on medical outcomes in prostate and colorectal cancer survivorship.

Additionally, quality of life measures will be evaluated, building on the pilot work done in this area for breast cancer survivors and providing additional novel and important contributions to the field of survivorship research.

> Find out more about the Cancer Survivors expert committee

> Read an overview of the Global Cancer Update Programme

> Find out more about the CUP Global Strategy