The survey of cancer specialists from a Midwestern health system showed that oncologists were much less likely than primary care physicians to give advice on health promotion strategies, including smoking cessation and weight loss, researchers reported in the journal Cancer.
With oncologists reticent to offer advice on changes of lifestyle, the onus might fall upon patients in order to bring the topic up and to find their own ways to address changes, said coauthor Bonnie Spring, a professor of preventive medicine, psychology, psychiatry, and public health and also the director of the Institute for Public Health and Medicine at Feinberg School of Medicine of Northwestern University in Chicago.
Spring said that patients need to realize their own lifestyle, weight, physical activity, smoking, and all of these things have a great influence on the likelihood their cancer will recur.
In order to investigate oncologist attitudes towards lifestyle changes, Spring along with her colleagues surveyed 91 doctors, including 30 oncologists, 30 primary care physicians, and 31 physicians in other specialties such as gynecologists, urologists, and dermatologists who treat survivors of melanoma, breast cancer, and prostate cancer.
90% of primary care physicians said that they recommend lifestyle changes like smoking cessation and weight loss to at least some cancer survivors. That was true for just 9.7% of specialists and 26.7% of oncologists.
The researchers conducted deep interviews with 12 of the 30 oncologists, who cited some concerns which drove their decision not to offer lifestyle counseling. The reason was that they feared their patients wouldn’t be able to change their lifestyle and continue to take their medications properly.
Many thought that cancer control was their primary concern. They were so focused on the life-or-death aspect of cancer, so everything else fell through the cracks.
Some others weren’t convinced by the studies showing that lifestyle factors could impact the risk of cancer. When oncologists addressed lifestyle factors, it was usually because the patient brought up the subject.
Although the new study reports on data that is gathered at one institution, Spring believes that the same results would be found across the nation and it would be widespread.