HEALTH PROMOTION

This page is part of the PanCare PLAIN summaries about late effects and recommendations for long-term follow-up care for survivors of childhood, adolescent, and young adult cancer. Click here, for more information on the PLAIN summaries.

A healthy lifestyle: taking care of your body

Living a healthy lifestyle means taking care of your physical and mental wellbeing. Overall, a healthy lifestyle can make you feel more energised, help you cope better with stress and to have a more positive outlook on life. Regularly making healthy decisions can reduce your risk of physical health problems such as diabetes, heart problems and some types of cancer.

Taking care of your body can make you feel better mentally. And when you feel happier, it is often easier to make healthy choices for your body as well. This brochure focuses on the things you can do to take better care of your body. For more information on how to improve your mental health, please read: Mental health promotion.

The biopsychosocial model describes the connection between:

  • Physical health (bio)
  • Mental or psychological health (psycho)
  • Social wellbeing (social)

The biopsychosocial model
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BioRender.com

Hover over the numbers in the figure for more information.

Some general rules

A healthy lifestyle includes regular exercise, eating healthy (and a wide variety of) foods, drinking enough fluids and getting enough sleep. Other important parts of a healthy lifestyle are taking good care of your mouth and teeth and protecting your skin from the sun.

In general, adults are advised to:

  • Exercise. Having an active lifestyle, including activities that get you at least slightly out of breath, will help you to keep your heart, lungs and blood vessels healthy. This might be brisk walking, swimming, sport of any kind, cycling, dancing, house or garden work for at least 150 minutes a week. Muscle strengthening activities help to keep muscles and bones strong. Try to do these types of activities twice a week. Examples would be lifting weights, running or exercising with resistance bands however climbing stairs, walking up hills, carrying shopping or children would also help.
  • Maintain a healthy weight. To determine if you have a healthy weight, you can calculate your Body Mass Index (BMI) or measure your waist circumference. To maintain a healthy weight, you should eat roughly the same amount of calories as your body uses up in one day. On average, this is 2000 calories for women and 2500 calories for men. The amount of calories the body needs differs between people and depends on your body structure, your genes and how active you are.
  • Eat healthy foods from each of the five food groups (fruits, vegetables, proteins, dairy and grains). Eating a wide variety of foods is important to prevent any nutrients or vitamin deficiencies. In case you have been diagnosed with a deficiency, your doctor may prescribe vitamin supplements.
  • Avoid (too much) sun exposure, especially in the middle of the day. When you go outside, it is recommended to use sunscreen with a high SPF and wear protective clothing.
  • See a dentist every 6 to 12 months.
  • Quit smoking (if you smoke) and limit your exposure to second-hand smoke. This includes cigarettes, cigars and pipes. Vaping is sometimes used to help people quit smoking, but still involves health risks and should not be taken up by people who do not already smoke. Your general practitioner can also help you if you want to quit smoking.
  • Avoid drinking alcohol. If you want to drink alcohol, drink no more than one unit of alcohol a day. Your general practitioner can help you if you want to stop.
  • Avoid taking recreational drugs. Your general practitioner can help you if you want to stop.
  • Limit your salt intake. Adults are recommended to eat no more than 6 grams of salt a day (about a teaspoon). In order to help monitor this it is helpful to note that processed food can contain a lot of salt. The salt used to cook both pasta and vegetables is also eventually eaten with food.
  • Drink at least 1.5 to 2 litres of fluids a day. Water is the healthiest drink but some of the daily fluid could be tea or milk.
  • Sleep 7 to 9 hours a night.
  • Avoid loud noises. It is important to prevent damage to the ears by avoiding loud noises or by wearing ear defenders (for example, at concerts or parties).
  • Practise safe sex (if you are sexually active). To prevent contracting diseases that can be transmitted by sex (STDs), condoms are very effective. If you want to have sex without a condom, for example when you are in an exclusive relationship, it is advised to test forsexually transmitted diseases (STDs) beforehand. Your general practitioner can provide you with more information on preventing STDs.
  • Vaccinations. Make sure that you have caught up with your childhood vaccination programme and that you have all vaccinations as recommended by your national vaccination guidelines. Your general practitioner will be able to provide more information regarding vaccinations.

It is important to keep in mind that these are just some general ‘rules’. There is no ‘one-size-fits-all’ approach for improving your lifestyle. If you would like to make a considerable change to your lifestyle (such as losing or gaining large amounts of weight or taking up intensive exercise), you may want to consult your general practitioner or other relevant specialists (see What can I do to improve my lifestyle?).

Why is a healthy lifestyle important for me?

A healthy lifestyle is beneficial for everyone who wants to prevent health problems, feel their best and stay healthier as they age. This is also relevant for people who have never had cancer treatment.

Some previous cancer treatments may increase the risk of having certain health problems later in life (late effects). A healthy lifestyle can help reduce or even prevent some late effects of childhood cancer and its treatment. That is why, for people who have received cancer treatment, living a healthy lifestyle is especially important.

Your risk of experiencing late effects – and which type of late effects you experience – depends, among other things, on the cancer treatment(s) you received. You can find out which treatment(s) you have received by looking at your treatment summary. If you do not have a treatment summary or if you have any questions, do contact your treating hospital.

Although a healthy lifestyle can often help prevent or reduce the severity of late effects, this is not always the case. Equally, if you go on to experience health problems after receiving cancer treatment, it does not always mean that this was caused by cancer or its treatment.

What tests should I have and when?

It is advised to measure your height, weight and calculate your BMI regularly. How often you should do this depends on your age:

  • Children (0-18 years): Every year
  • Adults (19 years and older): Every 5 years

For both children and adults, it is advised to measure blood pressure at least once every 5 years. Depending on your risk of being overweight or obese and/or having high blood pressure, you may be advised to have these measurements done more often. For more information on being overweight or obese and high blood pressure, please read: Overweight and obesity, Hypertension.

What can I do to improve my lifestyle?

If you would like to make changes to your lifestyle, you may want to consult your general practitioner or follow-up care specialist for advice. They can help you decide which changes to your lifestyle may be the most beneficial for you. They may also know if there are any programs available to support you, such as online coaching. Furthermore, they could refer you to a specialist.

Depending on the lifestyle change you are looking to make, you may be referred to a:

  • Physiotherapist (healthcare professional specialised in exercise) or occupational therapists (healthcare professional specialised in supporting people in their everyday activities)
  • Dietician (specialist who advises on eating habits and lifestyle)
  • Lifestyle coach (specialist who advises on a healthy lifestyle)
  • Psychologist (healthcare professional specialised in mental health)

The specialist may discuss different options with you for how you can improve your lifestyle.

What else can I do?

Making a positive change to your lifestyle is not always easy and takes time. Usually, it is not necessary to make a big change overnight. Even small changes to your lifestyle can have a positive impact on both your physical and mental health. For example, you could:

  • Walk or cycle short distances instead of taking the car or public transport.
  • Take the stairs instead of the lift.
  • Swap unhealthy snacks for fruit or vegetables that you like.
  • Go for a short walk after lunch or dinner.
  • Only allow unhealthy snacks on the weekends.
  • Swap using your phone for reading a book before bedtime.

When trying to improve your lifestyle, it is important to make a change that you feel comfortable with and that fits your life. This way, it will be easier for you to keep up. Here are some tips that can help you make a positive, lasting change:

  • Choose a sport or activity that you enjoy. Not everyone enjoys going to the gym, and that’s ok! Try different activities and find one that you enjoy.
  • Make a positive change together. For example, ask a friend or family member to exercise with you.
  • Set small, achievable goals. Big goals are much harder to achieve and you may feel discouraged if you do not reach them. On the other hand, reaching a smaller goal may empower you to maintain the lifestyle changes you have made.
  • Don’t follow very strict diets. They are often hard to keep up and can even be dangerous. It is important that your body gets the energy and nutrients it needs. Furthermore, when you lose weight gradually, it is more likely to stay off.
  • Don’t be too hard on yourself. It’s fine to have a piece of cake or fizzy drink every now and then, if you otherwise stick to a healthy diet.

If you have any further questions about improving your lifestyle, please contact your general practitioner or follow-up care specialist.

Where can I find more information?

You may find more information about living a healthy lifestyle online. However, it is important to be aware that this information is not always up to date or accurate.

Some sources of further information are:

  • NHS: Here you can find information about healthy living

On this website, you can also find more information related to these topics:

Please note

This PLAIN summary is based on the PanCareFollowUp guideline about “Health promotion” [1], which is based on the consensus of different national guidelines.

While the PanCare PLAIN information group strives to provide accurate and complete information that is up-to-date as of the date of publication, you can check with your general practitioner or follow-up care specialist if this summary reflects the most up-to-date information available and whether it is relevant for you.

Please do not rely solely on this information. It is best to also seek the advice of a qualified medical practitioner if you have questions regarding a specific medical condition, disease, diagnosis or symptom.

No warranty or representation, expressed or implied, is made concerning the accuracy, reliability, completeness, relevance, or timeliness of this information. PanCare has produced the English version and PanCare is not responsible for the translated versions of this summary.

The PanCare materials are free to use for anyone aiming to inform about late effects and long-term survivorship care. However, no financial advantage may be achieved. All communication should reference PanCare and link to the PanCare website.

[1] van Kalsbeek, R. et al. (2021) European PANCAREFOLLOWUP recommendations for surveillance of late effects of childhood, adolescent, and Young Adult Cancer, European journal of cancer. Available at: https://www.ejcancer.com/article/S0959-8049(21)00368-3/fulltext.