High incidence of metabolic diseases and sedentary lifestyle underline the need for regular counseling in LTFU for CCS- results from a monocentric prospective study

Abstract

Background Many childhood cancer survivors (CCS) develop treatment-related late effects years after the end of treatment, including increased risk of obesity, metabolic syndrome and related diseases. A healthy lifestyle can reduce the risk of associated comorbidities. Lifestyle counseling during regular long term follow up (LTFU) care could benefit these at-risk CCS. Methods Lifestyle counseling was implemented within LTFU care over the study period of one year. Metabolic markers and activity levels were prospectively evaluated as screening parameters for different risk groups. Perspectives of CCS, Physician and sports scientist were compared to identify those in need of counseling. Additionally, a follow-up appointment after one month was performed. Results During the counseling offer, 155 CCS (65% female, 35% male) aged between 18 and 63 years (median:30 years) were contacted. Among them, 112 CCS (72%) had an indication for lifestyle counseling based on assessments from physicians, sports scientists, or CCS themselves. 45% were affected by metabolic disorders, 25% met the criteria through BMI and 46% did not meet the recommended activity levels. A total of 120 CCS (77%) received lifestyle counseling, with those who underwent intensive cancer treatment showing the highest need. During the follow-up appointment, CCS indicated high adherence to recommendations and successful implementation into their daily lives. Conclusion Metabolic disorders and reduced physical activity impact around two-thirds (68%) of CCS. Nearly all survivors (97%) find the provision of lifestyle counseling during regular LTFU beneficial. Incorporating specialized healthcare professionals into survivorship care enhances the multidisciplinary approach and can aid in promoting a healthy lifestyle, potentially reducing long-term morbidity among CCS.