Lifestyle medicine is the science of preventing, treating, and reversing chronic disease in an evidence-based manner with optimizing and adapting lifestyle decisions to better support health.
Most health professionals treat chronic diseases with pills and injections. As physicians, we know these treatments can temporarily relieve acute symptoms and that is a true benefit. However, most of us would also agree that pills and injections don’t address the underlying cause of chronic disease.
Lifestyle medicine is a specialty that uses therapeutic lifestyle interventions to address key health behaviors that contribute to premature death, chronic disease, and healthcare costs. Lifestyle medicine focuses on addressing the underlying causes of disease.
Presenting patients with evidence-based behavior change strategies encourages them to make lasting lifestyle choices in key areas of their lives, from better nutrition to stress management. These interventions not only help relieve symptoms and reduce dependence on prescriptions, but evidence shows that they often help prevent chronic disease, including cancer.
Approximately 40% of all cancer cases in the U.S. could be prevented through health-related choices, such as vaccinations and modifiable lifestyle factors, according to the American Cancer Society. But lifestyle medicine isn’t only used as a preventive measure; it can benefit patients who have cancer. At Rocky Mountain Cancer Centers (RMCC), we regularly see the benefits of addressing lifestyle choices with patients. Dr. Patrick Richard, board-certified radiation oncologist at RMCC, talks about his experience with lifestyle medicine as he seeks to become board-certified in lifestyle medicine.
“When talking about cancer treatments and survivorship, my approach is to holistically evaluate my patients' current lifestyle and how their lifestyle choices may impede the treatment and impede them into life after treatment’” Dr. Richard said. “Lifestyle choices are important in every facet of our being: What we eat, what we breathe, and how we move are some of the ways we maintain or minimize disease.”
The 6 Pillars of Lifestyle Medicine
Many consider lifestyle medicine to be a relatively new subspecialty, but it has been practiced for thousands of years. The value of food as medicine was acknowledged centuries ago by Hippocrates. Public health recommendations for lifestyle modification, including diet and physical activity, have been widely encouraged for decades as preventive medicine.
The American College of Lifestyle Medicine (ACLM), the medical professional society that provides education and certification in lifestyle medicine, outlines the six pillars of lifestyle medicine:
- Nutrition – Eating a whole-food, plant-based eating pattern that avoids red meat, cold cuts, and other processed foods
- Physical activity – Getting regular and consistent activity to combat the negative effects of sedentary behavior
- Restorative sleep – Sleeping seven or more hours per night to promote optimal health
- Stress management – Identifying coping mechanisms for managing stress leads to improved well-being
- Avoidance of risky substances – Avoiding tobacco, alcohol, and recreational drugs
- Positive social connections – Engaging in healthy relationships and social support that help boost physical, mental, and emotional health
Coaching patients to adopt healthy behaviors summarized by the six pillars has been linked to improved overall health outcomes and decreased healthcare spending for both employers and patients. Motivated patients are also put on the path to sustainable, lifelong behavioral change.
Lifestyle Medicine and Cancer Care
Most physicians receive little or no formal education in medical school that supports the importance of nutrition, physical activity, sleep, and other lifestyle factors that impact health. However, physicians who spend time becoming familiar with the basics of lifestyle medicine greatly enrich the strategies they can use to help patients build habits that support their overall health as they receive treatment. At RMCC, where physicians are relentlessly dedicated to their patients’ health, having a lifestyle medicine discipline gives clinicians an enhanced approach to treatment.
This is particularly important for people with cancer, as there are several known risk factors that contribute to the development or recurrence of the disease.
“Initially, when seeing a patient, we look at what are the risk factors of getting cancer, recurrence of cancer, and how our treatments may affect each patient,” Dr. Richard said. “We look at their medical history and risk factors, such as hypertension and diabetes, lifestyle, such as smoking, eating habits, having insomnia or chronic stress. These are things we do and will continue to address with patients.”
For example, obesity is a well-recognized risk factor for cancer and is linked with a higher risk of getting 13 types of cancer and having that cancer recur.
“I encourage referring physicians to take a macro and micro evaluation of their patients,” Dr. Richard said. “The macro view is looking at their medical issues, and the micro view is delving into their lifestyle issues. Not just, ‘Do they have diabetes?’ but ‘Do they exercise?’ This will help determine if there is anything that can be modified to help better outcomes.”
Lifestyle medicine during cancer treatment, sometimes referred to as integrative oncology, can help patients during the treatment process. Stress and anxiety are to be expected when patients are diagnosed with cancer. Lifestyle medicine includes promoting relaxation techniques to cope with stress and help encourage healthy behaviors to fight the fatigue that comes with cancer treatment.
The same factors that can decrease cancer risk may also discourage cancer recurrence after treatment. The American Institute for Cancer Research reports healthy behaviors, such as improved diet, physical activity, and weight control are major contributors to long-term survival after a diagnosis of breast cancer. Reducing the risk of a recurrence is part of the lifestyle medicine plan at RMCC.
“After treatment, we assess what therapies they received and their individual risk of recurrence,” Dr. Richard said. “We point out anything that can be addressed in their lifestyle to modify risk of recurrence and other medical problems.”
A nutrition physical or assessment may also be performed, which includes collecting information about dietary practices, current treatment, and food security. The assessments help identify obstacles to adopting healthy behaviors, followed by referrals to resources and support.
Making lifestyle changes to improve health can be a challenge for the average patient, but after cancer treatment most patients are motivated to do everything they can to minimize the risk of a recurrence. Once patients start seeing the impact of lifestyle changes and how they affect their general well-being, they usually become lifelong adherents.
Meanwhile, if one of your patients develops cancer and you refer them to RMCC for treatment, their team will incorporate lifestyle medicine into their treatment approach.
“Being certified in Lifestyle Medicine helps us provide better cancer survivorship care,” Dr. Richard said. “My aim is to take this research and implement it into practice.”
Do you have a cancer patient who would benefit from lifestyle medicine? Refer a patient today.
