Implementation of regular lifestyle counseling during long-term follow up care of childhood cancer survivors: a monocentric prospective study (Preprint)

BACKGROUND Many childhood cancer survivors (CCS) develop treatment-related late effects, including increased risk of obesity and metabolic syndrome. A healthy lifestyle can reduce the risk of associated comorbidities. Therefore, at-risk CCS could benefit from lifestyle counseling during regular long term follow up (LTFU). OBJECTIVE We implemented a new form of care to decrease the long-term morbidity among CCS and to gain new insights about the lifestyle of those patients. METHODS Over a one-year study period, lifestyle counseling was integrated into LTFU care. Metabolic disorders, including hypercholesterolemia, diabetes mellitus, over-/underweight, and low activity levels, were assessed as screening parameters for various risk groups. The perspectives of CCS, physicians, and sports scientists were compared to identify those with the highest needs. A follow-up appointment after one month was performed. RESULTS Of the 155 CCS aged 18 to 63 years (65% female, 35% male), 112 (72%) had an indication for lifestyle counseling, identified by physicians, sports scientists, or the CCS themselves. Metabolic disorders affected 45%, and 46% did not meet recommended activity levels. A total of 120 CCS (77%) received lifestyle counseling, including 8 initially uninterested individuals who became open to recommendations. Those with intensive cancer treatment history showed the greatest need. Follow-up revealed high adherence to recommendations and successful integration into daily lives, with 97% of survivors finding the provision of lifestyle counseling during LTFU beneficial. CONCLUSIONS Incorporating specialized healthcare professionals into survivorship care enhances the multidisciplinary approach, promoting a healthy lifestyle and potentially reducing long-term morbidity among CCS.