Urologic Oncology: Seminars and Original Investigations
Original articleDietary patterns and health-related quality of life in bladder cancer survivors
Section snippets
1. Introduction
Society and medicine are placing an increasing emphasis on cancer survivorship [1]. As the population continues to age and cancer treatment evolves, the number of cancer survivors is expected to increase. Greater numbers will then be faced with the physical and psychosocial challenges of recovering from cancer and its treatment [2], [3]. This population is already known to have elevated risks of mortality and chronic health conditions [4]. Thus, it is important to align our goals of increased
2.1. Subjects
After approval by the Duke University Health System Institutional Review Board, potential subjects were identified through an institutional database and screened on predefined inclusion and exclusion criteria. Inclusion criteria were: (1) age ≥ 18 years, (2) history of care at our institution, and (3) histologically confirmed diagnosis of bladder cancer. Exclusion criteria were: (1) deceased, (2) inability to read/write English, (3) last known follow-up > 2 years prior, and (4) known cognitive
3.1. Survey response
Nearly half of subjects returned surveys (459 of 952). Clinicodemographic characteristics are summarized in Table 1. Female gender, current smoking status and longer time to last procedure were associated with lower odds of response (P < 0.005; 11 variables). Among respondents, the majority of subjects had low-stage disease and underwent transurethral resection as the primary procedure. Most subjects that underwent radical cystectomy received an ileal conduit. Only 5 subjects who returned
4. Discussion
To the best of our knowledge, this study is the largest to comprehensively assess diet quality and dietary patterns in bladder cancer survivors. Dietary patterns in our cohort were similar to the age-matched general U.S. population and prior cancer survivorship studies [1]. The average diet quality is one that “needs improvement” according to the HEI 2010. Both diet quality and dietary patterns did not differ significantly between those managed conservatively or via extirpative surgery. The
5. Conclusions
This large cohort of bladder cancer survivors had moderate adherence to the USDA's Dietary Guidelines for Americans with dietary patterns very similar to the older general U.S. population. Diet was not significantly different between those managed conservatively and long-term survivors following radical cystectomy. Compared to USDA recommendations, our cohort had particularly low intake of whole grains and fat-soluble vitamins, including vitamin D. Diet quality was significantly associated with
Conflict of interest
None.
Acknowledgments
I would like to acknowledge Dr. Kevin Weinfurt and Dr. Maragatha Kuchibhatla for their valuable input in the critical revision of this manuscript. They did not receive any compensation for their contributions.
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Funding: Research reported in this publication was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number TL1TR001116. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.