This study focused on healthy lifestyles of adults who had cancer during childhood. It looked at how healthy lifestyles — such as eating well or being physically active — varied between survivors who received more or less heart-damaging cancer treatments. Understanding these patterns helps doctors and survivors focus prevention efforts where they are most needed.
Lay Summary of Ruijie Li’s Study
What did we want to find out with our study?
Some cancer treatments used in childhood cancer affect the heart later in life. As a result, survivors of childhood cancer may have a higher risk of developing heart disease when reaching adulthood.1,2 A healthy lifestyle—such as eating well, being physically active, and avoiding smoking—can help reduce this risk.3,4
We wanted to find out whether adult survivors who received more heart-damaging cancer treatments have healthier lifestyles than those who received lower-risk treatments.
Why is this important?
Heart disease can develop slowly over many years. Survivors who are at higher risk because of their earlier treatment usually receive closer medical follow-up than those at lower risk. However, it is unknown whether they also take better care of their health in daily life.
Understanding this helps doctors and survivors focus prevention efforts where they are most needed.
What exactly did we do?
We invited 365 adults who survived childhood cancer to take part in a health assessment. We measured height, weight, blood pressure, and blood markers, and collected information on heart disease, cancer treatments, and lifestyle habits such as diet, physical activity, smoking, alcohol use, and time spent sitting. Participants were grouped in “low”, “moderate”, or “high” according to how risky their cancer treatment was for their heart, based on the type and dose of chemotherapy and radiation they received.
What did we find out and what does this mean?
Heart disease was rare: only about 6 out of 100 people were affected, and it occurred just as often in people from all treatment risk groups. More than half of survivors had at least one risk factor for future heart disease, such as high cholesterol, obesity, high blood pressure, or diabetes.
Lifestyle habits were similar across all risk groups:
- Diet quality was generally poor
- Most survivors met WHO physical activity recommendations, but many still spent long periods sitting, with around one third spending more than eight hours a day sitting
- About 12% of survivors currently smoked, and around 2% reported drinking alcohol daily or frequently
- Sleep duration was generally within the healthy range (7-9 hours per night)
People who had received higher-risk heart treatments did not have a healthier—or less healthy—lifestyle than others.
What do we recommend now?
Supporting a healthy lifestyle should be a regular part of follow-up care for everyone who survived childhood cancer. Survivors could protect their heart health by eating well, being physically active, sitting less, quitting smoking, drinking less alcohol, and get regular checks of heart health as part of their follow-up care.
Reference: Li R, Iniesta R R, Barker A R, Vlachopoulos D, Sláma T, Schindera C, & Belle F N. Lifestyle Behaviors and Cardiotoxic Treatment Risks in Adult Childhood Cancer Survivors. Pediatric Blood & Cancer. 2026. doi:10.1002/1545-5017.70089
Literature:
- Mainieri, F., et al., 2022. doi: 10.3390/biomedicines10123098.
- Mulrooney, D.A., et al., 2016. doi: 10.7326/M15-0424.
- Li, R., et al., 2024. doi: 10.3390/nu16091315.
- Wogksch, M.D., et al., 2021. doi: 10.1002/aac2.12042.
You can find the full article in English here.
Contact:
Dr. Fabiën Belle (fabien.belle@unibe.ch)
Here you can download the lay summary: