American Cancer Society nutrition and physical activity guideline for cancer survivors


Cheryl L. Rock, UC San Diego School of Medicine
Cynthia A. Thomson, The University of Arizona
Kristen R. Sullivan, American Cancer Society
Carol L. Howe, The University of Arizona Health Sciences
Lawrence H. Kushi, Kaiser Permanente Division of Research
Bette J. Caan, Kaiser Permanente Division of Research
Marian L. Neuhouser, Fred Hutchinson Cancer Research Center
Elisa V. Bandera, Rutgers Robert Wood Johnson Medical School at New Brunswick
Ying Wang, American Cancer Society
Kimberly Robien, Milken Institute School of Public Health
Karen M. Basen-Engquist, University of Texas MD Anderson Cancer Center
Justin C. Brown, Pennington Biomedical Research Center
Kerry S. Courneya, University of Alberta
Tracy E. Crane, The University of Arizona
David O. Garcia, The University of Arizona
Barbara L. Grant, St. Alphonsus Regional Medical Center
Kathryn K. Hamilton, Morristown Medical Center
Sheri J. Hartman, University of California, San Diego
Stacey A. Kenfield, University of California, San Francisco
Maria Elena Martinez, University of California, San Diego
Jeffrey A. Meyerhardt, Harvard Medical School
Larissa Nekhlyudov, Harvard Medical School
Linda Overholser, University of Colorado School of Medicine
Alpa V. Patel, American Cancer Society
Bernardine M. Pinto, University of South Carolina College of Nursing
Mary E. Platek, D'Youville College
Erika Rees-Punia, American Cancer Society
Colleen K. Spees, The Ohio State University College of Medicine
Susan M. Gapstur, Epidemiology Consultant
Marjorie L. McCullough, American Cancer Society

Document Type

Journal Article

Publication Date



CA Cancer Journal for Clinicians




alcohol; cancer survivors; dietary patterns; nutrition; obesity; physical activity


The overall 5-year relative survival rate for all cancers combined is now 68%, and there are over 16.9 million survivors in the United States. Evidence from laboratory and observational studies suggests that factors such as diet, physical activity, and obesity may affect risk for recurrence and overall survival after a cancer diagnosis. The purpose of this American Cancer Society guideline is to provide evidence-based, cancer-specific recommendations for anthropometric parameters, physical activity, diet, and alcohol intake for reducing recurrence and cancer-specific and overall mortality. The audiences for this guideline are health care providers caring for cancer survivors as well as cancer survivors and their families. The guideline is intended to serve as a resource for informing American Cancer Society programs, health policy, and the media. Sources of evidence that form the basis of this guideline are systematic literature reviews, meta-analyses, pooled analyses of cohort studies, and large randomized clinical trials published since 2012. Recommendations for nutrition and physical activity during cancer treatment, informed by current practice, large cancer care organizations, and reviews of other expert bodies, are also presented. To provide additional context for the guidelines, the authors also include information on the relationship between health-related behaviors and comorbidities, long-term sequelae and patient-reported outcomes, and health disparities, with attention to enabling survivors' ability to adhere to recommendations. Approaches to meet survivors' needs are addressed as well as clinical care coordination and resources for nutrition and physical activity counseling after a cancer diagnosis.


Exercise and Nutrition Sciences