Well-being Pathway (We-Path): An Italian integrative oncology community-based program for cancer survivors.

Abstract

e13874 Background: Integrative oncology underlines the role of nutrition, physical activity, and healthy lifestyle habits in enhancing survival and mitigating treatment-related toxicity in cancer patients. According to survivorship care guidelines, we aim to implement an integrative oncology community-based program that provides lifestyle counseling (LC) and adapted physical activity (APA) to cancer survivors. Here, we present preliminary 12-month results. Methods: During scheduled follow-up, the oncologist directly refers survivor cancer patients to the program based on identified risk factors or symptoms, including sedentary, overweight, smoking, metabolic syndrome, and delayed adverse events.We collect signed informed consent, anthropometric measures, lifestyle habits, overall quality of life (QoL), global health status (GHS), and patient satisfaction. The LC involves a one-hour consultation with a physician according to lifestyle medicine's six pillars. Patients are encouraged to identify the most critical topics by filling out the Macmillan concerns checklist. Motivation and tailored indications are provided to support the patient's engagement in a healthy lifestyle.The APA program, developed by an orthopedic surgeon and a kinesiologist, consists of 60-minute supervised exercise sessions in small groups twice weekly for two months. Pre- and post- tests included six-minute walking (6MWT), five times sit-to-stand (5xSTS), and handgrip strength (HGS) functional assessments. Results: 138 out of 168 referred patients have attended the program overall. The median of years since diagnosis was 3. 65 received LC alone, 46 started APA, and 26 attended both. Of note, 90% were breast cancer women. The median age was 54; most had a secondary school degree and were employed. 63.2% of patients did not engage in regular physical activity according to survivorship recommendations, 52.2 % reported poor sleep quality, and 47.1% of patients were overweight or obese. The mean GHS/QoL score at baseline was 71.3 (15.8). At initial evaluation, 68 breast cancer women included in APA groups covered a distance of 426 (96) m during 6MWT, completed 5xSTS in 9.7 (3.1) sec , and reported an average HGS of 25.4 (3.8) Kg . All functional measures improved after the APA intervention (p < 0.001).Most patients (82%) reported being satisfied with the program. Finally, no complications were identified. Follow-up is ongoing to evaluate patients' GHS/QoL and engagement. Conclusions: Survivors require tailored lifestyle education and supervised exercise intervention during follow-up to recover well-being after cancer treatment. Our integrative oncology community-based program, mostly participated by breast cancer women, highlights the importance of clear referral pathways for all cancer patients by involving oncologists, who play a pivotal role in influencing adherence to survivorship care guidelines.