{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:45:43Z","timestamp":1785545143844,"version":"3.56.0"},"reference-count":45,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Cancer"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec sec-type=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Many childhood cancer survivors (CCS) develop treatment-related late effects, including an 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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"objective\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We implemented a new form of care to decrease the long-term morbidity among CCS and to gain new insights into the lifestyle of those patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Over a 1-year study period, lifestyle counseling was integrated into LTFU care. Metabolic disorders, including hypercholesterolemia, diabetes mellitus, overweight or 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. Each lifestyle counseling included general recommendations for physical activity, as well as an assessment of individual preferences for and barriers to the implementation of a healthy lifestyle. A follow-up appointment after 1 month was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 155 CCS aged 18 to 63 years (n=100, 65% female and n=55, 35% male), 112 (72%) had an indication for lifestyle counseling, identified by physicians, sports scientists, or the CCS themselves. Metabolic disorders affected 45% (n=70) of these CCS, and 46% (n=72) did not meet recommended activity levels. A total of 120 (77%) CCS received lifestyle counseling, including 8 initially uninterested individuals who became open to recommendations. Those with intensive cancer treatment history showed the greatest need. A total of 65 (54%) CCS were advised to change their lifestyle in both areas (diet and exercise) while 51 (43%) CCS received recommendations for only exercise (n=43 CCS, 36%) or diet (n=8 CCS, 7%). A total of 4 (3%) CCS, although interested in counseling, received no advice, as they already met the recommendations. Follow-up revealed high adherence to recommendations and successful integration into daily lives. In total, 97% (n=150) of survivors indicated that the provision of lifestyle counseling during LTFU would be generally beneficial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Incorporating specialized health care professionals such as sports scientists into survivorship care enhances the multidisciplinary approach of LTFU care. Promoting a healthy lifestyle by offering guideline-based lifestyle counseling is broadly accepted among CCS and may reduce long-term morbidity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/59614","type":"journal-article","created":{"date-parts":[[2024,9,25]],"date-time":"2024-09-25T19:10:42Z","timestamp":1727291442000},"page":"e59614-e59614","source":"Crossref","is-referenced-by-count":1,"title":["Implementation of Regular Lifestyle Counseling During Long-Term Follow-Up Care of Childhood Cancer Survivors: Monocentric Prospective Study"],"prefix":"10.2196","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-6921-7385","authenticated-orcid":false,"given":"Franziska","family":"Richter","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2126-6831","authenticated-orcid":false,"given":"Lea Louisa","family":"Kronziel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0504-6465","authenticated-orcid":false,"given":"Inke","family":"K\u00f6nig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7047-2957","authenticated-orcid":false,"given":"Thorsten","family":"Langer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4428-8010","authenticated-orcid":false,"given":"Judith","family":"Gebauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2024,12,26]]},"reference":[{"issue":"4","key":"R1","doi-asserted-by":"publisher","first-page":"742","DOI":"10.1002\/ijc.34556","article-title":"Temporal patterns of childhood cancer survival 1991 to 2016: a nationwide register-study based on data from the German Childhood Cancer Registry","volume":"153","author":"Wellbrock","journal-title":"Int J Cancer"},{"key":"R2","unstructured":"Erdmann F Kaatsch P Grabow D Spix C . German childhood cancer registry\u2014annual report 2019 (1980-2018). Institut f\u00fcr Medizinische Biometrie, Epidemiologie und Informatik (IMBEI); URL: https:\/\/www.kinderkrebsregister.de\/fileadmin\/kliniken\/dkkr\/pdf\/jb\/jb2019\/Buch_DKKR_Jahresbericht_2019_komplett.pdf [Accessed 27-11-2024]"},{"issue":"10112","key":"R3","doi-asserted-by":"publisher","first-page":"2569","DOI":"10.1016\/S0140-6736(17)31610-0","article-title":"The cumulative burden of surviving childhood cancer: an initial report from the St Jude Lifetime Cohort Study (SJLIFE)","volume":"390","author":"Bhakta","journal-title":"Lancet"},{"issue":"3","key":"R4","doi-asserted-by":"publisher","first-page":"711","DOI":"10.1210\/er.2018-00092","article-title":"Long-term endocrine and metabolic consequences of cancer treatment: a systematic review","volume":"40","author":"Gebauer","journal-title":"Endocr Rev"},{"issue":"32","key":"R5","doi-asserted-by":"publisher","first-page":"3643","DOI":"10.1200\/JCO.2014.56.7511","article-title":"Exercise and risk of major cardiovascular events in adult survivors of childhood hodgkin lymphoma: a report from the childhood cancer survivor study","volume":"32","author":"Jones","journal-title":"J Clin Oncol"},{"issue":"3","key":"R6","doi-asserted-by":"publisher","first-page":"e108","DOI":"10.1016\/S1470-2045(23)00012-8","article-title":"Systematic review and updated recommendations for cardiomyopathy surveillance for survivors of childhood, adolescent, and young adult cancer from the International Late Effects of Childhood Cancer Guideline Harmonization Group","volume":"24","author":"Ehrhardt","journal-title":"Lancet Oncol"},{"issue":"21","key":"R7","doi-asserted-by":"publisher","first-page":"2190","DOI":"10.1200\/JCO.2017.76.5552","article-title":"Psychological symptoms, social outcomes, socioeconomic attainment, and health behaviors among survivors of childhood cancer: current state of the literature","volume":"36","author":"Brinkman","journal-title":"JCO"},{"issue":"3","key":"R8","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD012681.pub2","article-title":"Severe fatigue after treatment for childhood cancer","volume":"3","author":"van Deuren","journal-title":"Cochrane Database Syst Rev"},{"issue":"17","key":"R9","doi-asserted-by":"publisher","first-page":"2742","DOI":"10.1002\/cncr.28670","article-title":"Lifestyle and metabolic syndrome in adult survivors of childhood cancer: a report from the St. Jude Lifetime Cohort Study","volume":"120","author":"Smith","journal-title":"Cancer"},{"issue":"6","key":"R10","doi-asserted-by":"publisher","first-page":"1751","DOI":"10.1007\/s11764-022-01228-6","article-title":"Adherence to healthy lifestyle recommendations in Brazilian cancer survivors","volume":"17","author":"de Lima Melo","journal-title":"J Cancer Surviv"},{"issue":"3","key":"R11","doi-asserted-by":"publisher","first-page":"230","DOI":"10.3322\/caac.21719","article-title":"American Cancer Society nutrition and physical activity guideline for cancer survivors","volume":"72","author":"Rock","journal-title":"CA Cancer J Clin"},{"issue":"1","key":"R12","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.30034","article-title":"Clinical response to lifestyle counseling for dyslipidemia and elevated blood pressure in childhood cancer survivors","volume":"70","author":"Javalkar","journal-title":"Pediatr Blood Cancer"},{"issue":"4","key":"R13","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1093\/jn\/nxz268","article-title":"The World Cancer Research Fund\/American Institute for Cancer Research third expert report on diet, nutrition, physical activity, and cancer: impact and future directions","volume":"150","author":"Clinton","journal-title":"J Nutr"},{"issue":"15","key":"R14","doi-asserted-by":"publisher","first-page":"1572","DOI":"10.1056\/NEJMsa060185","article-title":"Chronic health conditions in adult survivors of childhood cancer","volume":"355","author":"Oeffinger","journal-title":"N Engl J Med"},{"issue":"2","key":"R15","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1007\/s13679-017-0260-0","article-title":"Early nutrition and physical activity interventions in childhood cancer survivors","volume":"6","author":"Zhang","journal-title":"Curr Obes Rep"},{"issue":"1","key":"R16","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1016\/j.jaccao.2023.12.008","article-title":"Modifiable cardiometabolic risk factors in survivors of childhood cancer:  state-of-the-art review","volume":"6","author":"Hammoud","journal-title":"JACC CardioOncol"},{"issue":"9","key":"R17","doi-asserted-by":"publisher","first-page":"1984","DOI":"10.1002\/cncr.24209","article-title":"Predictors of inactive lifestyle among adult survivors of childhood cancer: a report from the Childhood Cancer Survivor Study","volume":"115","author":"Ness","journal-title":"Cancer"},{"issue":"6","key":"R18","doi-asserted-by":"publisher","first-page":"iii","DOI":"10.1139\/apnm-2021-0298","article-title":"Importance of considering sex and gender in exercise and nutrition research","volume":"46","author":"Devries","journal-title":"Appl Physiol Nutr Metab"},{"issue":"2","key":"R19","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1016\/S1470-2045(09)70287-6","article-title":"The metabolic syndrome in cancer survivors","volume":"11","author":"de Haas","journal-title":"Lancet Oncol"},{"issue":"11","key":"R20","doi-asserted-by":"publisher","first-page":"1494","DOI":"10.1038\/sj.ijo.0802756","article-title":"Parental overweight, socioeconomic status and high birth weight are the major determinants of overweight and obesity in 5-7\u2009y-old children: baseline data of the Kiel Obesity Prevention Study (KOPS)","volume":"28","author":"Danielzik","journal-title":"Int J Obes"},{"issue":"12","key":"R21","doi-asserted-by":"publisher","first-page":"1017","DOI":"10.1016\/S1470-2045(06)70976-7","article-title":"Diet, exercise, and complementary therapies after primary treatment for cancer","volume":"7","author":"Jones","journal-title":"Lancet Oncol"},{"issue":"11","key":"R22","doi-asserted-by":"publisher","first-page":"1035","DOI":"10.1136\/archdischild-2019-318017","article-title":"Moving more: physical activity and its positive effects on long term conditions in children and young people","volume":"105","author":"Dimitri","journal-title":"Arch Dis Child"},{"issue":"7-8","key":"R23","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1159\/000488203","article-title":"Multidisciplinary late effects clinics for childhood cancer survivors in Germany\u2014a two-center study","volume":"41","author":"Gebauer","journal-title":"Oncol Res Treat"},{"issue":"1","key":"R24","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-019-6492-5","article-title":"Comprehensive assessments and related interventions to enhance the long-term outcomes of child, adolescent and young adult cancer survivors\u2014presentation of the CARE for CAYA-Program study protocol and associated literature review","volume":"20","author":"Salchow","journal-title":"BMC Cancer"},{"issue":"3","key":"R25","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1159\/000504200","article-title":"Guidelines for long-term follow-up after childhood cancer: practical implications for the daily work","volume":"43","author":"Gebauer","journal-title":"Oncol Res Treat"},{"issue":"4","key":"R26","doi-asserted-by":"publisher","first-page":"289","DOI":"10.14797\/mdcj-14-4-289","article-title":"Prediabetes: why should we care?","volume":"14","author":"Zand","journal-title":"Methodist Debakey Cardiovasc J"},{"issue":"2","key":"R27","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1177\/0309364616650079","article-title":"Limitations of body mass index for counseling individuals with unilateral lower extremity amputation","volume":"41","author":"Frost","journal-title":"Prosthet Orthot Int"},{"issue":"7","key":"R28","doi-asserted-by":"publisher","first-page":"1409","DOI":"10.1249\/MSS.0b013e3181e0c112","article-title":"American College of Sports Medicine roundtable on exercise guidelines for cancer survivors","volume":"42","author":"Schmitz","journal-title":"Med Sci Sports Exerc"},{"issue":"5","key":"R29","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1055\/s-0035-1552741","article-title":"S3-Leitline der Deutschen Gesellschaft f\u00fcr Ern\u00e4hrungsmedizin e. V. (DGEM) in Kooperation mit der Deutschen Gesellschaft f\u00fcr H\u00e4matologie und Onkologie e. V. (DGHO), der Arbeitsgemeinschaft \u201eSupportive Ma\u00dfnahmen in der Onkologie, Rehabilitation und Sozialmedizin\u201c der Deutschen Krebsgesellschaft (ASORS) und der \u00d6sterreichischen Arbeitsgemeinschaft f\u00fcr klinische Ern\u00e4hrung (AKE) [Article in German]","volume":"40","author":"Arends","journal-title":"Akt Ernahrungsmed"},{"issue":"2","key":"R30","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1038\/s41416-023-02499-1","article-title":"Educational attainment in survivors of childhood cancer in Denmark, Finland, and Sweden","volume":"130","author":"Mogensen","journal-title":"Br J Cancer"},{"issue":"3","key":"R31","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2021-053127","article-title":"Long-term follow-upcare for childhood, adolescent, and young adult cancer survivors","volume":"148","author":"Hudson","journal-title":"Pediatrics"},{"issue":"7","key":"R32","doi-asserted-by":"publisher","DOI":"10.3390\/nu11071652","article-title":"Physical activity, cardiorespiratory fitness, and the metabolic syndrome","volume":"11","author":"Myers","journal-title":"Nutrients"},{"key":"R33","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2017.01.010","article-title":"Physical activity levels and counseling by health care providers in cancer survivors","volume":"99","author":"Tarasenko","journal-title":"Prev Med"},{"issue":"4","key":"R34","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1177\/1043454221992322","article-title":"Health-promoting lifestyle and Its predictors in adolescent survivors of childhood cancer","volume":"38","author":"Huang","journal-title":"J Pediatr Oncol Nurs"},{"issue":"6","key":"R35","doi-asserted-by":"publisher","first-page":"7414","DOI":"10.1002\/cam4.5445","article-title":"Healthcare professionals\u2019 perceived barriers and facilitators of health behavior support provision: a qualitative study","volume":"12","author":"Bouwman","journal-title":"Cancer Med"},{"issue":"4","key":"R36","doi-asserted-by":"publisher","first-page":"243","DOI":"10.3322\/caac.21142","article-title":"Nutrition and physical activity guidelines for cancer survivors","volume":"62","author":"Rock","journal-title":"CA Cancer J Clin"},{"issue":"1","key":"R37","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1097\/MPH.0000000000001988","article-title":"Adiposity in survivors of cancer in childhood: how is it measured and why does it matter?","volume":"43","author":"Guolla","journal-title":"J Pediatr Hematol Oncol"},{"issue":"11","key":"R38","doi-asserted-by":"publisher","first-page":"5183","DOI":"10.1210\/jc.2019-00627","article-title":"Endocrine and metabolic disorders in survivors of childhood cancers and health-related quality of life and physical activity","volume":"104","author":"Pradhan","journal-title":"J Clin Endocrinol Metab"},{"issue":"14","key":"R39","doi-asserted-by":"publisher","first-page":"2363","DOI":"10.1200\/JCO.2008.21.1441","article-title":"Health behaviors, medical care, and interventions to promote healthy living in the childhood cancer survivor study cohort","volume":"27","author":"Nathan","journal-title":"J Clin Oncol"},{"issue":"5","key":"R40","doi-asserted-by":"publisher","first-page":"611","DOI":"10.3945\/an.115.008946","article-title":"Obesity in childhood cancer survivors: call for early weight management","volume":"6","author":"Zhang","journal-title":"Adv Nutr"},{"issue":"14","key":"R41","doi-asserted-by":"publisher","first-page":"12855","DOI":"10.1007\/s00432-023-05145-8","article-title":"Implementation of a clinical long-term follow-up database for adult childhood cancer survivors in Germany: a feasibility study at two specialised late effects clinics","volume":"149","author":"Sleimann","journal-title":"J Cancer Res Clin Oncol"},{"issue":"7","key":"R42","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2023-081823","article-title":"Characteristics and feedback of adult survivors of childhood cancer seen in Swiss comprehensive follow-up clinics led by general internists: a prospective cohort study","volume":"14","author":"Tinner","journal-title":"BMJ Open"},{"issue":"3","key":"R43","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.2375","article-title":"A multimodal lifestyle psychosocial survivorship program in young cancer survivors: the CARE for CAYA program\u2014a randomized clinical trial embedded in a longitudinal cohort study","volume":"7","author":"von Grundherr","journal-title":"JAMA Netw Open"},{"issue":"11","key":"R44","doi-asserted-by":"publisher","first-page":"755","DOI":"10.1097\/CIN.0000000000000781","article-title":"Mobile health applications, cancer survivors, and lifestyle modification: an integrative review","volume":"39","author":"Kelley","journal-title":"Comput Inform Nurs"},{"key":"R45","doi-asserted-by":"crossref","unstructured":"Richter F Kronziel LL K\u00f6nig IR Langer T Gebauer J . High incidence of metabolic diseases and sedentary lifestyle underline the need for regular counseling in LTFU for CCS- results from a monocentric prospective study. Research Square. Preprint posted online onMay23, 2023. [doi: 10.21203\/rs.3.rs-2947105\/v1] [Medline: 36711555]","DOI":"10.21203\/rs.3.rs-2947105\/v1"}],"container-title":["JMIR Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/cancer.jmir.org\/2024\/1\/e59614","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T22:32:25Z","timestamp":1785537145000},"score":1,"resource":{"primary":{"URL":"https:\/\/cancer.jmir.org\/2024\/1\/e59614"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,26]]},"references-count":45,"URL":"https:\/\/doi.org\/10.2196\/59614","relation":{},"ISSN":["2369-1999"],"issn-type":[{"value":"2369-1999","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,26]]},"article-number":"v10i4e59614"}}