Table 3.

Modifiable risk factors, recommendations, and their potential impact on cancer-specific outcomes and long-term toxicities

Risk factor	Recommendations	Potential impact
Diet modification	•  Consume vegetables, fruits, and grains •  Minimize intake of red meats, saturated fats, high sugar foods •  High fiber diet if tolerated	•  Reduction in all-cause mortality associated with healthy eating scores •  Improved cardiovascular outcomes
Physical activity	•  Aim for at least 150 min of physical activity per week	•  Associated with reduced risk of recurrence and overall survival •  Improved quality of life and reduced psychosocial distress •  Reduced risk of osteoporosis with weight bearing exercises •  Improved cardiovascular outcomes
Smoking	•  Cessation of tobacco products	•  Reduced risk of developing smoking related malignancies •  Reduced all-cause mortality compared to former smokers •  Improved cardiovascular outcomes •  Reduced risk of osteoporosis •  Improved erectile dysfunction severity
Alcohol intake	•  Avoid or limit alcohol consumption to less than 3 standard drinks per day for men (2 for women)	•  Reduced risk of developing alcohol related malignancies •  Improved cardiovascular outcomes •  Reduced risk of osteoporosis
Vitamin D/calcium supplementation	•  Replete calcium and vitamin D to normal levels	•  Improved progression free recurrence •  Data on overall survival is mixed •  Reduced risk of osteoporosis
Weight management	•  Aim for healthy body mass index (BMI)	•  Reduced risk of developing secondary obesity related malignancies •  Improved control of other medical comorbidities, such as diabetes and cardiovascular disease