WEDNESDAY, April 30 (HealthDay News) -- Cancer survivors who eat more fruits and vegetables, stay physically active and avoid tobacco have a higher quality of life than those who don't do these things.

The bad news is that many cancer survivors aren't eating right and aren't exercising enough, although a good three-quarters do follow recommendations not to light up.

"We all know that living a healthy lifestyle, eating well, being physically active and not smoking reduces the risk of physical problems and improves overall physical health," said Kevin Stein, director of Quality of Life Research at the American Cancer Society's Behavioral Research Center. "Here we have additional evidence that it not only reduces disease burden but also improves emotional health and quality of life and, moreover, the effect appears to be cumulative. The more you comply, the better your quality of life."

Stein is senior author of a new study detailing the findings, published in the May issue of the Journal of Clinical Oncology.

Yet the message doesn't seem to be getting through.

"When I sit down and talk to patients about changing their lifestyle after treating them for cancer, a lot of times you're glaring into people's eyes, and they don't really believe what you're telling them," said Dr. Jay Brooks, chairman of hematology/oncology at Ochsner Health System in Baton Rouge, La. "I don't think really people really grasp the importance of what they do in their lives in terms of how it affects what happens to them."

That would include behaviors engaged in both before and after a cancer diagnosis and treatment.

More than 10 million Americans are cancer survivors, making them more vulnerable to other health conditions such as heart disease, osteoporosis, diabetes and, more generally, a reduced health-related quality of life.

The American Cancer Society recommends that cancer survivors engage in 30 minutes of exercise at least five times a week, eat at least five servings of fruits and vegetables a day, and not smoke.

Previous studies have shown that a healthy lifestyle can prevent cancer recurrence and prolong survival, yet many of these studies were conducted at elite cancer treatment centers, Stein said.

The new study aimed to get a more realistic portrayal of the issue by asking more than 9,000 survivors about their quality of life. Participants were either two-, five- or 10-year survivors of six different types of cancer.

Only 14.8 percent to 19.1 percent of survivors were meeting the five-a-day fruits and vegetables recommendation, while 29.6 percent to 47.3 percent were meeting the physical activity recommendation.

On the other hand, 82.6 percent to 91.6 percent didn't smoke.

But a mere 5 percent were meeting all three recommendations, up to 12.5 percent weren't complying with any lifestyle behavior recommendations, and less than 10 percent were meeting two or more.

The findings echoed a recent study that found that cancer survivors have rates of obesity and physical inactivity similar to those of the general population. That study, published in the June 1 issue of Cancer, found that less than one-quarter of cancer survivors were regularly physically active, and more than 18 percent were obese.

"We want to focus on survivors because of their increased risk" for other conditions as well as cancer recurrence, Stein said. "In addition, they're in the health-care system, so this is a teachable moment," he added. "We have an opportunity to talk to them about their health, communicate to them, 'Hey, you've dodged a bullet this time, here's an opportunity for you to live a healthy lifestyle and reduce the risk of a second cancer or another co-morbid condition and also improving your quality of life.' "

More information

The American Cancer Society has more on cancer risk and lifestyle factors.