By Dawn M Mussallem, D.O.
Breast Clinic, Mayo Clinic
Jacksonville, FL
Breast cancer recurrence is multifactorial and includes both modifiable and nonmodifiable risk factors. Nonmodifiable risks are things you can’t change such as age, family history, breast cancer subtype, and ethnic background. However, your lifestyle is a modifiable risk factor and this is something that you can control. Studies suggest that healthy living not only reduces your risk of breast cancer recurrence but it also reduces the risk of major disease threats; the biggest of which is heart disease, the number one cause of death in women. Also, a healthy lifestyle enhances overall wellbeing—so you feel better when you live a healthy lifestyle.
So, let’s talk about aspects of your lifestyle that matter in the fight against breast cancer.
Maintain a healthy weight
It is estimated that two thirds of breast cancer survivors are overweight or obese. Unfortunately, weight gain during treatment for early stage breast cancer is common1 and only 10% of women with breast cancer related weight gain return to their pretreatment weight.2 This is a major concern because weight gain after a breast cancer diagnosis increases the risk of death from breast cancer but also increases the risk of dying from other diseases like cardiovascular disease3. The Women’s Interventional Nutrition Study highlights the favorable effect of weight loss on breast cancer survival showing that a six pound decrease in weight after breast cancer diagnosis was associated with improved breast cancer specific survival. Efforts toward weight management should focus on optimization of your overall body composition with an emphasis on losing body fat and gaining muscle. Talk with your doctor to determine what your goal body weight should be and how to factor in regular exercise and optimal nutrition modifications according to your health needs.
Be physically active
Research shows that of all the lifestyle factors, physical activity has the most robust effect on breast cancer outcomes. Studies consistently demonstrate an association between exercise and enhanced quality of life during cancer treatment and improved survival after a breast cancer diagnosis.4 The Nurses’ Health Study showed a 50% lower risk of breast cancer recurrence, breast cancer death, and death from any cause in breast cancer survivors who exercised at a moderate intensity for three to five hours a week compared to women who engaged in very little activity.5
Exercise is a very important part of your overall breast cancer treatment strategy so be good to your body and aim for at least 30 minutes of “moderate-intensity physical activity” five days a week or more and make sure you include strength exercises on two of these days!
But remember implementing a daily exercise routine does not have to be costly. Start where you are, if you can only walk for ten minute intervals at a time to start then walk three to four times a day. Slowly build up your endurance until you can walk for a consecutive 30 minutes a day. Similarly, strength training can be done at home. Ask you healthcare provider about meeting with a physical therapist for a cancer rehabilitation exercise prescription.
Eat well
Among lifestyle factors, we know that nutrition is an important determinant of overall health, and represents a pivotal element of preventable cancer risk.
Though high-quality research on how diet influences the risk of breast cancer is in the early stages, experts at the American Institute for Cancer Research (AICR) have extensively reviewed the available research and AICR6 recommends that cancer survivors follow a plant-based, high fiber diet that is rich in vegetables (non-starch), fruits, whole grains, wild fish, and healthy fats from olive oil, nuts, seeds. Try to limit consumption of red meat (beef, pork, lamb) and do your best to avoid fast foods, refined sugars, processed grains and processed meat.
Breast cancer survivors often ask what the healthiest diet to reduce breast cancer recurrence is. A small study of early stage breast cancer survivors investigated the benefit of the Mediterranean diet. 199 women followed the Mediterranean Diet and 108 women opted to remain on their Standard American Diet (SAD). After three years of follow-up, 11 of the women on SAD developed a breast cancer recurrence however none of the women who followed the Mediterranean diet had a breast cancer recurrence.7 This is an exciting finding and the Mediterranean Diet is also good for many other aspect of your health including your heart and brain. Ongoing research with larger, longer duration studies is important to prove this effect is long-term.
There is no one perfect food or diet that can prevent cancer. Remember it is the overall pattern of one’s diet that is important not one particular element but a combination of fresh, nutrition whole foods especially vegetables, fruits and whole grains!
Drink less alcohol
Alcohol increases the risk of several cancers including breast cancer and it doesn’t matter what you drink – all types of alcohol contribute to an increased breast cancer risk. Research shows that alcohol use among breast cancer survivors increases the risk of a breast cancer recurrence and increases the risk of a new breast cancer developing in the opposite breast.8 The quantity of how much you drink matters and the more you drink the higher the risk. Women should not exceed one alcoholic drink a day (one drink = 12oz beer; 1oz 100 proof liquor; 5oz wine). One drink a day increases a postmenopausal women’s relative risk of breast cancer by approximately 10%.
Conclusion
You can greatly lower the overall chances of breast cancer returning, improve survival, and increase the overall quality of your life by incorporating exercise and healthy modifications into your daily routine.
There is no one perfect food or diet that can prevent cancer. Remember it is the overall pattern of one’s diet that is important not one particular element but a combination of fresh, nutrition whole foods especially vegetables, fruits and whole grains!