By Darria Long Gillespie, MD, MBA
With Breast Cancer Awareness Month still in effect, it's important to discuss not just how to prevent and diagnose breast cancer, but what to do after the diagnosis. How can you optimize your health and strengthen your resolve to not only defeat the disease, but prevent it from coming back? Here are answers to a few common questions:
What are the most important lifestyle factors that affect people who have been diagnosed with breast cancer? Three crucial factors are at play: obesity, inactivity and poor dietary quality. Taking steps to address these increase the likelihood of improving both cancer survival rates and overall longevity. They may even improve prognosis, especially in early-stage cancers. While studies are still early and we need more research to know exactly how these factors impact breast cancer, research has shown promising trends.
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Role of Obesity
Body fat increases estrogen levels, insulin levels and inflammation, all of which may promote the growth of cancer. Higher weight is not only associated with increased incidence of cancer (higher chance of getting it in the first place), but higher rates of recurrence.
Role of Physical Activity
Multiple observational studies have shown better outcomes in more active women. For example, studies of women who were active (approximately 3 hours per week of walking) had a 50% lower risk of breast cancer recurrence, death and even death from other causes than women who did less than one hour of moderate-intensity recreational activity per week.
Role of Diet
It's unclear if one's diet is related to breast cancer due to its impact on obesity, or if it's a separate factor altogether, but there is some evidence that a high fat diet may be its own risk factor for breast cancer survival.
While there's no one food that will either "cure" or "cause" cancer, there are some you may want to consider minimizing in your diet -- or at least avoiding in excess.
Eat Less: Saturated fats: There's evidence that saturated fats may increase cancer risk (red meats, margarines, baked goods, snack foods, French fries).
Eat More: Foods high in antioxidants, fiber and low in saturated fats such as fruits, vegetables, beans and grains. Stick to healthy oils like olive, canola and peanut oils, and nuts, fish and beans for protein. It's not known which of the compounds in veggies and fruits are most protective, so it's best to eat a combination of all of them.
What About Alcohol?
Alcohol can increase levels of estrogens in the blood, and large amounts may increase your risk of cancer or worsen your prognosis. What's a large amount? We don't know yet, but most experts agree that two drinks or more per day may increase the risk. If you're currently taking chemotherapy, be even more careful, as alcohol may interfere with your medications.
You knew I was going to include this, didn't you? In one study, survivors who smoked had 120% higher risk of a second breast cancer, and seven times the risk if they also had at least one alcoholic drink per day.
What's the biggest mistake breast cancer survivors make when attempting to change their lifestyle?
"Expecting too much too soon," says Hester Hill Schnipper, Chief of Oncology Social Work at Beth Israel Deaconess Medical Center, a breast cancer survivor herself and author of Woman to Woman: A Handbook for Women Newly Diagnosed with Breast Cancer and After Breast Cancer: A Commonsense Guide to Life after Treatment. "It's important to be realistic." On the other hand, she says, "don't put too much pressure on yourself to change your entire lifestyle immediately."
And yet there's another danger. "Sometimes the devastation of a diagnosis is so significant that it's easy to disregard all lifestyle changes and just give up," says Vincent Devita, MD, an oncologist and former director of the Yale Cancer Center. "Modern treatments are so advanced now, with significant chances of survival, that it's more important than ever to make healthy lifestyle changes."
Are Supplements Effective?
Unfortunately, there's no evidence that dietary supplements can lower the risk of cancer recurring or improve survival rates. The American Cancer Society actually says that these may even harm cancer patients by giving them too much of any one nutrient, or interacting with their cancer medications.
Still, it's important to speak with your doctor to make sure you are getting the basic nutrients. Women with breast cancer can be at higher risk of osteoporosis because of the adverse effects of chemotherapy on bone health, so make certain you're getting your daily dose of calcium and Vitamin D.
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