Everyone can benefit from a healthy lifestyle. Making healthy choices can be physically and mentally rewarding at any age. For breast cancer survivors, some healthy behaviors may lower the risk of recurrence and improve survival. Others may not impact breast cancer survival, but are part of a lifestyle that may help protect against other cancers and diseases. A healthy lifestyle includes:
Weight gain after breast cancer diagnosis may increase the risk of breast cancer mortality and overall mortality. Maintaining a healthy weight is one of the best things you can do for your health. Being overweight or obese causes;
- Heart disease
- Stroke
- Diabetes
- Colon and rectal cancer
- Endometrial (lining of the uterus) cancer
- Esophageal cancer
- Kidney cancer
- Pancreatic cancer
Being overweight or obese may also increase this risk of;
- Gallbladder cancer
- Liver cancer
- Multiple myeloma
- Non-Hodgkin lymphoma
- Ovarian cancer
- Prostate cancer
Regular exercise and eating a healthy diet are the best ways to maintain a healthy weight.
At this time, we don’t fully understand how diet affects survival after breast cancer. Being overweight or obese (and weight gain) after a breast cancer diagnosis decreases survival. However, there is no diet, dietary pattern or nutrient proven to improve breast cancer survival (or decrease survival). Some dietary factors have been studied more than others. These include carotenoids, dietary fat and soy (see below). A healthy diet is important for everyone, including breast cancer survivors. This diet (outlined below) promotes overall health and may help protect against different types of cancer and other diseases. Achieve and maintain a healthy weight. Survivors who are overweight or obese should limit high-calorie foods and beverages and increase physical activity to help with weight loss.
- Eat at least 2 ½ cups of fruits and vegetables every day.
- Choose 100 percent whole grain foods such as 100 percent whole grain breads and cereals, brown rice, millet and quinoa.
- Limit red meat and processed meat. Choose chicken, fish or beans more often.
- Limit “bad” fats (saturated and trans fats). These are found in foods such as red meat, fatty deli meats, poultry skin, full fat dairy, fried foods, margarine, donuts and microwave popcorn.
- Eat “good” fats (polyunsaturated and monounsaturated fats). These are found in foods such as olive and canola oil, nuts and natural nut butters, avocado and olives.
- Limit alcohol intake to less than 1 drink a day for women and fewer than 2 drinks a day for men.
Carotenoids (found in fruits and vegetables)
Carotenoids are natural orange-red food pigments found in foods such as carrots, sweet potatoes, squash and melons. Many carotenoids, such as beta-carotene, are antioxidants and can be converted into vitamin A in the body. Researchers can study carotenoids by measuring levels of carotenoids in the blood or through a person’s diet. In general, fruits and vegetables are the best sources of carotenoids (rather than supplements) and are part of a healthy diet.
Dietary fat
Researchers are studying whether eating a low-fat diet after a breast cancer diagnosis improves survival. Findings are mixed. Findings from the Women’s Intervention Nutrition Study showed reducing dietary fat intake may improve disease-free survival (survival without a breast cancer recurrence). Women in this study who reduced their fat intake also lost weight, which may have played a role in their improved survival. Findings from the Women’s Health Initiative study showed reducing dietary fat increased overall survival in women diagnosed with breast cancer. Other studies have found no difference in survival after a breast cancer diagnosis for women who eat a diet low in fat compared to those who eat a diet high in fat.
Soy foods
Current studies suggest eating moderate amounts of soy foods is safe for breast cancer survivors. Some studies have found a diet high in soy may decrease the risk of breast cancer recurrence and breast cancer mortality (death from breast cancer). Most of these findings are from studies of Asian women, who tend to eat more soy throughout their lives (starting early in life) compared to other women. One analysis combined data from 3 large studies of survivors from both Asian and Western countries. It found women who ate at least 10 mg of soy per day after a breast cancer diagnosis had a 25 percent lower risk of recurrence compared to those eating less than 4 mg per day. However, soy is not recommended as a way to lower the risk of breast cancer recurrence. Questions remain about study findings. For example, women who regularly eat soy tend to be healthier than those who don’t, which may account for the benefits shown in studies.
Some findings suggest drinking alcohol may increase the risk of Breast cancer mortality (death from breast cancer) and Overall mortality (death from any cause, not necessarily breast cancer). Other studies show no increased risk of death from breast cancer or any cause for survivors who drink alcohol. One reason for these mixed findings may be that drinking in moderation has some health benefits. It may lower the risk of heart disease, high blood pressure and death. No one should drink a lot of alcohol. The American Cancer Society recommends that cancer survivors limit alcohol intake to less than 1 drink a day for women and fewer than 2 drinks a day for men. Drinking more has no health benefits and many serious health risks. After talking with your health care provider, make informed choices about drinking low to moderate amounts of alcohol.
Researchers often use MET (metabolic equivalent) hours to assess the total amount of activity a person gets. The more energy and activity needs, the higher its MET score. For example, 1 MET hour is the energy used to sit quietly for 1 hour, but walking for 1 hour scores from 2 ½ to 4 ½ MET hours (depending on how quickly you walk). More vigorous activities, like playing tennis, biking or swimming for 1 hour, score higher. Adding the MET scores of different activities gives a total number of MET hours.
How much activity gives a benefit? A pooled analysis that combined data from over 13,000 breast cancer survivors found those who were more active had better survival. For example, survivors who got 10 or more MET hours of activity a week (about 3 or more hours of moderate-paced walking) had a 30 percent lower overall mortality compared to less active survivors. Breast cancer survivors may not need to do intense exercise to get a benefit though. One study found activity equal to a 30-minute brisk walk several times a week, improved survival. The American Cancer Society recommends breast cancer survivors:
- Avoid inactivity and return to normal daily activity as soon as possible after diagnosis
- Get regular physical activity
- Aim for at least 150 minutes of exercise per week
- Do strength training exercises at least twice a week
A meta-analysis that combined the findings from 16 studies showed breast cancer survivors who got this recommended 150 minutes of exercise per week had an:
- 11 percent lower risk of breast cancer mortality
- 24 percent lower risk of overall mortality
Being physically active is one of the best things you can do for your health. It helps you maintain a healthy weight and lowers your risk of heart disease, stroke and diabetes. For breast cancer survivors, it can also:
- Improve body image
- Improve mood
- Improve physical condition and movement
- Improve quality of life
- Increase sexuality
- Increase energy
- Maintain bone health
- Reduce fatigue
- Reduce stress and anxiety
- Reduce distress and depression
Physical activity and lymphedema
In the past, there was some concern exercise might increase the risk of lymphedema for breast cancer survivors and worsen symptoms in those who developed the condition. However, after recovery from breast surgery, arm exercises (such as weight-lifting) don’t appear to increase the risk of lymphedema. (It’s best to avoid strenuous exercise right after breast surgery though.) Studies also show weight-lifting (moderate, in a supervised setting) can reduce symptoms in survivors with lymphedema, as well as improve body image, sexuality and physical strength. Talk with your health care provider before starting an exercise program to manage lymphedema.
There’s growing evidence smoking decreases survival for women diagnosed with breast cancer. A pooled analysis that combined data from about 10,000 survivors found smoking increased the risk of: Breast cancer-specific mortality (death from breast cancer) and Overall mortality (death from any cause, not necessarily breast cancer). The more women smoked, the higher these risks. Stopping smoking, or never starting to smoke, is one of the best things you can do for your health. Smoking causes:
- Heart disease
- Stroke
- Bladder cancer
- Cervical cancer
- Colon cancer
- Diabetes
- Esophageal cancer
- Kidney cancer
- Larynx cancer
- Liver cancer
- Lung cancer
- Pancreatic cancer
- Stomach cancer
- Throat and mouth cancers
The benefits of quitting smoking
For smokers, it’s never too late to benefit from quitting. The risk of heart disease goes down very quickly after stopping smoking. And, over time, the risk of lung and other cancers can drop to near that of someone who never smoked. Talk with your health care provider about ways to quit. There are many resources to help including:
American Cancer Society – Guide to Quitting Smoking
www.cancer.org/
American Lung Association – Freedom from Smoking
www.ffsonline.org
National Cancer Institute’s Free Help to Quit Smoking
www.cancer.gov/cancertopics/tobacco/smoking
1-877-44U-QUIT (1-877-448-7848)
National Cancer Institute’s Smokefree.gov
www.women.smokefree.gov
State Tobacco Quit Lines
1-800-QuitNow (1-800-784-8669)
U.S. Department of Defense – Quit Tobacco
www.ucanquit2.org
Source: Susan G. Komen