Lifestyle impacts different cancers differently. While healthy diet, regular exercise and ideal weight generally improve the outlook for most cancer warriors, current research offers specific advice for specific types of the disease.
In this installment of Lifestyle Matters, we look at these research-based recommendations for men and women living through and beyond breast, colorectal and prostate cancer.
This series is based on the recently published American Cancer Society Nutrition and Physical Activity Guidelines for Cancer Survivors, which summarizes the latest findings on lifestyle choices.
Breast cancer dancers
Weight is the key issue for women who have been diagnosed with breast cancer. Achieving and maintaining a normal weight remains absolutely the best thing a woman can do to thrive today and for many tomorrows.
Here's the skinny - while being overweight or obese before and after a breast cancer diagnosis is very common, it's not good. Why?
Carrying too many pounds increases the risk of lymph node involvement and lymphedema (swelling of the arm closest to the involved breast). A higher body mass index (BMI) of 25+ is also associated with life-threatening events, such as cancer appearing in the other breast, recurrence and shorter lifespan.
Here are some more facts and figures.
- According to the Nurses' Health Study, increasing BMI from .5 to 2 units following treatment pumps up the likelihood of recurrence by 40 percent, compared to those who didn't gain weight.
- With increases of more than 2 units in BMI, the risk of recurrence expands to 53 percent.
- The same study found that women who lost weight following treatment "did not experience significantly poorer outcomes." Translated - losing weight helps improve outcome.
Now there are plenty of flaws relating to the BMI scales. So it's important for anyone affected by breast cancer to work closely with their healthcare providers to determine an ideal weight and come up with plans for achieving those numbers.
Even small losses help
Having many pounds to shed can feel - and in fact is - a daunting task. The good news is that even modest weight loss - of say 5-10 percent - over six months to a year helps.
Recent reviews of scientific literature find that small to modest amounts of weight loss improve breast -cancer specific factors, including circulating estrogens and inflammation. Estrogen, the female hormone, drives the majority of breast cancers and it likes to set up residence in adipose fat.
Changing the mix
Unfortunately, chemotherapy and hormonal (estrogen blocking) treatments can decrease lean body mass and replace it with - you guessed it - fat.
So, what's a girl to do? Whether you're in active treatment or have finished that phase, start doing some resistance training - lift some weights or use the weight of your limbs to get the muscles churning and building.
Really and truly, as much as most of us hate it, exercise is really one of the best things people who are dealing with breast cancer or its aftermath can do to feel and function better.
A meta-analysis of 14 randomized controlled trials involving 717 breast cancer victors found that physical activity improved quality of life, physical functioning and energy levels.
Another study review, which included more than 12,000 breast cancer thrivers showed that physical activity following diagnosis was seen with a 24 percent lower rate of recurrence and a 34 percent lower risk of succumbing to the disease and a 41 percent mortality from all causes.
Exercise - and weight loss - are also known to reduce lymphedema.
Trained exercise therapists are available to help design a movement plan and provide guidance and/or accountability all along the way.
Studies looking at specific food choices have been inconsistent over the years. Eating more fruits and vegetables hasn't been proven to benefit women with a history of breast cancer. That said, some research has shown that diets high in colorful foods from nature which are rich in carotenoids are likely to delay the reappearance of breast cancer.
Soy and flaxseed, both of which are great sources of phytoestrogens, are safe to eat according to three large studies. And there is some evidence these foods may even be beneficial for patients who are taking tamoxifen.
To drink or not to drink alcohol
Studies regarding drinking alcohol have been a totally mixed bag. The benefit of moderate consumption is lowering the risk of cardiovascular disease, which is a common condition in women who've had breast cancer. On the other hand, alcohol has also been associated with an increased risk of new breast cancers, recurrences and even death.
Talking with a health professional about specific risks and benefits - along with an approach of "moderation in all things" - is probably a wise strategy for most.
Colorectal cancer warriors
Interestingly, a recent American Cancer Society study uncovered that obesity prior to a colorectal cancer diagnosis was linked to higher risk of not making it due to all causes, the cancer itself and cardiovascular disease. However, one's BMI following diagnosis didn't seem to impact lifespan.
As with breast cancer, physical activity improves quality of life, functioning and helps to alleviate fatigue. Folks who have a history of this cancer and are physically active have lower risks of recurrence, perishing from the cancer and/or all other causes.
Diet is known to play a role in developing colorectal cancer, but very little research has been conducted on the effects of diet on living beyond the disease.
The largest study of Stage III colorectal cancer patients found that a Western diet (high fat, starch, sugar) resulted in worse outcomes. Eating lots of fruits and vegetables, poultry and fish wasn't associated with cancer recurrence or mortality.
People who have chronic bowel problems or have issues affecting nutrient absorption should see a registered dietician for guidance.
Take care with supplements
Low vitamin D levels, as measured in the blood, are known to increase the risk of developing colorectal cancer. Vitamin D may also influence outcome; research in this area is ongoing.
Research has failed to show any benefit of vitamin and fiber supplements or modest diet changes in reducing polyp recurrence. Folate slightly increases the risk of having multiple benign tumors (adenomas), and calcium supplements may provide a slight benefit in preventing polyps from recurring.
Prostate cancer champions
Body weight and obesity need to be the number one concern of men with a history of prostate cancer. Too much weight is associated with more aggressive forms of the disease that tends to progress with time. Men who are obese after diagnosis are at significantly higher risk of the disease cutting short their lives.
Some points to ponder:
- Saturated fat (eggs, meat, dairy sources), but not total fat intake, seems linked to worse outcomes.
- Monounsaturated fats (olives, nuts, peanut/olive/canola oils, avocados) are associated with a better outlook.
- Fish and tomato sauce consumption are related to lower risks of recurrence.
- Ground flaxseed and omega-3 fatty acid consumption is linked to lower tumor growth and proliferation.
- Calcium supplements have been linked to aggressive disease.
- Men who engaged in at least three hours of vigorous activity a week, in one study, had a 60 percent decreased risk of prostate cancer taking their lives.
The common theme
If you, a friend or a loved one have been diagnosed with cancer, the best self-care techniques remain pretty similar - achieve and maintain an ideal weight, stay physically active and eat a diet that's rich in natural nutrients and low in saturated fats and processed foods.
Ask for help to make and stick with a plan to make these recommendations a part of your healthy lifestyle.