“Although more than 90 per cent of patients with breast cancer have early stage disease at diagnosis, about 25 per cent will eventually die of distant metastasis,” says an article in the Canadian Medical Association Journal (CMAJ February 21, 2017).
Women with breast cancer would like to improve their prognosis and live long. Making positive lifestyle changes can improve long-term prognosis and be psychologically beneficial, since the feeling of loss of control is one of the biggest challenges of a cancer diagnosis.
So which lifestyle changes can be recommended to patients in addition to standard breast cancer treatments?
The CMAJ article reviews the role of lifestyle factors, particularly weight management, exercise, diet, smoking, alcohol intake and vitamin supplementation, on the prognosis of patients with breast cancer. Here is the summary.
Weight gain during or after breast cancer treatment increases the risk of recurrence and reduces survival, irrespective of baseline body mass index (BMI). Patients who are obese or overweight at breast cancer diagnosis have a poorer prognosis. So lose weight.
Physical activity can reduce breast cancer mortality by about 40 per cent and has the most powerful effect of any lifestyle factor on breast cancer outcomes. At least 150 minutes per week (about 30 minutes a day) of physical activity is recommended, but less than 13 per cent of patients with breast cancer attain this. So exercise more.
Western-style diets (high in processed grains, processed meats and red meat) and prudent diets (high in fruits, vegetables, whole grains and chicken) have similar rates of breast cancer recurrence. Diets rich in saturated fat, especially from high-fat dairy products, may be associated with increased breast cancer deaths. Soy products have not been found to increase breast cancer recurrence and may actually reduce it. Eat less and stop eating fatty food.
Recent evidence has shown a strong association between a history of smoking and breast cancer mortality. Women who quit smoking after diagnosis of breast cancer have higher overall survival and possibly better breast cancer–specific survival. So quit smoking.
Findings are too inconsistent to conclude that alcohol consumption affects breast cancer outcomes. However, limiting alcohol consumption to one or fewer drinks per day reduces the risk of a second primary breast cancer.
Moderate increases in dietary vitamin C or oral supplementation may reduce breast cancer mortality, but randomized trials are needed to confirm these findings. Vitamin E supplementation is not associated with breast cancer outcomes. Low levels of vitamin D at diagnosis have been associated with an increased risk of breast cancer deaths. However, randomized trials are needed to determine whether supplementation improves prognosis. One multivitamin a day and Vitamin D 2000 units a day is good for your health.
So the message is clear – make positive life-style changes like exercise more, lose weight and eat healthy. And keep smiling.
Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!