Several lifestyle changes can improve outcomes after a breast cancer diagnosis, but exercise is by far the best habit is in order, researchers say.
Women with breast cancer, either newly diagnosed or at any time in their “survival” phase, the need to exercise regularly and to prevent weight gain, said Dr. Ellen Warner, of Odette Cancer Center at Sunnybrook Health Sciences Center in Toronto, co-author of the research review.
Warner and her colleague Julie Hammer together to review nearly 70 articles that addressed lifestyle changes that can have an impact on the risk of breast cancer recurrence and survival after breast cancer.
They found that regular physical activity can reduce the risk of dying from breast cancer by 40 percent compared to women who did not exercise. Unfortunately, less than 13 percent of the women with breast cancer achieve the recommended 150 minutes per week of physical activity.
“Exercise is the greatest gain to reduce the risk of recurrence and many other secondary benefits, such as helping with weight management (which lowers the risk of recurrence and fewer side effects of chemo, radiation, and hormone therapy,” Warner told Reuters Health by e-mail.
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Gaining weight during or after breast cancer treatment is risky – it increases the chance of a recurrence and reduces the chances of survival, the review concludes.
Women who are already overweight or obese also have a higher risk of recurrence and death, but it is not clear whether weight loss actually improves those goals. Studies are underway to examine this further, the researchers write in the Canadian Medical Association Journal.
Does diet matter? Yes and no. Breast cancer recurrence rates are similar to, or women eating a diet with plenty of fruits, vegetables, whole grains, and chicken or a diet high in processed grains, processed meats and red meat. But high dietary saturated fats increase the risk of death from breast cancer. Soy products, however, do not increase the risk of breast cancer recurrence and may even decrease.
“Women with breast cancer is not need to extreme diet changes (like cutting out meat, dairy, sugar, soy, etc.),” Warner said. “There is no evidence that these are effective. She eats everything in moderation and following Canada’s food guide would be useful if they do not know very much about nutrition.”
Women with breast cancer – well, everyone actually should stop smoking. It is strongly associated with the risk of death from breast cancer, and quitting improves overall survival.
What about the intake of alcohol and vitamin supplements? The evidence is limited and inconsistent, so further research is needed before making specific recommendations, the team notes.
“There is a large ongoing Canadian study of women ages 40 years and younger newly diagnosed with breast cancer named RUBY, and one of the projects in this research is to look at how various lifestyle factors (diet, exercises, supplements, etc.) impact on the prognosis for that specific age group,” Warner said.
“The adoption of a healthy lifestyle is great, but should never be seen as a replacement for conventional therapy,” she concluded.
In their review, the authors note that very few of the studies included met the highest standards of clinical studies.
Dr. Livia Augustin from St. Michael’s Hospital in Toronto and the Fondazione Giovanni Pascale National Cancer Institute in Naples, Italy, has, together with others, designed a clinical trial (dedica) to investigate whether low glycemic index diet, exercise and vitamin D reduces breast cancer recurrence.
“People with breast cancer suffer from multiple co-morbidities, such as heart disease, diabetes, and osteoporosis, and therefore many health complications; therefore, stopping smoking, increasing vitamin D, if needed, increasing physical activity and improving the nutritional aspects are of crucial therapeutic targets to reduce complications and the costs of health care and help to live longer with a better quality of life,” Augustin told Reuters Health by e-mail.