By Colleen Doyle, MS, RD
In my work at the American Cancer Society, when I talk with people who've been diagnosed with cancer, they tend to ask me 3 things: what can I do to reduce the chance that my cancer will come back? What can I do to help me not develop some other kind of cancer? How can I help my family members reduce their own risk for developing cancer?
For many years, answering questions 2 and 3 was a cinch.
We've known for years that for people who don't smoke, the most important ways to reduce their risk of cancer are to strive to be at a healthy weight, live a physically active lifestyle, eat a diet made up mostly of fruits, vegetables and whole grains, and watch how much alcohol is consumed (if any, at all). As a matter of fact, a recent study published by ACS researchers showed that non-smokers who most closely followed those recommendations had a significantly lower risk of premature death from cancer, cardiovascular disease, and all causes when compared to people who followed the guidelines least closely.
So giving advice about how to reduce their risk of developing another type of cancer and providing information to pass on to their own family members was pretty easy, because that data has been around for many years.
Answers about how to reduce the risk of recurrence were not as clear. But they've recently gotten clearer.
Over the last several years, evidence has accumulated for a number of cancers that achieving and maintaining a healthy weight, getting enough physical activity, and eating a healthy diet can reduce the chance of recurrence and increase the likelihood of disease-free survival after a diagnosis of cancer. Big news.
Achieve and Maintain a Healthy Weight
Extra weight is linked to increased risk of the cancer coming back and decreased survival rates among breast, prostate, and colorectal (colon) cancer survivors, and possibly others. Being overweight is a risk factor for these 3 cancers (and others), and many people with cancer are overweight at the time of diagnosis. For these survivors, setting lifelong goals to achieve and maintain a healthy weight are among the most important health-related goals that can be set. Healthy ways to control weight include:
- Limiting high-calorie foods
- Drinking fewer beverages high in fat and/or added sugar
- Eating more low-calorie foods like vegetables and fruits
- Adding more physical activity throughout the day
Be Active on a Regular Basis
Many studies have shown that being physically active has a tremendous impact on quality of life of cancer survivors. Now, studies have demonstrated that physical activity after cancer diagnosis is also associated with a lower risk of the cancer coming back and improved overall survival among multiple cancer survivor groups, including breast, colon, prostate, and ovarian cancer.
Among breast cancer survivors, a recent analysis showed that getting exercise after diagnosis was associated with a 34% lower risk of breast cancer deaths, a 41% lower risk of dying from all causes, and a 24% lower risk of breast cancer recurrence. Among colon cancer survivors, studies suggest exercise cuts deaths from colon cancer and all causes, and cuts the risk of the cancer coming back by up to 50%.
Our recommendations, and those of the American College of Sports Medicine, encourage survivors to aim to exercise for at least 150 minutes per week, and to include strength training exercises at least 2 days per week. For survivors who have not been previously active, gradually working up to these recommendations is the way to go.
Fill your plate with vegetables, fruits, and whole grains
Recent reviews suggest that food choices may affect risk for recurrence and overall survival among survivors. The majority of these studies have focused on breast cancer, but more evidence has also emerged for colon and prostate cancer survivors.
Similar to what we've seen for cancer prevention, it looks like it's the overall dietary pattern that is important for cancer survivorship -it's not one food, or even one food group, that makes the difference. It's likely the combination of many different nutrients coming from many different foods --working together -- that offers the best protection. Studies suggest that the best protection comes from a diet that:
- Is high in fruits, vegetables and, whole grains
- Includes more fish and poultry instead of red and processed meats
- Includes low fat instead of full-fat dairy products,
- Includes nuts and olive oil instead of less healthy sources of fat, such as butter or trans fats found in many processed snack foods.
The bottom line
Do we have all the answers related to nutrition, physical activity, and cancer survivorship? No. But do we have enough information and evidence to recommend that anyone who's been diagnosed with cancer should strive to be at a healthy weight, live a physically active lifestyle, and add more fruits, vegetables and whole grains to their meals and snacks? Absolutely. It's an important message that I'm sharing with everyone I know who has been diagnosed with any kind of cancer.
Doyle is director of nutrition and physical activity for the American Cancer Society.