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Survivorship: During and After Treatment

Can I Do Anything to Prevent Cancer Recurrence?

While eating right, exercising, and seeing your cancer care team for follow-up visits are helpful, they cannot keep cancer from recurring. Many people blame themselves for missing a doctor visit, not eating right, or postponing a CT scan for a family vacation. But even if you do everything just right, the cancer still might come back. Still, there are certain actions you can take to be as healthy as possible.

Diet

After completing cancer treatment, many people decide to eat better in the hope that these changes will improve their chance for survival.

The American Cancer Society recommends that cancer survivors in stable health after treatment follow the same nutrition guidelines as those recommended for cancer prevention. It’s thought that the same factors that can increase cancer risk might also promote cancer recurrence after treatment. For instance, research has suggested that the risk of breast cancer recurrence might be higher in women who are obese and don’t eat many fruits and vegetables. Prostate cancer recurrence risk might be higher in men who eat a lot of saturated fats.

What to do

In general, an adult should:

  • Eat a variety of vegetables -dark green, red and orange  each day, as well as fiber-rich legumes (beans and peas), and others.
  • Eat foods that are high in nutrients in amounts that help you get to and stay at a healthy body weight
  • Eat fruits, especially whole fruits with a variety of colors
  • Limit or avoid red meat (beef, pork, lamb) and processed meats (foods like hot dogs, sausage, and luncheon meats).
  • Select foods made with whole grains rather than refined grains and sugars.
  • Avoid sugary beverages

If you’re overweight, consider losing weight by cutting calories and increasing your activity to get to and stay at a healthy weight. (Check with your cancer care team before starting an exercise program.)

Several types of cancer are linked to alcohol intake. It is best not to drink, but if you choose to drink, you should have no more than 1 drink a day for women and 2 for men. The more you drink, the higher your cancer risk.

Vitamins and supplements

Sometimes people think taking certain vitamins, herbs, or other dietary supplements will give them an extra edge in preventing recurrence. Available research does not support this belief. In fact, some research has shown that supplements containing high levels of single nutrients (greater than the Dietary Reference Intakes) may have unexpected harmful effects on cancer survivors.

Blood tests can show if your levels of certain vitamins are low. Based on these tests, your doctor might recommend supplements to raise levels of certain vitamins, but the evidence so far does not show that high vitamin levels help lower cancer risk. It’s best to talk with your cancer care team before starting any vitamin or other dietary supplement.

See Dietary Supplements: What Is Safe? for more information on vitamins and supplements.

Physical activity

A few studies have looked at the effect of physical activity on survival of people with cancer. Still, research has not yet shown whether physical activity can help prevent cancer recurrence or slow the progression of disease. But studies have shown that regular physical activity can reduce anxiety and depression, improve mood, boost self-esteem, and reduce symptoms of fatigue, nausea, pain, and diarrhea. These benefits can be gained through moderate to vigorous physical activity on most, if not all days of the week. (Moderate activities are those that make you breathe as hard as you would during a brisk walk.Vigorous activities make you use large muscle groups and make your heart beat faster, make you breathe faster and deeper, and also make you sweat.)

What to do

Talk to your cancer care team about an exercise plan that’s good for you. The American Cancer Society recommends cancer survivors:

  • Take part in regular physical activity.
  • Limit sitting or lying down time  and return to normal daily activities as soon as possible.
  • Aim to get at least 150 to 300 minutes per week of moderate intensity activity or 75 to 150 minutes per week of vigorous activity.
  • Include strength training exercises at least 2 days per week.

A little bit of physical movement is far better than none. It helps if you start slowly and build up over time. In choosing a level of activity, it’s important to think about your physical abilities and your recent levels of activity. It’s also important to do something you enjoy.

Can I ever be sure the cancer will never come back?

No, it’s not possible to guarantee that once you have completed cancer treatment the cancer will never come back. Although your doctor may say, “The cancer is gone” or “I think I removed all the cancer” or “I see no evidence of any cancer,” the fact remains that there’s always a chance that there are some cancer cells left in your body that survived, even though they can’t be seen or found with any test used today. Over time, these cells can begin to grow again.

While you don’t want to ever think about the chance of having a second cancer – one that’s not related to the first cancer – this is also possible. Having one cancer doesn’t make you immune to having a second or even a third different cancer.

What should I look for if I am worried about a recurrence?

It’s easy to obsess over every ache and pain if you’re worried about cancer returning. Check with your cancer care team for a list of common signs of recurrence of your type of cancer.

There are only a few major symptoms that could mean serious problems. If you have any of the problems listed below, tell your cancer care team at once.

  • Return of the cancer symptoms you had before (for example, a lump or new growth where your cancer first started)
  • New or unusual pain that’s unrelated to an injury and doesn’t go away
  • Weight loss without trying
  • Easy bleeding or unexplained bruising
  • A rash or allergic reaction, such as swelling, severe itching, or wheezing
  • Chills or fevers
  • Frequent headaches
  • Shortness of breath
  • Bloody stools or blood in your urine
  • New lumps, bumps, or swelling with no known cause
  • Nausea, vomiting, diarrhea, loss of appetite, or trouble swallowing
  • A cough that doesn’t go away
  • Any other signs your cancer care team has talked to you about or any unusual symptoms that you just can’t explain

Whenever you have a symptom, your first thought might be that your cancer has come back. Remember that there are illnesses and medical problems that have nothing to do with your previous cancer. You can still get colds, infections, arthritis, heart problems, and so on – just like anyone else. As with any illness, your primary care provider is the best person to find the cause of your symptoms. If you’re seeing a new doctor, be sure they know about your history of cancer and its treatment.

Help from patient support groups

Some people find it very hard to not worry about cancer coming back. For some people these thoughts become a fear that interferes with daily life. Some people deal with these thoughts by distraction, or by focusing on what’s most important to them each day. Others take measures such as joining a peer support group or seeing a mental health professional.

Talk to your cancer care team about your worries and concerns. Get help if you need it to deal with your emotions and live life to the fullest.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Rock CL, Thomson C, Gansler T, et al. American Cancer Society guideline for diet and physical activity for cancer prevention. CA: A Cancer Journal for Clinicians. 2020;70(4). doi:10.3322/caac.21591. Accessed at https://onlinelibrary.wiley.com/doi/full/10.3322/caac.21591 on June 9, 2020.

Last Revised: June 9, 2020