For patients with breast cancer, physical activity and avoiding weight gain are the most important lifestyle choices that can reduce the risk of cancer recurrence and death, according to an evidence-based review published in CMAJ (Canadian Medical Association Journal).
"Of all lifestyle factors, physical activity has the most robust effect on breast cancer outcomes," writes Dr. Ellen Warner, Sunnybrook Health Sciences Centre, Toronto, Ontario, with coauthor Julia Hamer. "Weight gain of more than 10% body weight after a breast cancer diagnosis increases breast cancer mortality and all-cause mortality. However, there are good reasons to discourage even moderate weight gain because of its negative effects on mood and body image," the authors state.
Key findings of the study include:
Avoid weight gain -- weight gain during or after breast cancer treatment is linked to breast cancer-related death. Women who are overweight or obese at diagnosis also have poorer prognoses.
Exercise -- patients should engage in at least 30 minutes of moderate exercise a day, five days a week, or 75 minutes of vigorous exercise per week. Two to three sessions of strength training for large muscle groups are also recommended.
Diet -- no specific type of diet has been shown to reduce the risk of breast cancer recurrence. Evidence indicates that patients do not need to avoid soy, and it may help with weight management if used to replace higher-calorie meat protein.
Vitamin supplementation -- moderate consumption of vitamin C may be helpful although more evidence is needed. Vitamin D supplements may be taken to maintain adequate levels for bone strength, since chemotherapy and hormonal treatments can reduce bone density.
Smoking -- stop smoking. While it is unclear if stopping smoking after a breast cancer diagnosis affects recurrence, the risk of death from smoking-related health issues is a strong reason to quit.
Alcohol intake -- limiting consumption to one or fewer alcoholic drinks per day may help reduce the risk of a second breast cancer.
Making positive lifestyle changes can also be psychologically beneficial to patients by empowering them, since the feeling of loss of control is one of the biggest challenges of a cancer diagnosis," write the authors.
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