If you’ve had breast cancer and you’ve been through the hurdles of treatment, your biggest fear might be that it may come back. It’s the last thing anybody wants to face. In most cases, it doesn’t come back, but it can’t be ruled out.
If there’s a recurrence, breast cancer is most likely to come back within the first 2 years after you’ve finished treatment. So it’s especially important to pay attention to your health and well-being particularly during this time.
While there's no way to predict if your cancer will come back, don’t let the fear control your everyday life. Research shows that lifestyle changes and medications can help you stay as healthy as possible and may help reduce your risk of having cancer again.
Here are some of the changes you can make to give yourself the best chance to avoid breast cancer recurrence.
Keep Up With Exercise
A recent study shows that if you regularly exercise even for at least 2.5 hours per week, you can improve your overall health. It may also lower the risk of your cancer coming back. Research also shows that if you’re overweight, cancer is more likely to come back. Physical activity can help you reduce or maintain your weight at a healthy range for your body type.
Exercise can include waking, running, cardio activities, strength training, and flexibility. Guidelines recommend:
- At least 150 minutes (2.5 hours) of moderate aerobic exercise (like brisk walking) per week or 75 minutes per week of harder physical activity like running.
- 2 days of muscle training with weights per week.
That’s a lot to do if you’re not active now. Take it one step at a time, starting with even a few minutes. Gradually, you’ll be able to do more.
Eat a Well-Balanced Diet
When you eat a healthy diet filled with whole foods, your overall health improves. These foods can also give you the energy you need as your body recovers from cancer.
- Eat at least 5 servings of fruits and vegetables per day
- Limit red meats like beef, lamb, and pork
- Try to eat two to three servings of fish per week. The omega-3 fatty acids in fish are good for your health
- Cut down or avoid foods with high fats or too many calories. This may increase estrogen, a type of hormone in your blood that increases your risk for cancer.
- Add fiber to your daily diet.
- Avoid sugary drinks.
Limit or Avoid Alcohol
Studies show that there is a link between moderate and heavy alcohol use and breast cancer. Alcohol is known to raise estrogen levels in your blood. This makes it more likely for you to get cancer again. If you’re a cancer survivor, it’s best to avoid alcohol altogether.
If you do choose to drink, make sure to limit it to only one drink a day to lower your chances of your cancer coming back.
If You Smoke, Quit
Smoking tobacco is linked to many types of cancers. If you’ve not already quit, this is a top priority for your overall health and will make it less likely for your breast cancer to return.
To help you quit for good:
Keep Up With Your Health Screenings
After you’ve finished your cancer treatments, you still need to go to your doctor for your follow-up screenings. Your health care team may meet with you every few months after your treatment. They do this so that they can keep a close eye on any changes that may show signs that your cancer has come back. After you reach 5 years since your last treatment, you may need to see your doctor only once a year.
If you’ve had some of your breast removed as part of cancer treatment, you may need to get a mammogram, a scan that checks for breast cancer, every 6 to 12 months after treatment. You may need to continue the scans once a year after that. If you had both breasts removed, you may not need a mammogram.
Depending on the stage and type of cancer you had, the number of follow-ups may differ. It’s important not to skip or miss your follow-ups as cancer is more likely to come back within 2 years after treatment.
During these visits, it’s a good time to ask your doctor any questions or concerns you may have about what to watch out for, treatment side-effects, or your overall health.
Check on Whether You Need Medications
After you complete your cancer treatment, if you have a high chance of your cancer returning, your doctor may prescribe you certain drugs to reduce your risk.
Tamoxifen and raloxifene (Evista) are two such drugs. These drugs are approved for use in the U.S. and doctors usually prescribe them to lower the chances of estrogen-related breast cancer. Both drugs block estrogen hormone in breast cells. Studies show that they reduce your chances of getting breast cancer again by about 40%.
Tamoxifen. You take this once a day by mouth as a pill or liquid. It may make it less likely for you to get cancer in parts of your breast that weren’t affected earlier. You may have side effects like hot flashes, vaginal discharge, irregular periods, loss of sexual interest, memory loss, fatigue, and joint pain.
Raloxifene. It’s a pill you take once a day. It’s usually given to women who are post-menopausal -- those who stopped having their periods. It may also help you avoid or treat osteoporosis, when your bone density thins, putting you at risk of fractures.
While rare, these drugs can also cause blood clots in your leg veins or lungs. This can be a serious side effect that may need immediate medical attention. Contact your doctor as soon as possible if you think you have a blood clot.
Aromatase Inhibitors. If you have high risk of breast cancer coming back, aromatase inhibitor (AI) drugs may be another option. These drugs include anastrozole (Arimidex) and exemestane (Aromasin). They lower the estrogen levels in your body that can lead to breast cancer. It’s a daily pill mostly given to postmenopausal women for up to 5 years if you’re at a risk to develop blood clots and you’re unable to take tamoxifen or raloxifene.
Aromatase inhibitors aren’t approved to lower breast cancer risk in women who’ve never had breast cancer.
Take Care of Your Emotional Needs
A breast cancer diagnosis can take quite a toll on your body, both physically and mentally. The treatments can affect each person differently. And the uncertainty that comes along with breast cancer may also affect your self-worth, identity, and your confidence.
After treatment, managing your new normal and coming to terms with all that has happened may feel challenging. It’s important to take the time to heal and prioritize your overall emotional and mental health, in addition to your physical health.
- Make some time for self-care and put your needs first.
- Talk to a professional counselor or therapist if fears of breast cancer coming back start to interfere with your daily life.
- Connect with other people who’ve had breast cancer to gain a sense of community.
- Follow news on new treatments or findings.
- Practice mindfulness to reduce stress. Yoga, meditation, and other relaxation techniques can help you center yourself.
- Pick up a hobby that you’ve enjoyed before, or explore new ones.
- Journal your feelings.
Keep in mind that if breast cancer does come back, it is not your fault and it can often be treated.