When you finish treatment for breast cancer, you might have a mix of feelings. Going through treatment is physically and mentally exhausting, with many side effects from chemotherapy, radiation, surgery, and immunotherapy. Once the treatment phase is over, is there anything you can do to boost your odds of staying cancer-free?
The answer is YES. There’s a lot you can do in your everyday life -- in addition to taking any meds your doctor prescribes to help prevent recurrence and keeping up with your screenings.
Cancer experts have long advised breast cancer survivors that the same healthy lifestyle habits that have been shown to lower your chance of developing breast cancer in the first place are also likely to cut the risk of breast cancer recurrence. In the past, that advice was based mostly on expert opinion.
But more recently, studies specifically done in breast cancer survivors have added weight to that opinion. These findings suggest that regular physical activity and a healthy diet that is high in vegetables, fruits, whole grains, and beans, and low in processed carbohydrates and high in fiber can help guard against breast recurrence and death.
You’ve Got to Move It, Move It
Being physically active has clear benefits.
Women who got regular physical activity before their cancer diagnosis and after treatment are less likely to have their cancer come back or to die compared with those who were inactive. That’s according to a 2020 study from researchers at Roswell Park Comprehensive Cancer Center in Buffalo, NY.
The study focused on 1,340 women with breast cancer and the CDC’s physical activity guidelines for adults, which are to get at least 150 minutes of moderate-intensity physical activity and 2 days of muscle-strengthening activity every week. In the study, women who did that were less likely to have their cancer come back than those who were inactive. They also were less likely to die over the 2 years of the study period. Even those who were considered to be “low active,” meaning that they came close to meeting the recommended activity levels but didn’t quite get there, had improved survival, as well.
Fitness Tips for Breast Cancer Survivors
Your body has been through a lot – from the cancer itself to the treatments for it. No one is expecting you to run a marathon unless you want to. But don’t underestimate the power of regular movement.
Start small. Even a daily 15-minute walk has benefits. “You don’t have to do a lot of intense workouts to benefit,” says Karen Basen-Engquist, PhD, the director of the Center for Energy Balance in Cancer Prevention and Survivorship at The University of Texas MD Anderson Cancer Center. “It can be hard to begin exercising when you’re experiencing fatigue related to cancer treatment, but moving just a small amount most days can help you reach the point where you can do more.”
Tell your doctor. You may have glossed over the guidance you often see in fitness magazines: "Consult your doctor before starting any exercise program." Don't ignore that advice this time. Check with your treatment team to see how much exercise they feel you can handle at this point in your recovery.
Set realistic expectations. If you were running an 8-minute mile before you started chemotherapy, don't expect to be able to match that pace 3 or 4 months after your last dose. And that’s OK.
Don't stress your bones and joints. This is especially important if you’ve had bone loss related to chemotherapy. Instead of running or high-impact aerobics, which could add to your risk of fractures, start with walking. Or try swimming, a no-impact way to work your muscles and your cardiovascular system.
Be aware of your ability to balance. If you have neuropathy (tingling or numbness) in your feet or hands after chemotherapy, that can affect your balance. Be careful about activities where you might risk falling. Instead of running on a treadmill, for example, you might prefer to work out on an exercise bicycle.
Make time for strength training. It can make a difference in your daily life. “While we can’t say whether or not it improves overall survival, the evidence shows that breast cancer survivors who do strength training see improvements in their fatigue, quality of life, and physical functioning,” Basen-Engquist says.
What to Eat: Leafy Greens and Smart Carb Intake
What about food? The good news is that the general principles of healthy eating are also beneficial for breast cancer survivors.
Two recent studies suggest that a healthy diet can help breast cancer survivors live longer. Both studies involve data from about a quarter of a million women who took part in two large observational studies called the Nurses’ Health Studies. The studies followed these women, all of whom were under 55 and cancer-free when they began, for up to 30 years. By 2011, about 9,000 of the study participants had been diagnosed with breast cancer.
The first study found that women who ate the greatest amounts of fruits and vegetables after their breast cancer diagnosis had an overall lower risk of dying during the course of the study compared to those who ate the least amounts.
When the researchers dug deeper, they found that it was leafy greens and cruciferous vegetables like broccoli, cauliflower, and Brussels sprouts that were driving most of the benefits. Women who ate almost a full serving of cruciferous vegetables daily had a 13% lower risk of dying from any cause during the study, compared to those who ate almost none of these vegetables. And women who ate almost two servings of leafy greens daily were 20% less likely to die, compared to those who ate almost no greens.
Carbs were key in the second study – specifically, what kinds or types of carbs women ate. It found that high glycemic load carbs -- those that cause your blood sugar to spike, like sugary beverages, processed foods like chips and donuts, and fast food like cheeseburgers and french fries -- posed an increased risk. Breast cancer survivors with high glycemic load diets were more likely to die of breast cancer than those who ate lower glycemic load diets. They also found that women who ate high-fiber diets had a lower risk of death than those who ate diets low in fiber.
The bottom line: Eat more fruits, vegetables, and whole grains.
“Taken together, the research suggests that women diagnosed with breast cancer may benefit from eating a diet high in fruits and vegetables and eating less rapidly digested foods sources, such as whole grains and non-starchy vegetables,” says Nigel Brockton, PhD, vice president of research for the American Institute of Cancer Research (AICR).
And there was good news for fans of tofu and edamame: Despite past concerns that the estrogen-like properties of soy might contribute to breast cancer, evidence now shows that the opposite is true. “If anything, soy has a beneficial effect and may even reduce the risk of breast cancer recurrence,” Brockton says. “I also often get questions about dairy contributing to breast cancer, and it does not. The evidence is very clear on that.”
Maintaining a Healthy Weight
In general, getting regular physical activity and eating a healthy diet can help keep you from gaining too much weight, something that researchers have also found is important after breast cancer.
“There is strong evidence that a higher body mass index after diagnosis is associated with poorer outcomes in breast cancer,” Brockton says. “Avoiding weight gain and doing your best to stay at a healthy weight is important.”
Overall, Brockton says that the AICR’s recommendations about diet and physical activity for cancer prevention are still wise advice for breast cancer survivors to avoid a recurrence. These include:
- Maintain a healthy weight.
- Be physically active.
- Eat more whole grains, vegetables, fruits, and legumes (like beans).
- Avoid sugary drinks and limit your intake of fast foods and processed foods high in fats, starches, and sugars.
- Limit red meats like beef, pork, and lamb.
- Avoid processed meats and alcohol.