When you finish treatment for breast cancer you're probably looking for everything you can do to stay cancer-free.
There's a lot you can do, in addition to taking any meds your doctor prescribes to help prevent recurrence and keeping up with your screenings. And a lot of it will sound familiar.
The same healthy lifestyle habits that are supposed to lower the odds of developing breast cancer in the first place are also likely to cut the risk of breast cancer recurrence. Studies specific to breast cancer survivors back that up: regular physical activity and a healthy diet that's rich in fiber, vegetables, fruits, whole grains, and beans -- and low in sugary fare -- may help guard against breast recurrence.
Here's the breakdown of what to aim for.
You’ve Got to Move It, Move It
Being physically active has clear benefits.
Women who got regular physical activity before their breast 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 included 1,340 women with breast cancer and and focused on U.S. physical activity guidelines for adults, which are to do this:
at least 150 minutes of moderate-intensity physical activity per week
at least 2 days of muscle-strengthening activity every week.
In the study, breast cancer was less likely to come back in women who met those goals than in those who were inactive. Survival was also better during the study for the women who met those goals -- and even for those who the researchers called “low active,” meaning that they came close to meeting the recommended activity levels but didn’t quite get there.
Fitness Tips for Breast Cancer Survivors
Your body has been through a lot, between breast cancer itself and its treatments. 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 what experts often say: "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 ran 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 from 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 More (and Less) Of
What about food? The bottom line:
- Eat more fruits, non-starchy vegetables (especially leafy greens and cruciferous veggies such as broccoli, cauliflower, and Brussels sprouts), and whole grains.
- Limit foods that have a high glycemic load, such as sugary drinks and treats.
“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).
Here's a look at two research papers that helped show that.
The data come from about 250,000 U.S. women who were part of the Nurses’ Health Studies. They were all younger than 55 and cancer-free when the studies started. About 9,000 were diagnosed with breast cancer at some point during the studies, which spanned 30 years. This research was observational, meaning that the women weren't assigned to eat certain types of food. But they filled out questionnaires about what they ate. This shows patterns among the large group of people, based on what they said they typically ate and drank.
Among the women who developed breast cancer, those who reported eating the greatest amounts of fruits and vegetables were less likely to die during the study, compared to those who ate the least amounts of fruits and vegetables.
In particular, leafy greens and cruciferous vegetables like broccoli, cauliflower, and Brussels sprouts drove most of the benefits.
- Women who reported eating almost a full serving of cruciferous vegetables daily were 13% less likely to die of any cause during the study, compared to those who ate almost none of these vegetables.
- Those who reported eating nearly 2 servings of leafy greens daily were 20% less likely to die, compared to those who hardly ate any greens.
When it came to carbs, those with high glycemic load -- like sugary drinks, processed foods like chips and doughnuts, and fast food like cheeseburgers and french fries -- carried an increased risk. Breast cancer survivors with high glycemic load diets were more likely to die of breast cancer during the studies than those who ate lower glycemic load diets. And women who ate high-fiber diets had a lower risk of death than those who ate diets low in fiber.
And there's good news about 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.
Aim for 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 research shows 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 help prevent a recurrence. These include:
