By Heather Millar
Within just a few hours of being diagnosed with breast cancer, I searched desperately for the bright side. “Well,” I said to my husband after a blubbering crying jag. “At least maybe I’ll lose weight during cancer treatment.”
Hah. I made that comment because of my impressions of cancer patients I’d known a generation ago. In those days, most cancers were found at later stages, when advanced enough to cause weight loss. Today, it’s a good news/bad news thing: More cancers are being found earlier before the disease causes weight loss; but today, more of us are overweight or obese when diagnosed. And many cancer patients gain weight during treatment.
I was about 10 pounds over my ideal weight when I was diagnosed. I blamed the weight on being peri-menopausal. But really, it was probably my love of stinky, fattening cheese and that glass of wine, or two, with dinner.
Then, when cancer exploded into my life, something I never imagined could happen, happened: I gained about 15 pounds during treatment. Thank you, nausea-fighting steroids and hormone-affecting drugs.
Since I finished active treatment last fall, I’ve been running and cycling five or six days a week and counting calories. I’m not going nuts. I don’t believe that crazy diets work; and I don’t have time for two- or three-hour workouts. The weight came on slowly, and the best thing I can do is take if off slowly. I’ve lost about 10 pounds so far. Only 15 to go!
Lately, though, I’ve been losing my ambition. The hard thing about taking weight off slowly is that you have to remain motivated for a long time. Really, you have to remain motivated forever: first, to lose it, and then, to keep it off.
And I’ve been getting lazy. I’ve been counting calories in my head, not on my iPhone app (easy to forget those jelly beans I bummed off my kid or the piece of bacon that I ate while cooking). I’ve occasionally been having a weekday glass of vino when I promised myself that I wouldn’t. They’re minor infractions; but ones that have stalled my weight loss campaign.
Recently, as if they knew of my faltering resolve, the American Cancer Society released new diet and exercise guidelines for cancer patients and survivors.
You can read the summary here and the full report here. The full report, an update of previous guidelines released in 2006, is more accessible to non-experts than many scientific papers. It offers detailed advice for specific cancers such as breast, colorectal, endometrial, ovarian, hematologic, lung, prostate, gastrointestinal, and head and neck. It also gives detailed advice on how to deal with specific barriers to exercise, such as lymphedema or fatigue or advanced disease.
Here’s the headline: The science of cancer survivorship is growing exponentially. That’s good news. That research wouldn’t be funded or possible if more of us weren’t living longer. And that science strongly shows that the cancer survivors who live the longest and the best are those who maintain a healthy weight, who eat a diet rich in fruits, vegetables and fiber, and who remain physically active.
Stay with me! Don’t zone out! I know this may seem more like a scolding drumbeat than news. I often joke that every health story I’ve ever written ends with: “Don’t get fat. Eat right. Exercise.”
The striking thing about this ACS report, I think, is the overwhelming strength of the evidence supporting healthy habits for cancer survivors. This is the first time the data has been strong enough to release formal guidelines for cancer survivors, as has been done before for cancer prevention. Here are just a few tidbits to give us all a motivational kick in the pants:
• Increasing evidence indicates that being overweight increases the risk of recurrence and reduces the likelihood of disease-free and overall survival among those diagnosed with cancer.
• A meta-analysis [that means a study compiling results of all the available studies] demonstrated that post-diagnosis exercise was associated with a 34% lower risk of breast cancer deaths, a 41% lower risk of all-cause mortality, and a 24% lower risk of breast cancer recurrence.
• Another meta-analysis of 44 studies that included over 3000 participants with varying cancer types, exercise significantly reduced cancer-related fatigue levels.
• At least 20 prospective observational studies have shown that physically active cancer survivors have a lower risk of cancer recurrences and improved survival.
• Results from observational studies suggest that diet and food choices may affect cancer progression, risk of recurrence, and overall survival in individuals who have been treated for cancer.
So while the advice may not seem new, the reasons for following the advice are new and overwhelming. You can start small, trying losing a pound a week, or even half a pound. Here’s what the report recommends:
• Achieve and maintain a healthy weight.
• Try to exercise 150 minutes a week. You can do it. That’s only 22 minutes a day.
• Eat a diet rich in vegetables, fruits and whole grains.
• Be careful about nutritional supplements; ask your oncologist before starting a supplement. Growing evidence suggests that certain supplements may actually be bad for cancer survivors.
So I’m firing up my iPhone calorie counting app again. As soon as I finish this post, I’m going for a run with the dog. May we all live long and prosper.