Now that you’re a breast cancer survivor, what can you do help prevent breast cancer recurrence? Thankfully, long-term survivorship has increased, but with that comes more post-treatment side effects including weight gain and co-morbidities like heart disease and type 2 diabetes.

Eating a healthy diet, living a healthy lifestyle and maintaining a healthy weight play a crucial role in warding off cancer recurrence as well as other chronic diseases and conditions.

Excess body weight is linked to breast cancer in post-menopausal women. The AICR (American Institute for Cancer Research) recommends that cancer survivors follow the recommendations for cancer prevention. Regarding weight, it’s ideal to “be as lean as possible without becoming underweight”. This is key for many cancers including post-menopausal breast cancer.

How does excess body fat contribute to breast cancer development? These three factors play a role:

• Estrogen – Since fat cells are the main site for estrogen synthesis, extra body fat increases estrogen which can facilitate the spread of cancer cells.
• Insulin – Increased weight typically leads to increased blood insulin levels. Higher blood insulin levels cause cells to multiply more rapidly which can foster tumor cell growth.
• Inflammation – Excess weight can lead to chronic inflammation, which can lead to DNA changes that lead to cancer.

Being as lean as possible without being underweight is a great goal, but what are some ways to achieve a healthy weight and prevent recurrence?

• Move more! – Physical activity reduces the risk of post-menopausal breast cancer. The American Cancer Society recommends five  30-minutes of physical activity a week while AICR recommends 30 minutes of physical activity daily. These 30-minute activity sessions need not be done continuously and can be broken down into smaller 10 or 15-minute sessions. In the beginning, start with your current activity level and proceed from there. It’s OK to start small and gradually increase your amount of time. Even if you don’t lose weight, you’re still receiving “benefits” because positive metabolic changes are taking place in your body.
• Significantly decrease or eliminate your alcohol consumption. Sometimes alcohol gets overlooked as a risk factor for breast cancer, but it is a carcinogen (cancer igniter) that damages DNA which can lead to cancer. Even at low levels, it can contribute to breast cancer. *If you’re not going to give up alcohol completely, women should not consume more than one drink/day.
• Increase fruit and vegetable intake. By default, this will most likely replace unhealthy high-calorie foods with healthy low-calorie fruits and vegetables. In addition to getting a plethora of vitamins and minerals, you’ll also be getting a  potent dose of cancer-fighting plant foods containing antioxidants, phytochemicals and fiber.
• Replace saturated fats (palm oil, butter, red meat) with healthy monounsaturated fats (olive oil, canola oil, avocados), polyunsaturated fats (vegetable oil, soybean oil, sunflower seeds) and omega-3 fatty acids (salmon, walnuts, ground flaxseed).
• Replace refined grains with cancer-fighting whole grains.
• Keep trigger foods away! If cake, pastries and beef jerky are your weaknesses, don’t keep them in your house!
• Watch portion sizes – The trick with this is to be mindful and learn what healthy portions look like. Over-consuming foods (even healthy ones) can lead to weight gain.

A note on Soy and Flaxseeds:

• Soy foods in moderate amounts (1 – 2 servings and even 3 servings) are safe and may possibly be protective among breast cancer survivors, even those taking tamoxifen.
• Flaxseed (1- 4 Tbsp/day) may offer protective benefits against breast cancer, especially post-menopausal breast cancer. There is some human research with flaxseed, but such is limited at this time.

We’re not always given choices in life, but when we are it’s an opportunity to be proactive with our health. When we move and eat the right foods, it’s our opportunity to arm ourselves to prevent cancer, recurrence of breast cancer and ward off other potential diseases and common cancer co-morbidities like heart disease and type 2 diabetes. The other “secret key” is VARIETY. There isn’t a magic bullet food and as per research, it appears that a multitude of components in foods work synergistically to produce beneficial health effects.

Let’s give it a shot, what do you think?

Key References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5112289/

http://www.aicr.org/continuous-update-project/breast-cancer.html

https://www.consultant360.com/n411/news/even-obese-breast-cancer-survivors-may-cut-heart-disease-risk-exercise

http://www.todaysdietitian.com/newarchives/0117p34.shtml

http://blog.aicr.org/2017/06/06/healthtalk-flaxseed-and-breast-cancer/

https://www.ncbi.nlm.nih.gov/pubmed/27130687

https://www.mdlinx.com/obstetrics-gynecology/medical-news-article/2016/05/23/breast-cancer-alcohol-incidence-mortality-systematic/6653878/

https://www.cancer.org/cancer/cancer-causes/diet-physical-activity/body-weight-and-cancer-risk/effects.html

Wendy Kaplan, MS, RDN, CSO, CDCES, CDN is a registered nutritionist specializing in oncology and weight management in Long Island and in the New York City area. Connect with Wendy on Facebook, Instagram and Twitter and read more of her blog posts and download recipes at Food4HealthRD.comof her blog posts and download recipes at Food4HealthRD.com