Suggestions for a Healthy Lifestyle Following Breast Cancer Treatment

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Making changes to your lifestyle following treatment for cancer can help prevent cancer recurrence and decrease risk of other chronic health problems. The pillars of lifestyle change include food choice, movement, stress management, sleep, social connection and avoiding risky substances. After a cancer diagnosis many people want to change their lifestyle to help prevent future health problems. It can seem overwhelming. Focus on what has the most meaning to you. Here are some ideas and resources.

Food Choice

The foods we choose to eat are important for health reasons but can also have deep meaning for personal, psychological and cultural reasons.

• Focus on plant-based foods including plenty of vegetables and fruit, whole grains. This would include diet patterns such as a Mediterranean diet, DASH diet or an anti-inflammatory diet.
• Include a variety of whole foods with many colors to help make sure you get plenty of vitamins, minerals and phytonutrients.
• Try to include at least 5 servings of vegetables and fruits a day. It would be hard to eat too many vegetables.
• Including plenty of fiber from whole grains, vegetables, fruit and legumes.
• Limit added sugar to no mor than 6 tsp for women and 9 tsp for men. One medium chocolate chip cookie has about 2 tsp of sugar. A 12-oz can of a soft drink has about 10 tsp of sugar. Added sugar does not include the sugar found in fruit.
• Avoid refined grain products such as processed bread products
• Limit processed meat such as hot dogs, deli meats or sausage.
• If you eat red meat, limit the amount of beef, pork or lamb to more than 18 ounces of cooked meat a week.
• Focus on healthy fats such as olive oil, plant sources of oil and omega 3 fatty acids. Limit fats that are solid at room temperature.
• Omega 3 fatty acids can be found in fatty fish such as salmon and sardines. Other sources include walnuts and flax seed.
• Soy foods may improve outcomes after breast cancer. But avoid soy supplements and processed soy foods such as soy “hot dogs”.
• Beverages such as coffee, tea and green tea contain phytonutrients that may be helpful. Avoid adding sugar or creamer.
• It is important to enjoy your food choices.
• Supplements may be helpful, harmful or have no benefit. Supplements do not replace a healthy diet. Please share what supplements you are taking with your cancer care team. If you are interested in adding supplements such as vitamins or natural products consider an integrative medicine consultation.

Resources

Ask your provider about getting a referral to registered dietitian or health coach. The following resources can also be helpful:

• Eating Well
• American Cancer Society Main Dishes
• American Institute for Cancer Research Setting Your Table to Prevent Cancer
• USDA MyPlate Eating Healthy with MyPlate

Movement

The strongest data on lifestyle changes to improve cancer outcomes is for physical activity and exercise, including decreasing the risk recurrence for some cancers. Physical activity improves fatigue, bone health, sleep and quality of life. It may help improve peripheral neuropathy and cognitive function and reduce falls.

• Aim for activity 150 minutes, even up to 300 minutes of moderate intensity aerobic activity. This would be about 30-60 minutes 5 days a week.
• During a moderate activity exercise, you would be able to talk, but not sing. An example would be brisk walking.
• If you were not exercising before you developed cancer even light activity can be helpful. Begin slowly and build up. Start with 1-3 light to moderate activity sessions of 20 minutes. Do exercise that is enjoyable for you.
• Include resistance or strength training at least twice a week. Work major muscle groups. Completed 2-3 sets of about 10 repetitions of an exercise. If you have never done resistance training, consider an exercise specialist if available. Seek advise about resistance training if you have lymphedema.
• Stretch major muscle groups at least twice a week
• Include core muscle exercise and balance especially if you are older or at risk for falling.
• In addition, avoid being inactive. Consider taking short walking breaks through the day. Take the stairs, take phone calls standing up.
• Find an exercise buddy or join a class to help keep you motivated.

Resources:

Referral to Steps to Wellness – exercise-based oncology rehabilitation can be helpful as well as the following:

• YouTube Videos:
  • Walk at Home
  • Yoga with Adriene
• HASFit The Best Home Workouts - has options for beginners and seniors
• Centers for Disease Control and Prevention Index of physical activity basics and benefits

Stress Management

The diagnosis of a major illness such as cancer is one of the top 5 stressor in life. Fear of recurrence, anxiety, and depression are common and normal. It is important to remember that your thoughts, emotions or stress did not cause your cancer.

• Mindfulness practices such as meditation or mindfulness-based stress reduction have been well studied and can reduce fear of recurrence, anxiety and depression.
• Physical activity improves anxiety and depression and may be as effective as antidepressant medications.
• Yoga, tai chi, and qigong combine often combine movement and meditation and may have physical activity and stress reduction benefits.
• Experiment with relaxation techniques that you find helpful for decreasing stress. This might be breathing, music, light stretching, a short walk. Find what works best for you.
• Consider keeping a journal. Include writing about things that you are thankful for.
• Remember, not all stress is bad stress. Stress can help us do “hard things”. That feeling of accomplishment builds confidence for tackling more “hard things”.
• Enough sleep, healthy food choices and movement all help control stress too!
• Reach out to a supportive friend or family member to help cope.
• When you can stop and recognize unhelpful negative thoughts.
• Practice self-compassion. Talk to yourself like a supportive friend would.
• Consider seeing a counselor or participating in support groups.
• There is a difference between stress and anxiety. Stress will usually come and go. Anxiety is more constant usually with feelings of apprehension or dread. If you are experiencing anxiety you may want to consider seeking out a counselor or discuss with your primary care provider.

Resources:

Referral to counseling and support groups can be helpful in addition to the following:

• Insight Timer - meditation app with a free option that includes guided meditation, breathing and relaxing music.
• Calm and Headspace meditation apps both have free and paid options.
• American Cancer Society Coping and Living Well During Cancer Treatment
• National Institute of Mental Health I’m So Stressed Out! Fact Sheet
• National Cancer Institute Coping with Cancer

Restorative Sleep

Fatigue after treatment for cancer is the most common continued side effects. One way to help improve fatigue is work on how well you sleep.

• Aim for 7-9 hours of sleep, this might be 7-8 hours of sleep if you are older
• Try to go to bed and get up at the same time every day. Avoid sleeping in when you stay up late or had problems sleeping
• Avoid caffeine after about 2pm.
• You might feel sleepy after alcohol but it interferes with the quality of sleep
• Avoid screens of any kind, TV, phone, iPad while in bed
• Keep your bedroom cool and dark for sleep.
• Exercise improves fatigue and can help with sleep as long as it occurs more than 2 hours prior to bedtime.
• If after 20 minutes you are unable to fall back asleep get out of bed, do something relaxing and then go back to bed. Avoid using computers, phones or TV at that time.
• Try to get sun in your eyes in the morning.

Resources

• CBT-I
• Sleep Foundation Sleep Better, For the Journey Ahead 

Social Connection

Research studies increasingly remind us of the importance of social connections and relationships for our overall health. Social connection can improve and strengthen our mental, emotional and physical health. It is all connected.

• Take time to spend with others.
• Be there when someone needs you.
• Share experiences
• Attend events with others
• Be flexible, supportive and excited about what others are doing.
• Attend community celebrations
• Join a group involved in activities that are interesting to you.
• When possible, stay positive while interacting with others.

Resources

• Centers for Disease Control Improving Social Connectedness

Avoidance of Risky Behaviors

Adopting a healthy lifestyle includes avoiding some things as well. Avoiding tobacco and secondhand smoke is one of the best things you can do for your health. Avoiding or drinking alcohol in moderation is linked to a lower risk of heart disease, high blood pressure, and overall mortality. Too much sun exposure can damage the DNA in our skin cells which can lead to skin cancer. It’s best to use sunscreen, or better yet, cover up with protective clothing.

• Avoid use of tobacco
• Avoid secondary exposure to smoke
• Drink alcohol sparingly, if at all
• Use sunscreen with SPF of at least 30 when in the sun. Reapply every 2 hours or after swimming or sweating. Keeping covered with light clothing also protects you from the sun.

Resources:

• 802Quits Get Answers to Your Quitting Questions
• Centers for Disease Control How to Quit Smoking

What we know about integrative health care has come to us thanks to the efforts, experiences, and collective wisdom of people from many cultures and backgrounds. We wish to acknowledge all the healers, researchers, patients, and peoples who have informed the content of this tool.

Author(s)

This handout was adapted for the Osher Center for Integrative Health at the University of Wisconsin-Madison by Kim Dittus MD, PhD.

Date Created: April 2024