Lifestyle

Those are excellent questions, and they are the basis for my evidence-based book, A Cancer Prevention Guide for the Human Race (http://www.amazon.com/Cancer-Prevention-Guide-Human-Race/dp/1608446913), which is the only current research-based cancer prevention book written specifically for lay readers. First, let me start by noting that the overwhelming majority of disease prevention research (http://www.doctorwascher.com/tag/prevention), including cancer prevention research, is based upon rather “low-level” types of research, including survey-based public health studies and retrospective clinical studies. While these methods of research are relatively quick and inexpensive to perform, the data that they produce is highly prone to various forms of bias. That is to say, their conclusions are often not highly accurate. On the other hand, prospective, randomized, placebo-controlled clinical research trials, when performed properly, provide the highest level of research evidence available. However, because this type of research is so demanding, and so expensive to perform, very few cancer prevention studies are performed using this “high-level” research approach. With this in mind, even rather conservative estimates of cancer risk associated with lifestyle and dietary factors suggest that somewhere between 40 and 60 percent of all cancer cases are directly linked to modifiable lifestyle, dietary, and environmental factors. (Some important cancer risk factors cannot be modified at this time, including the genes that we inherit from our parents, increasing age, and gender.) What is especially important to note is that some of the very worst cancer killers are the very same cancers that are most closely linked to modifiable lifestyle and dietary factors, including lung cancer, breast cancer, pancreatic cancer, esophageal cancer, stomach (gastric) cancer, and other common major cancers. At this time, we are able to effectively cure approximately 60 to 65 percent of all cancers. However, for many of the “bad actor” cancers, the likelihood of cure, even with aggressive treatment, remains very low at this time. As I say in A Cancer Prevention Guide for the Human Race, “…an ounce of cancer prevention is worth a ton of cancer cure!” Those are excellent questions, and they are the basis for my evidence-based book, A Cancer Prevention Guide for the Human Race (http://www.amazon.com/Cancer-Prevention-Guide-Human-Race/dp/1608446913), which is the only current research-based cancer prevention book written specifically for lay readers. First, let me start by noting that the overwhelming majority of disease prevention research (http://www.doctorwascher.com/tag/prevention), including cancer prevention research, is based upon rather “low-level” types of research, including survey-based public health studies and retrospective clinical studies. While these methods of research are relatively quick and inexpensive to perform, the data that they produce is highly prone to various forms of bias. That is to say, their conclusions are often not highly accurate. On the other hand, prospective, randomized, placebo-controlled clinical research trials, when performed properly, provide the highest level of research evidence available. However, because this type of research is so demanding, and so expensive to perform, very few cancer prevention studies are performed using this “high-level” research approach. With this in mind, even rather conservative estimates of cancer risk associated with lifestyle and dietary factors suggest that somewhere between 40 and 60 percent of all cancer cases are directly linked to modifiable lifestyle, dietary, and environmental factors. (Some important cancer risk factors cannot be modified at this time, including the genes that we inherit from our parents, increasing age, and gender.) What is especially important to note is that some of the very worst cancer killers are the very same cancers that are most closely linked to modifiable lifestyle and dietary factors, including lung cancer, breast cancer, pancreatic cancer, esophageal cancer, stomach (gastric) cancer, and other common major cancers. At this time, we are able to effectively cure approximately 60 to 65 percent of all cancers. However, for many of the “bad actor” cancers, the likelihood of cure, even with aggressive treatment, remains very low at this time. As I say in A Cancer Prevention Guide for the Human Race, “…an ounce of cancer prevention is worth a ton of cancer cure!”

I think that working out a nutrition and food plan is the most important change one can make for a long-term recovery. While weight loss will probably be an outcome of changing the way you eat, you first must start by examining which foods will work best for your body and what amounts you need to get optimum nutrition. Weight control and exercise are the two related factors that are truly under our control and that might have a bearing on the outcome of treatment for early stage breast cancer.

I have a 5-step process that I use as part of my cancer coaching. Step 2 is all about healing and stimulating the immune system. I start by talking about how healing takes place and what is needed for optimal healing. Then we look at the factors that may be contributing to cancer cell growth; inflammation, an acidic environment, too much sugar and refined/processed foods. For each factor, there are recommended diet and lifestyle changes that we discuss. I share some research data on things like the importance of exercise, the effect of anti-cancer foods etc. I believe people need to have a basic understanding of how cancer cells are fed so that they can feel like the changes they are making are truly going to help their healing. One of the most important things I emphasize is pleasure. If you start an exercise routine and don't enjoy it - it won't give you the benefits you are looking for and you are not likely to keep it up! So we find a way to make it enjoyable. Maybe it is walking with a friend, maybe going to a park that you love or listening to your favorite music and dancing!! The same goes for the diet changes, they have to be enjoyable!! So the combination I use is increased knowledge, empowerment (yes, you can make a difference on your healing journey), ideas (how can you have fun and make these changes), tools (guided meditations, exercises) and support(from me and from themselves - self love is a big part of the healing journey and a whole other step in my process). I have a 5-step process that I use as part of my cancer coaching. Step 2 is all about healing and stimulating the immune system. I start by talking about how healing takes place and what is needed for optimal healing. Then we look at the factors that may be contributing to cancer cell growth; inflammation, an acidic environment, too much sugar and refined/processed foods. For each factor, there are recommended diet and lifestyle changes that we discuss. I share some research data on things like the importance of exercise, the effect of anti-cancer foods etc. I believe people need to have a basic understanding of how cancer cells are fed so that they can feel like the changes they are making are truly going to help their healing. One of the most important things I emphasize is pleasure. If you start an exercise routine and don't enjoy it - it won't give you the benefits you are looking for and you are not likely to keep it up! So we find a way to make it enjoyable. Maybe it is walking with a friend, maybe going to a park that you love or listening to your favorite music and dancing!! The same goes for the diet changes, they have to be enjoyable!! So the combination I use is increased knowledge, empowerment (yes, you can make a difference on your healing journey), ideas (how can you have fun and make these changes), tools (guided meditations, exercises) and support(from me and from themselves - self love is a big part of the healing journey and a whole other step in my process).

Estrogen in natural food (unprocessed has been shown like ORGANIC soy) to occupy receptors like tamoxifen does. It is not our enemy at all.

Healthy foods are the natural ones - real fruit (organic when possible, unsprayed), vegetables,all COLORS. The colors indicate the broad variety of healthy phytochemicals (plant-substances our bodies need).

NO SODA or JUNK food, less fried foods or NONE. Lower amounts of salt. Try to avoid food coloring, artificial flavors and preservatives. Our bodies do not recognize that stuff as 'food'/'nutrition'.

REAL food as often as possible in small amounts at a time.

Wild fish is better than farmed (they feed those poor fish all sorts of crap), free-range animals if you eat them also better. Estrogen in natural food (unprocessed has been shown like ORGANIC soy) to occupy receptors like tamoxifen does. It is not our enemy at all.

Healthy foods are the natural ones - real fruit (organic when possible, unsprayed), vegetables,all COLORS. The colors indicate the broad variety of healthy phytochemicals (plant-substances our bodies need).

NO SODA or JUNK food, less fried foods or NONE. Lower amounts of salt. Try to avoid food coloring, artificial flavors and preservatives. Our bodies do not recognize that stuff as 'food'/'nutrition'.

REAL food as often as possible in small amounts at a time.

Wild fish is better than farmed (they feed those poor fish all sorts of crap), free-range animals if you eat them also better.

The term "lifestyle modifications" means many things, and I'll try to elaborate. Just as we all learn (often the hard way) that the secret to weight loss is no secret at all, it's old fashioned diet and exercise, the same can be said with other areas of health maintenance and disease prevention. We're learning more every day about the effects of obesity, processed food diets, lack of sleep, chronic stress, and other realities of modern living in terms of their contribution to many diseases as well as cancer. Not all diseases and cancer can be prevented by a healthy lifestyle, but here are some facts:

- postmenopausal women who are overweight have a higher risk of developing breast cancer, and if they've been treated for breast cancer, their risk of recurrence is increased if they are overweight
- moderate exercise has been shown to reduce the risk of breast cancer development as well as the risk of recurrent disease
- a high fat diet has been linked to an increased risk of breast cancer
- more than one alcoholic drink per day (in women) is associated with an increasing risk of breast cancer
the list goes on and on...


But I think we also do our patients a disservice by harping too much on these studies, because many then will feel that they brought the cancer (or other disease) on themselves by not controlling their diet, activity level, or stress. The reality is that breast cancer and many other diseases are caused and exacerbated by multiple factors - this is why studies looking at preventative methods are so difficult. And it's also why the studies that pop up every so often regarding the benefits of a particular nutrient or extract need to be placed in proper perspective - it's usually not as simple as one nutrient or extract.


My recommendation for all of my patients, not just those with breast cancer, is to take care of themselves. As we get older, our bodies become less tolerant to the effects of lack of sleep, heavy alcohol intake, and the dietary habits that we had when we were in our 20's. Our bodies have changed - we have to change our habits if we want to try to stay healthy. So the basics:

- Low fat (not no fat!!) diet - focus on the healthy fats such as olive oil, salmon, walnuts, avocado
- Plant-based diet - focus on lots of greens and veggies of all colors, as well as fruits. You may feel it's easier to take your fruits and veggies in pill form, but while you may be getting some of the vitamins and extracts, the way the real foods interact is very complex (just like how cancer develops) and cannot be replicated in a pill. Trace nutrients that we may not even know about will also be missing, as well as fiber, not to mention the wonderful taste of properly prepared, fresh vegetables!
- Animal protein is ok, just consider the source and eat in moderation
- Don't forget non-animal sources of protein such as legumes, beans, and quinoa
- Moderation in alcohol intake - 0-1 per day
- Moderate exercise - it's ok if you can't do you spinning class like you did 10 years ago - a good 30 minute walk once a day is fine! If you need that endorphin rush of spinning or other strenuous activity, make sure to balance it with some more meditative exercise such as yoga or pilates
- Proper sleep - we all need 7-9 hours a night, period. Our bodies repair themselves during sleep, and you can't just "catch up" on the weekends. Those that catch me on-line after 10pm pacific time - feel free to call me out on this one!
- Meditation / Reflection - so very important to take some time each day to reflect on what is good in your life - having a sense of appreciation and gratitude for the good things will help make it easier to get through the tough times. This can be as formal or informal as you want, it's just important to fit this in somewhere.


Those are the basics - we could go on for hours, and I'd welcome comments and suggestions from others on these points. Just remember that you're not doing this specifically for breast cancer prevention - these are steps to make you a healthier and happier person. The term "lifestyle modifications" means many things, and I'll try to elaborate. Just as we all learn (often the hard way) that the secret to weight loss is no secret at all, it's old fashioned diet and exercise, the same can be said with other areas of health maintenance and disease prevention. We're learning more every day about the effects of obesity, processed food diets, lack of sleep, chronic stress, and other realities of modern living in terms of their contribution to many diseases as well as cancer. Not all diseases and cancer can be prevented by a healthy lifestyle, but here are some facts:

- postmenopausal women who are overweight have a higher risk of developing breast cancer, and if they've been treated for breast cancer, their risk of recurrence is increased if they are overweight
- moderate exercise has been shown to reduce the risk of breast cancer development as well as the risk of recurrent disease
- a high fat diet has been linked to an increased risk of breast cancer
- more than one alcoholic drink per day (in women) is associated with an increasing risk of breast cancer
the list goes on and on...


But I think we also do our patients a disservice by harping too much on these studies, because many then will feel that they brought the cancer (or other disease) on themselves by not controlling their diet, activity level, or stress. The reality is that breast cancer and many other diseases are caused and exacerbated by multiple factors - this is why studies looking at preventative methods are so difficult. And it's also why the studies that pop up every so often regarding the benefits of a particular nutrient or extract need to be placed in proper perspective - it's usually not as simple as one nutrient or extract.


My recommendation for all of my patients, not just those with breast cancer, is to take care of themselves. As we get older, our bodies become less tolerant to the effects of lack of sleep, heavy alcohol intake, and the dietary habits that we had when we were in our 20's. Our bodies have changed - we have to change our habits if we want to try to stay healthy. So the basics:

- Low fat (not no fat!!) diet - focus on the healthy fats such as olive oil, salmon, walnuts, avocado
- Plant-based diet - focus on lots of greens and veggies of all colors, as well as fruits. You may feel it's easier to take your fruits and veggies in pill form, but while you may be getting some of the vitamins and extracts, the way the real foods interact is very complex (just like how cancer develops) and cannot be replicated in a pill. Trace nutrients that we may not even know about will also be missing, as well as fiber, not to mention the wonderful taste of properly prepared, fresh vegetables!
- Animal protein is ok, just consider the source and eat in moderation
- Don't forget non-animal sources of protein such as legumes, beans, and quinoa
- Moderation in alcohol intake - 0-1 per day
- Moderate exercise - it's ok if you can't do you spinning class like you did 10 years ago - a good 30 minute walk once a day is fine! If you need that endorphin rush of spinning or other strenuous activity, make sure to balance it with some more meditative exercise such as yoga or pilates
- Proper sleep - we all need 7-9 hours a night, period. Our bodies repair themselves during sleep, and you can't just "catch up" on the weekends. Those that catch me on-line after 10pm pacific time - feel free to call me out on this one!
- Meditation / Reflection - so very important to take some time each day to reflect on what is good in your life - having a sense of appreciation and gratitude for the good things will help make it easier to get through the tough times. This can be as formal or informal as you want, it's just important to fit this in somewhere.


Those are the basics - we could go on for hours, and I'd welcome comments and suggestions from others on these points. Just remember that you're not doing this specifically for breast cancer prevention - these are steps to make you a healthier and happier person.

If there's one thing that can comes up time and time again for risk reduction in breast cancer survivors it is exercise; moderate, daily exercise. This, most recently on ABC World News Tonight 10/3/11: http://abcnews.go.com/WNT/video/breast-cancer-awareness-hit-gym-14659881

I took up cycling following treatment not necessarily to prevent recurrence, but because exercise in and of itself helped reduce symptoms brought on by treatment, especially tamoxifen. Other helpful strategies: I eat a largely vegetable based diet, little if any red meat; I avoid situations that do nothing but cook up stress for me; and when possible, I laugh long and hard. There's everything to be said for surrounding yourself with loving, open people.

The other caveat I believe all of us understand is that there are certain kinds of breast cancer that are more amenable to these kind of interventions. Mine happened to be one, even though I was diagnosed at a later stage, it was ER/PR positive.

Biologically speaking, there are also breast cancers that are so aggressive no amount of self-propelled activity is going to change the outcome. I don't want any woman with advanced disease to blame herself for not doing enough. We all must do what we can by understanding our cancer and what helps make us tick. Add New AnswerI had always thought I was a pretty healthy person. I was wrong. I was an avid exerciser, likely too intense, and intense exercise can weaken the immune system. I had frequent and lengthy colds, and did not realize something was wrong. I was always a healthy eater, but did not realize that peanut butter is inflammatory, can contain aflatoxins and is supportive to cancer cells. I lived on peanut butter, thought it a better alternative to meat. I ate plenty of vegetables, some of the time, but not enough variety, especially the strong cancer fighters. I had considerable stress in my life. I grew up in a stressful environment, lived in a stressful relationship for many years and a had a stressful job for 23 years. I drank too much alcohol and did not partake in mind-body, stress relieving modalities. Cheese, love it, ate much. Now, I try to relax, eat mostly a plant based diet and consider wine and cheese a treat. I partake in moderate exercise. I have a wonderful husband and two terrific boys. I love life and appreciate all that I have. I still have stress, most of us do, but instead of anger, there is love. For me, for them, love heals.

My biggest change was learning how to take care of myself and achieving a better work/life balance. Like many women, before cancer I tended to take better care of everyone around me than I did of myself, and to prioritize work more than anything else in my life. It was hard, and sometimes it still is, but I have learned to do better self-care in every realm: physically, emotionally, and spiritually. My biggest change was learning how to take care of myself and achieving a better work/life balance. Like many women, before cancer I tended to take better care of everyone around me than I did of myself, and to prioritize work more than anything else in my life. It was hard, and sometimes it still is, but I have learned to do better self-care in every realm: physically, emotionally, and spiritually.