Lifestyle Changes

Starting an exercise program after treatment is a great way to regain mobility and increase energy levels. I would suggest a rehabilitative exercise program that will correct any postural imbalances caused by treatment/surgical procedures and in general get you moving in a safe environment. Begin with simple stretches focusing on the areas affected by surgery. For example, if you had a mastectomy, start by performing gentle stretches that will open up your chest muscles and strengthen your back muscles. By performing exercises that rebuild your foundation first, you will be able to progress to more challenging programs before you know it.

For more information on rehabilitative exercise programs go to http://www.movingonfromcancer.com The easiest way to get back into exercise is not to stop during treatment. I remember the doctor told me to walk and begin exercise the day after my bilat MX. It was freezing out and my coat would not fit over my drains, so I walked the stairs in my building. When finished, I was exhausted and slept for 16 hours. From then on I made sure I walked every day until the doctor said I could run. I also went to physical therapy, which was a big help. She gave me safe exercises to do to regain muscle function and insisted I ride the exercise bike and did some stretching and massage to help with the healing. I really believe the exercise helped me heal quickly, both mentally as well as physically. If you have had a MX, be sure to buy a zip front snug sports bra as this will make exercise much more comfortable than if wearing the surgical bra.

I just posted a guest blog by David Haas on my site, some good info on this topic: http://elynjacobs.blogspot.com/2011/08/health-fitness-helps-cancer-patients.html" target=_blank>http://elynjacobs.blogspot.com/2011/08/health-fitness-helps-cancer-patients.html

I had a problem with this question too. Until about nine months after my mastectomy, I was only aware of and focused on the losses brought to me by cancer. As a result of amazing support (and a lot of oncology therapy) I slowly started to realize that cancer was also bringing gifts into my life. Make no mistake – that didn’t make me grateful for having cancer. But I had to realize that there were things now in my life, solely due to cancer, for which I was deeply grateful.

Because this realization kept bothering me, I had to write it down, and out came my Gifts and Losses List. You can see my list at http://www.wherewegonow.com/gifts-and-losses/debbies-list#. I think the reason I found making the list so healing was because I honestly admitted and appreciated both the gifts and the losses of cancer. I didn’t try to sugarcoat the losses any more than I tried to deny the gifts. By looking at my new life beyond cancer in this way, I found myself truly starting to heal.

It is undeniable that the things you had to give up due to cancer are losses. In my case, I could never have found optimism by denying the pain of their loss. It took some time (remember I said it was nine months after my mastectomy when I wrote the list), but eventually I was able to recognize that pain was only part of what cancer was bringing into my life. By recognizing the gift of gratitude for all the support I received, I was opening myself up to the yin and yang of the entire experience.


If you feel ready, why don’t you try to write your own Gifts and Losses List? No pressure. It’s entirely private and up to you. If you give it a try, I hope you recognize a few people or things in your life solely due to cancer for which you feel gratitude. It’s a small start, but for me the Gifts and Losses list brought some balance back into my life. I had a problem with this question too. Until about nine months after my mastectomy, I was only aware of and focused on the losses brought to me by cancer. As a result of amazing support (and a lot of oncology therapy) I slowly started to realize that cancer was also bringing gifts into my life. Make no mistake – that didn’t make me grateful for having cancer. But I had to realize that there were things now in my life, solely due to cancer, for which I was deeply grateful.

Because this realization kept bothering me, I had to write it down, and out came my Gifts and Losses List. You can see my list at http://www.wherewegonow.com/gifts-and-losses/debbies-list#. I think the reason I found making the list so healing was because I honestly admitted and appreciated both the gifts and the losses of cancer. I didn’t try to sugarcoat the losses any more than I tried to deny the gifts. By looking at my new life beyond cancer in this way, I found myself truly starting to heal.

It is undeniable that the things you had to give up due to cancer are losses. In my case, I could never have found optimism by denying the pain of their loss. It took some time (remember I said it was nine months after my mastectomy when I wrote the list), but eventually I was able to recognize that pain was only part of what cancer was bringing into my life. By recognizing the gift of gratitude for all the support I received, I was opening myself up to the yin and yang of the entire experience.


If you feel ready, why don’t you try to write your own Gifts and Losses List? No pressure. It’s entirely private and up to you. If you give it a try, I hope you recognize a few people or things in your life solely due to cancer for which you feel gratitude. It’s a small start, but for me the Gifts and Losses list brought some balance back into my life.

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).

I love this answer. Thank you! Hands down, food was the most effective lifestyle modification. Trial and error (mostly error) helped me to figure what worked and what didn’t. I hired health professionals and did everything from raw/vegan foods, heavy dairy/meat, juicing, supplements, and even Ensure® when I couldn’t keep anything down. This journey led me to go back to school and to finally figure it out on my own. Every person is unique and food can make all the difference.

I also had weekly reiki and massage treatments, walked daily, practiced qigong, and used spirituality in the form of meditation and prayer to answer the “Why Me” question. I worked with my acupuncturist to schedule treatment immediately after chemo which drastically reduced my body aches. Adding these therapies even after 3 years has been easy simply because they work. I feel better than before my diagnosis and I want to make sure I stay that way.

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.

I echo Pink Kitchen's answer. We can find alternatives; we just need to be creative in finding substitutes for our former faves. Comfort food can be redefined. I replaced candy with smoothies, tofu with salmon, and ice cream with Greek yogurt. As my mom used to say, "where there is a will there is a way." The hardest part for me was replacing soy and sugar. I have a serious sweet-tooth - but that's not a good thing when you're a cancer survivor. So I had to educate myself about healthier alternatives. I also had to learn how to bake my favorite goodies with whole grains rather than white flour - and no sugar. In the beginning, some recipes I found were delicious - while others were more like a brick!In the end, I began creating my own.

As for soy, it seem to be added to everything! So I had to become very aware of reading labels. However, this frustration led me to start blogging at Pink Kitchen, so that other survivors could be better informed about making healthy food choices as well as alternatives to the foods they had been accustomed to eating.

In my case, there were 4 things I did right away:

1.) I bought a juicer. Fresh veggie juice provides energy. I try to juice every day, and I always include one veggie in the cruciferous (cabbage/broccoli) family. They are great cancer fighters! I also like to use celery, which is a great detoxifier.
2.) Cut out sugars and white flours (I use stevia and occasionally brown rice syrup or agave when I bake.)
3.) Begin eating less pasta - even whole wheat - because it is processed. Instead, I now eat more whole grains such as barley, millet, and quinoa and save pasta for an occasional treat.
4.) Have raw foods with at least two meals.

If you have specific questions about foods or recipes, let me know, either here or at Pink Kitchen :) In my case, there were 4 things I did right away:

1.) I bought a juicer. Fresh veggie juice provides energy. I try to juice every day, and I always include one veggie in the cruciferous (cabbage/broccoli) family. They are great cancer fighters! I also like to use celery, which is a great detoxifier.
2.) Cut out sugars and white flours (I use stevia and occasionally brown rice syrup or agave when I bake.)
3.) Begin eating less pasta - even whole wheat - because it is processed. Instead, I now eat more whole grains such as barley, millet, and quinoa and save pasta for an occasional treat.
4.) Have raw foods with at least two meals.

If you have specific questions about foods or recipes, let me know, either here or at Pink Kitchen :)

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.

Getting to where I am now has taken a long time and I have had to be very patient with my own process. My journey to a healthier lifestyle started with small steps. My first ones were to regain my physical fitness and stamina after chemotherapy. I started by working with a personal trainer to slowly create an exercise plan that could accommodate the limitations I had while still in treatment. As I worked on that plan and my fitness improved, I have gradually modified the plan to meet my increased capacity and desire for higher levels of fitness. At the same time, I carefully examined my nutrition. Since my BC was highly estrogen positive, I have been studying how to limit the negative sources of estrogen in my system, and my diet has been a primary way to work on this. For instance, I decided I needed to lose weight (fat is a source of estrogen) and have figured how best to do that for my body. I have learned that weight loss is very individual and requires a customized approach to meet an individual's habits, history, and lifestyle. My most effective way has been to eliminate meat, poultry, and pork, and to move towards a plant-based diet. I have also tried to eliminate all sources of antibiotics, hormones, and other toxins from my food. Getting to where I am now has taken a long time and I have had to be very patient with my own process. My journey to a healthier lifestyle started with small steps. My first ones were to regain my physical fitness and stamina after chemotherapy. I started by working with a personal trainer to slowly create an exercise plan that could accommodate the limitations I had while still in treatment. As I worked on that plan and my fitness improved, I have gradually modified the plan to meet my increased capacity and desire for higher levels of fitness. At the same time, I carefully examined my nutrition. Since my BC was highly estrogen positive, I have been studying how to limit the negative sources of estrogen in my system, and my diet has been a primary way to work on this. For instance, I decided I needed to lose weight (fat is a source of estrogen) and have figured how best to do that for my body. I have learned that weight loss is very individual and requires a customized approach to meet an individual's habits, history, and lifestyle. My most effective way has been to eliminate meat, poultry, and pork, and to move towards a plant-based diet. I have also tried to eliminate all sources of antibiotics, hormones, and other toxins from my food.

I made many changes, but seeing my mother pass from bc just after I finished treatment certainly provided all the encouragement I needed. My Wall Street career, while exciting, was no longer for me. I had always exercised, but now I have toned things down. Now I walk and lift weights, but gone are the 7 mile runs and intense workouts. Giving up meat and poultry was easy, now I indulge only for an occasional elk burger on the grill, seems somewhat ok to me as the elk is grass fed and not injected or fed anything to fatten it up. I love food, but mostly fruits, whole grains,nuts, beans and veges...have given up milk, cut back on cheese and wine, but those are the two things I cannot give up entirely. I used to eat much shellfish, but it causes me much pain (arthritis and resulting inflammation) so I cut that back considerably, likely a good idea as the shrimp available these days is not very healthy....what ever happened to wild, seems its all farmed and injected with antibiotics...the smell alone is a huge turn off. The only hard part about the changes is being social....I refuse to eat unhealthy food, and that makes dining with friends often difficult...brings on all kinds of unwanted "oh, you are so good" comments I can really live without. Sure, the cake looks divine, but I don't eat sugar. Don't hate me...

Thanks for your question! I have done a number of things, the most important of which, is quitting a stressful job and doing what I love. I eat a whole-foods, organic diet, greatly reducing sugar, white flour, dairy and red meat, and eliminating soda and alcohol. I drink two cups daily of Dr. Lee's green tea (five times the cancer-fighting properties of normal green tea) I exercise daily and do a lot of prayer and visualization. I also take a number of supplements and consult with integrative practitioners, most recently the Block Center in Chicago.

Has it been difficult? Yes, sometimes, but I've gotten used to it, and it makes me feel empowered that I'm doing something to impact my health. Hope that answers your question!

Hi,
When I started Tamoxifen I had terrible hot flashes. I spoke with my med onc and she recommend that I take 400 units of Vitamin E twice a day. It really help me. I think that everyone should check with their own doctor before taking any vitamins when they are on Tamoxifen.

Another thing that really helped in the summer was a "chillow pillow". It a small flat pillow that you lay over your regular pillow. It really keeps you cool. Just google chillow pillow and you will find it. It was not costly and I found a place that shipped it free. To reduce the effects of hot flashes, keep cool. Slight increases in your body's core temperature can trigger hot flashes. Dress in layers so that you can remove outer clothing when you feel too warm. Open a window or use a fan or air conditioner to keep air flowing. Lower the room temperature, if you can. If you feel a hot flash coming on, sip a cold or cool drink. Apply a cool damp pad to your forehead.

Watch what you eat and drink. Hot and spicy foods, caffeinated beverages and alcohol can trigger hot flashes. Learn to recognize your own triggers and avoid foods or drinks that bring on hot flashes.

Relax. Some women find relief from mild hot flashes through yoga, meditation, relaxation or other stress-reducing techniques. Breathe deeply. Deep, slow abdominal breathing (paced respiration) may decrease hot flashes.

Don't smoke. Smoking is linked to increased hot flashes.