Lifestyle Modifications

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 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.