After breast cancer treatment: How to adapt your lifestyle for optimal health

By Alisa Bowman

Each month, hundreds of people ask Google about breast cancer diet cures.

Rather than spitting out lists of obscure cancer-fighting foods and lifestyle remedies, the search engine tends to deliver advice that people have heard many times over.

That’s because the lifestyle changes that help survivors of breast cancer feel better and reduce their risk of recurrence are no different than what’s recommended to improve overall health, regardless of someone’s cancer status, says Stacy D. D’Andre, M.D., a Mayo Clinic medical oncologist with a special interest in integrative medicine.

“Lifestyle changes can improve outcomes for people with breast cancer, but also can help prevent other diseases such as diabetes or heart disease,” says Dr. D’Andre. “Healthy diet, exercise, stress reduction and good sleep can improve quality of life, energy levels and cognitive function.”

For someone undergoing breast cancer treatment, however, achieving a healthy lifestyle can, at times, feel like an impossible mission. Below, Dr. D’Andre offers helpful advice for making it all happen, no matter your fatigue, insomnia and other symptoms.

Eat a balanced diet

Among people who’ve been diagnosed with breast cancer, those who consume diets rich in fruits, vegetables and whole grains tend to live longer than those who eat few plant-based whole foods, according to two recent reviews of the research. In addition to reducing your risk of recurrence, a plant-based diet can improve your quality of life.

Know that “plant-based” isn’t necessarily synonymous with “meat-free.” It simply means that veggies, fruit, legumes, nuts, seeds and whole grains make up the majority of your diet.

No one food contains all the nutrients you need, so aim for a colorful variety of fruits and vegetables. Choose healthy sources of fat, such as olive oil, avocados, nuts and seeds over the saturated fats abundantly found in processed and fatty animal products, lard, coconut and palm oils, and fried and processed foods. Finally, opt for higher-fiber whole grains, legumes and other minimally processed foods over highly processed foods, which usually contain less fiber.

Maintain a healthy weight

People who are underweight, overweight or obese are all associated with an increased risk of breast cancer recurrence. Conversely, mounting evidence indicates that maintaining a healthy weight may reduce your risk of recurrence and secondary cancers.

Talk to your healthcare professional to better understand what changes may be needed to reach a weight goal. Along with your weight and waist circumference, your healthcare professional can look at your medical history to help determine if you’d benefit from losing weight with diet changes, or gaining muscle with resistance training exercise.

It can take time and effort to change your body composition. Many people do better when they have support from family and friends. You also may find it helpful to talk about your weight goals with a registered dietitian or certified fitness trainer.

Stay active

In addition to the role of exercise in achieving a healthy weight, being active also reduces your risk of many diseases, including breast cancer.

One study compared the activity levels of 103 people who had been diagnosed with advanced breast cancer. Compared with the least active people, highly active people in the study were more likely to survive their diagnosis.

If you’re experiencing fatigue stemming from cancer or cancer treatment, go slowly, advises Dr. D’Andre. Ease into exercise by gradually increasing your time and intensity as you feel able. Set a goal to move a little more, gradually working up to 30 daily minutes or more of physical activity most days.

Get enough sleep

Sleep can help restore your energy after cancer treatment. However, it also can be hard to come by.

In a study of 200 breast cancer survivors, more than one-third of participants experienced difficulties with falling asleep, staying asleep or waking too early.

Your sleep quality will likely improve over time. Until then, you can improve your chances of good sleep by doing the following:

•  Sleep in a cool, dark, quiet room. If needed, get room-darkening shades, earplugs, a fan or white noise.
• Stick to a sleep schedule. Go to bed and wake at the same time every day, including weekends.
• Unwind before bed. Avoid prolonged use of light-emitting digital screens such as cellphones or tablets. Instead, do something calming like taking a bath or reading.

In addition, consider talking to your healthcare professional about cognitive behavioral therapy for insomnia (CBT-I). This structured therapy takes place over 4 to 8 sessions. Your sleep specialist will help you better understand and solve the underlying problems related to your insomnia.

Avoid tobacco

Breast cancer survivors who smoke or use other forms of tobacco are at greater risk of dying prematurely than people who don’t use tobacco. If you’ve tried quitting without much success, you aren’t alone. It can be challenging to stop smoking — especially without help. Talk to your healthcare professional about prescription medications that may support you as you quit. Also, consider using quit-smoking products like nicotine replacement patches and gums.

Avoid or limit alcohol

Research has been somewhat inconsistent when it comes to alcohol. Many studies suggest that consuming alcohol increases the risk of breast cancer recurrence or the risk of developing a second primary breast cancer. The risk may be particularly high for breast cancer survivors who are postmenopausal, obese or diagnosed with estrogen receptor positive tumors. However, some studies have failed to show an association between alcohol consumption and breast cancer recurrence.

“Most cancer societies do recommend avoiding alcohol, or at least limiting use,” says Dr. D’Andre.

If you feel the need to cut back on alcohol, look for alternative ways to relax and unwind, such as qigong, counseling, stress management classes or meditation, says Dr. D’Andre.

Take steps to manage stress

Your state of mind can influence your physical body. For example, when you are upset or anxious, your blood pressure may increase or you may start to feel lightheaded.

This is why mindfulness-based techniques are typically at the top of the list of integrative therapies that healthcare professionals recommend for breast cancer survivors, says Dr. D’Andre.

Mindfulness involves staying focused on the present moment. It requires you to place your awareness on what you are experiencing in an open, curious and nonjudgemental way. For example, instead of getting caught up in worries about an upcoming medical appointment, you might observe the thoughts and emotions that come up for you. This moment of nonjudgemental awareness gives you the space to move forward more thoughtfully and calmly.

To learn mindfulness, consider enrolling in a mindfulness-based cancer recovery (MBCR) or mindfulness-based stress reduction for breast cancer (MBSR-BC) course. These classes typically take place over 6 to 8 weeks, with weekly group sessions that last 2 to 3 hours.

Do what you can

Changing your lifestyle can be challenging, especially if you’re experiencing fatigue stemming from treatment.

Know that you don’t have to overhaul everything at once.

“It is better to make small changes and build on them over time,” says Dr. D’Andre. “We know that small changes can make a big impact.”

Learn more

Learn more about breast cancer and find a clinical trial at Mayo Clinic.

Join the Breast Cancer Support Group on Mayo Clinic Connect, an online community moderated by Mayo Clinic for patients and caregivers.

Explore the free education and support offered by the Stephen and Barbara Slaggie Family Cancer Education Center at Mayo Clinic.

Also, read these articles:

• Coping with ‘the new normal’: Breast cancer survivorship as a Black woman
• Cancer fatigue: A common cancer side effect that is different for everyone
• Nourishing your health: Diet and nutrition factors for cancer prevention

A version of this article was originally published by Mayo Clinic Press.