If you’re post-treatment for hormone-driven breast cancer, you may decide to change your food, booze and exercise habits.   

The goal? Minimize and contain your fear of recurrence.

The changes you make are unique to you – customized, if you will – to match your habit-change tolerance and commitment.

Because you’re uncertain how to go about that, you ask your oncologist.

And she/he says?

It depends on your doctor.

Ask any ER/PR+ breast cancer survivor about diet/nutrition/lifestyle advice from their doc, and you’ll get varied responses.

Here’s how I know this.

I asked ~140 women in the breast cancer community: “Did you receive nutritional guidance from your medical team? If so, was it or was it not helpful?” 

The majority (54%) said they received no guidance. Of those who did, ~ 25% said it wasn’t helpful.

Breast surgeons and oncologists at best receive minimal nutrition training.

In their defense and to put this in context, when nutrition isn’t part of an educational curriculum, it’s beyond scope of practice to provide nutritional guidance.

Dr. Jennifer Ligibel, a Dana-Farber Cancer Institute breast oncologist speaks to that lack of training here.     

But who else are you going to ask?

No one told you about working with an oncology dietitian; you didn’t even know they existed. 

I’m not an oncology dietitian, but I am a lifestyle dietitian. At the time of my own ER/PR+ diagnosis, I was running a thriving nutrition therapy practice. . .I know how to help people adopt lifestyle habits that support their health. 

Now, I help hormone-driven breast cancer survivors end food fear and rebuild their health after treatment ends. Below is my advice on making health habit changes that may help reduce your risk of recurrence. Taking action is empowering and helps minimize/eliminate that fear!

Get Ready, Get Set, Go!

We don’t (yet) have a proven anti-cancer diet or exercise protocol.

We do have good research linking healthy habits to impressive outcomes for recovery and risk reduction.

Below I summarize the most encouraging evidence-based nutrition, fitness, and lifestyle interventions we have currently.

When you’re ready to make changes, start with one thing. Don’t overwhelm yourself, especially if you think you must fix all the things at once.

You need to keep going when you encounter setbacks that come with changing behaviors and habits. You also need to be realistic in your expectations.

When you’re feeling vulnerable (or DESPERATE!), it’s normal to search for a miracle solution.

This isn’t that. This is evidence-based guidance on self-care practices. . .safe, researched and practical.

DIET and NUTRITION

What’s the difference?

• Diet is the different kinds of foods you choose to eat.
• Nutrition is the outcome of the processes by which your body takes in and uses food sources.

The Type of DIET You Choose to Eat

While research continues to support a plant-based diet, the correlation between diet and breast cancer remains controversial.

Recommendations for general health and to potentially reduce breast cancer risk include increasing fruits, vegetables, whole grains and beans (legumes), while limiting red (especially processed) meat.

Plants are good sources of phytochemicals, high in fiber, and low in calories (helping to maintain a healthy weight), all of which support breast cancer risk reduction. (1)  

The QUALITY of Food You Eat

Most studies on the risk of breast cancer recurrence in relation to individual foods and nutrients have shown inconsistent results. (2)

Yet a recent review of current research looking at overall dietary intake (pattern) suggests that foods of higher quality, for example, a piece of whole fruit versus a glass of fruit drink, are associated with a decreased risk of overall and non-breast cancer mortality. (3)

Research is ongoing in this area, with strong interest centered around the impact of overall dietary patterns and quality on breast cancer risk reduction, so stay tuned. In the meantime, uplevel the quality of foods you choose; we don’t need research to confirm the benefit of doing that! 

The BALANCE in Your Diet

Does your diet lean more toward foods low in nutrients and high in calories?

Is your plate missing the green, yellow, orange and red colors of fruits and veggies?

Do you skip some meals and overeat at others?

Do you most often eat out and on the run?

Do you manage stress with a steady intake of your favorite alcoholic beverage?

Research shows a strong positive correlation between alcohol, obesity and less healthy eating patterns and increased risk of breast cancer. Modifying HABITS promotes better overall balance, in turn reducing overall risk. (4, 5)

The Effect of MEAL TIMING on Body Weight and Risk Reduction

A growing area of research connects the timing of eating to metabolic function, biomarkers, body weight and breast cancer risk.

You may be familiar with intermittent fasting? That’s what meal timing is all about. 

Current research suggests that aligning food intake with our body’s internal clocks positively effects insulin resistance, metabolic and physiologic pathways, and hormones released in rhythm with light of day and dark of night.

One newer piece of research suggests the risk of recurrence is reduced in breast cancer survivors who have a nightly fast of 13 hours. I write about that here.

EXERCISE

A robust collection of studies points to the power of exercise as a potent habit for breast cancer risk reduction; both initial diagnosis and recurrence.

We all know women who’ve exercised regularly and still are diagnosed with breast cancer (yours truly included). Yet research shows women who are more physically strong, fit and active at the time of diagnosis have improved treatment outcomes, faster recovery times, experience positive effects on fatigue and the management of stress and anxiety.

Surprisingly, we have more definitive research on exercise and breast cancer than we do on nutrition and breast cancer, so what are you waiting for? Move it! (6, 7, 8, 9)

LIFESTYLE

Diet, exercise, alcohol consumption, body weight, sleep habits and stress management.

Collectively, these make up our lifestyle habits.

Yet what about the actual environment in which we carry out our lifestyle? 85% – 90% of breast cancer cases have ZERO genetic link, and every two minutes a woman is diagnosed. Something is broken.

Like nutrition and breast cancer, the research on the environment connection is complex. Adding to that complexity is breast cancer’s long dormancy and multifactorial nature.

However, complex doesn’t mean we can’t take cues from current findings and work to reduce environmental risk whenever possible. (10)

I recommend:

• storing food in glass vs. plastic containers
• reducing or eliminating exposure to second-hand smoke
• never heating/re-heating food in the microwave in containers other than glass (even when labels indicate otherwise)
• purchasing (or making!) household cleaners and personal care products free of fragrance, chemicals, parabens and phthalates 

Wrap It Up!

It may feel like you’re in control of nothing. Breast cancer does that, doesn’t it?

And even if you do “everything right”, you can still have a recurrence; there’s no guarantee.

However, there are things you can do to be actively involved in your post-treatment health.

Not to mention, taking charge is empowering.

So let’s go – you can do this, I know you can!

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Thanks for reading my blog post!

Most survivors of hormone-positive breast cancer get anxious when they think about what to eat after finishing treatment, so I’ve created the Peaceful Plate program to help survivors eat with peace, not panic. 

When you eat with peace, you feel free to enjoy your food again.

Ready to eat with peace? 

CLICK HERE and grab your FREE copy of The Five Foods Survivors Should Eat

CLICK THIS LINK and watch my 2-minute Peaceful Plate program video!

Follow me on Instagram @hormone.breastcancer.dietitian

This information is for educational purposes only and is not intended as medical advice. Please consult your dietitian or doctor for guidance specific to your needs.

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SOURCES

1. AICR’S Foods That Fight Cancer  
2. Dietary Patterns and Risk of Breast Cancer
3. Overall Dietary Intake and Prognosis After Breast Cancer: A Systematic Review
4. Alcohol Consumption and Breast Cancer Recurrence and Survival Among Women With Early-Stage Breast Cancer: The Life After Cancer Epidemiology Study.
5. Lifestyle, Nutrition and Breast Cancer: Facts and Presumptions for Consideration
6. Priorities for the Primary Prevention of Breast Cancer
7. Diet and Cancer: Risk Factors and Epidemiological Evidence
8. Effects of an 18-week Exercise Programme Started Early During Breast Cancer Treatment: A Randomised Controlled Trial.
9. Effects of a Physical Exercise Rehabilitation Group Program on Anxiety, Depression, Body Image, and Health-Related Quality of Life Among Breast Cancer Patients.
10. Environmental Chemicals and Breast Cancer: An Updated Review of Epidemiological Literature Informed By Biological Mechanisms.