Many people with cancer oftenseek advice around behaviors that may reduce the risk of recurrence orprogression of the disease, whilst also mitigating the side effects oftreatments. Making positive lifestyle changes can be empowering, physically andpsychologically, at a time where you may be left feeling a lack of control. Thesuggestions in this document are protective against several types of cancersand other health conditions such as cardiovascular disease and diabetes, sothey should certainly do no harm!

It isimportant however to recognize that finding quality studies that look atindividual lifestyle factors in specific health conditions including cancersand in isolation is challenging. So, it is important to follow the advice ofyour doctor and/or dietician who may encourage a specific diet for example tohelp you to gain or lose weight or to treat any deficiencies you may have.

Most importantly the changes that you makeshould be tolerable and not too restrictive at worst and enjoyable and lifeenhancing at best!

Physical activity

The temptation for those with/or recovering from cancer may be to  rest and recuperate and that is indeed important, but physical activity has a  powerful effect on physical and psychological well-being. It can help to  support a healthy weight, increase energy levels, prevent, or manage  conditions such as heart disease, high blood pressure, and type 2 diabetes,  strengthen bones and muscles and improve mood, balance, and coordination.  

Clinical  research has also proven that appropriate exercise can help prevent  headaches, fatigue, functional decline, cognitive impairment, depression, and  anxiety. We suggest you find an exercise or activity that works for you. For  many, walking is easy to build into daily activity, others choose yoga,  workouts in the gym, cycling, swimming, or other sports. An ideal target is  at least 30 minutes of physical activity every day.

Weight  management 

The International Agency for the Research of Cancer and the World  Cancer Research Fund are consistent in their view that being overweight or  obese is one of the risk factors for the development of several types of  cancer, but also for the survival and prognosis of patients with cancer.

It is therefore important to achieve and maintain a healthy Body  Mass Index (BMI) and waist measurement to reduce the risk of cancer and  recurrence.

• To calculate your BMI visit:

www.wcrf-uk.org/health-advice-and-support/health-checks/bmi-calculator/

• To check  your waist measurement visit

www.wcrf-uk.org/health-advice-and-support/health-checks/how-to-measure-your-waist/

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The Norwegian Health Directorate and  World Cancer Research Fund promote a well-balanced diet incorporating lots of  vegetables, fruit and berries, whole-grain foods and fish, and limited  amounts of processed meat, red meat, salt,and sugar. A good balance should be  struck between the amount of energy you obtain through food and drink and the  amount of energy you expend through physical activity.

In greater detail you should:

• Eat at least five portions  (approximately500g) of vegetables, fruit and berries every day which contain a  variety of vitamins, and minerals that are considered antioxidant and can aid  with the protection and repair of DNA and cell damage.

• Eat 70-90g of whole grain foods every  day, which equates to:

- Four slices of bread containing a  generous portion of wholemeal flour, for example, labeled “ekstra grovt”  (extra whole grain) in the Brødskala’n (Bread Scale symbol).

- A bowl of whole grain cereal and two  slices of extra whole grain bread.

- Or a bowl of oatmeal and one portion  of whole grain pasta or whole grain rice.

• Eat fish two to three times a week.

- At least 200grams should be fatty fish  such as salmon, trout, mackerel,or herring.

- Six sandwich topping portions of fish  equals one dinner portion.

• Choose lean meat such as chicken and  turkey and lean meat products with low salt content.

Keep red meat consumption, (such as  beef, lamb, pork, goat, veal, and mutton) which whilst a reliable source of  nutrient sand important for a healthy, balanced diet, to no more than 3  portions a week, which is around 350–500g cooked weight (or 525–750g raw  weight) a week. Researchers are still investigating how red meat causes  cancer. One conceivable way involves a compound called haem, which contains  iron and gives red meat its colour. Haem can trigger the formation of  cancer-causing compounds which have been shown to damage the lining of the  bowel, which may cause bowel cancer.

• Limit consumption of processed meat (such as bacon, sausage,and salami)  that has been transformed through salting, curing, fermentation, smoking, or  other processes to enhance flavour or improve preservation. Processed meat,  as well as being made from red meat, contains added nitrites and nitrates,  which can also be digested to form compounds that are thought to cause  cancer.

• Include low-fat dairy foods in the  daily diet, choose edible oils,  liquid margarine,and soft margarine spreads instead of hard margarines and  butter.

• Choose foods that are low in salt and  limit the use of salt  when preparing food and at the table. No more than 5g per day should be  needed.

• Avoid foods and drinks that are high  in sugar as there is some  evolving evidence to suggest high sugar levels may increase the risk and  proliferation of a range of cancers.

• And choose water as a thirst-quencher.  

There is some work being done on  ketogenic (low carbohydrate and high protein) diets which are thought to  replace glucose as the source of energy in our diets with ketone bodies which  as well as being an alternative source of energy can potentially slow tumour  growth and increase survival due to changes in the immune response, gene  expression, and amount of reactive oxygen species.

The following link develops this theme  further:

www.wcrf-uk.org/wp-content/uploads/2021/06/Eat-well-during-cancer-2019-WEB.pdf

Smoking cessation

Evidence consistently shows a strong association between a history  of smoking, cancer risk, and indeed mortality.

The  association between cessation of smoking and increased survival may, in  addition to reducing cancer risk, also be due to the reduction in other  disease processes such as ischaemic heart disease. The risk does not appear  to be dose related but binary in that you are either a smoker or not.

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Alcohol intake

It  is postulated that alcohol causes cellular stress, is toxic to genes, causes  inflammation, and alters folate metabolism which would otherwise be  protective.

Alcohol intake should therefore be avoided where possible or kept  within recommended limits. The World Cancer Research Fund suggests a limit of  no more than 1 drink per day for women and 2 for men.

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Coffee and tea  

Coffee may have a protective effect and  may even decrease cancer development by up to 18% through reducing oxidative  stress, repairing DNA damage, reducing inflammation, and its influence on  enzyme activity in the body.

Tea is a rich source of polyphenols including catechins. Green tea is  thought to have anti and pro-oxidant activity. It may influence the immune  system to prevent the proliferation and invasion of cancerous cells.

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Complementary and Alternative Medicines

Whilst outside of the scope of this  document some Complementary and Alternative Medicines appear to have  undergone careful evaluation and have been found to be safe and effective.  These include acupuncture, yoga, and meditation to name a few. However, there  are others that do not work, may be harmful, or could interact negatively  with your medicines.

Please see the following link for some further information: https://www.cancer.gov/about-cancer/treatment/cam/patient

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Sleep 

Results from studies on whether sleep  duration, sleep quality, circadian rhythm, and sleep disorders can affect  cancer risk are not consistent or conclusive, which may reflect difficulties  in accurately gathering data about sleep over the long term.

Theoretically, there appears to be a  benefit from keeping a regular sleep and sleeping between 7-9 hours each  night and the key to good sleep is to:

• Be consistent-go to bed at the same  time each night and get up at the same time each morning, including at the  weekends.

• Make sure your bedroom is quiet, dark,  relaxing, and at a comfortable temperature.

• Remove electronic devices such as TVs,  computers, and phones from the bedroom.

• Avoid large meals, caffeine, and  alcohol before bedtime.

• Do not use tobacco.

• Get some exercise during the day which can help you fall asleep more  easily at night.

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Summary

We hope the information presented here  helps set in motion some positive lifestyle changes, if indeed needed, which  will benefit both your physical and psychological well-being.