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/
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.
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.
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.
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
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.
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.
for further information
These sites are reliable sources of information:
World Cancer Research Fund
https://www.wcrf-uk.org/preventing-cancer/
https://www.wcrf-uk.org/health-advice-and-support/living-with-cancer/International
Agency for Research on Cancer
https://www.iarc.who.int/American Cancer Society
https://www.cancer.org/treatment/survivorship-during-and-after-treatment/be-healthy-after-treatment.html
https://www.cancer.gov/about-cancer/treatment/cam/patient
Norwegian Health Directorate
https://www.helsedirektoratet.no/
Cancer Research UK
https://www.cancerresearchuk.org/about-cancer/causes-of-cancer
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