New Year's Resolutions, Part I: 10 Ways to Limit Your Risk of Recurrence

Patient Expert

"I always make New Year's resolutions, and I never keep them. Why bother?"

I'll tell you why: because the following resolutions are on a different plane from your usual vows to call your mother at least once a week, or lose 10 pounds.

This year, you're resolving to do everything you can to help prevent a breast cancer recurrence.

You went through the long, tough treatment - slash, poison, burn - that's supposed to kill those cancer cells, ALL of them.

But is the cancer really gone? There's no way to know for sure. You're hoping if any cells are hiding out, they stay hidden. But"

There's no way to KNOW cancer won't come back.

Luckily, there are certain things you can do to help keep it at bay. And while none of these is a guarantee you'll remain cancer-free, all of them at least improve your chances.

Some are absolutely proven - e.g., controlling your weight. The data's in; we know obesity increases your risk of recurrence.

For some, the evidence is still anecdotal. For instance, most doctors believe that a healthy diet helps reduce your risk of recurrence. The National Cancer Institute hasn't yet done the complicated, years-long clinical trials to prove it. But why not eat healthy anyway?

The following 10 resolutions are common-sense things all of us survivors can follow to limit our risk. As I said before, there are no guarantees with breast cancer - until we know what causes it, we won't know how to prevent it. But go ahead, roll the dice; at least some of the following will probably help prevent a recurrence.

  1. Take your drugs. The most common reason for the failure of long-term hormone therapy drugs is that we simply don't take them. We let our prescriptions for Femara or tamoxifen lapse, due to expense or inertia. Or even if we have them, we let those little bottles sit at the back of the kitchen table, ignored as we down our daily multivitamin. Or we conveniently "forget" to take them, as we find the side effects disagreeable.

You want the absolutely proven benefit of these drugs? Take that pill EVERY DAY.

  1. Don't blow off appointments with your oncologist or surgeon. Every 4 months, every 6 months, once a year - whatever your schedule of regular appointments, you're on it for a reason: so that the doctor can ask those questions whose answers can point to a recurrence.

"Any bone pain? Does it hurt when I press your side here? Shortness of breath?" Your doctor wants you to remain cancer-free as much as you do. Do yourself a favor - do NOT skip appointments.

  1. Speaking of appointments, call and make one if you notice a new lump in your breast or, if you've had a mastectomy, any lumps or "gravelly" feeling around your incision scar, on your chest, or in your armpit.

A recurrence in the breast or armpit is far easier to treat then metastasis elsewhere in your body. But you have to notice and report it ASAP, not wait and see if it goes away. You've noticed a lump? Don't waste time worrying - just call the doctor.

  1. Control your weight. Studies show that postmenopausal women whose BMI (body mass index) is greater than 30 are 1 ½ times more likely to have a recurrence than women at a healthier weight.

Is your BMI over 30? Use our simple BMI calculator to find out. And, if it is - visit, the food and nutrition section of this Web site, for good tips and strategies to help you shed some pounds.

  1. Cut back on alcohol, or avoid it entirely. A study released this past April showed that survivors consuming more than 1 drink a day - red wine, gin, beer, doesn't matter what type - have a 20% to 30% greater risk of recurrence.

And what, exactly, is "1 drink?" 12 ounces of beer; 5 ounces of wine (about 2/3 cup); or 1.5 ounces (one shot) of hard liquor.

  1. Suffering through hot flashes, and other nasty menopausal or drug-induced symptoms? Please don't resort to hormone replacement therapy for relief. Although researchers demonstrated back in 2003 that HRT increases breast cancer risk in healthy women, it was only more recently, in 2008, that there was enough data to ascertain that HRT increases survivors' risk of recurrence by about 15%.

If hot flashes and other symptoms are seriously affecting your quality of life, then doctors recommend you use the lowest dose of HRT, for the shortest amount of time, to provide relief.

  1. This may seem like a no-brainer, but" don't miss your yearly mammogram. The simple, low-cost mammogram is still the easiest and most effective way for survivors who've had a lumpectomy to detect a recurrence in the same breast.

And for all of us to identify - as early as possible - a new cancer in the other breast.

Scheduled for a mammogram? No meeting, no carpooling, no exercise class is more important than that 10-minute stint in the radiology room.

  1. Exercise Sigh; groan. I know, you hear it over and over again: exercise is good for you. But studies prove it: for women with hormone-receptive breast cancer, a minimum of 4 hours per week of moderate-intensity exercise (e.g., vigorous walking, treadmill, etc.) confers a 34% drop in recurrence risk.

  2. Count those fat grams! You may be used to checking the carbs and calories on the side of your Lean Cuisine frozen dinner; take a look at the fat grams, too. A 2005 study showed that women consuming 33g fat or less per day lowered their risk of recurrence by about 20%, compared to women consuming 51g or more.

  3. Here's my personal favorite recurrence risk reducer: meditation. The mind-body connection is real, and it works. It's been proven that stress lowers your resistance to disease. And that meditation lowers stress levels. My conclusion is that meditation increases your ability to fight off a recurrence.

When I wake up in the morning, I spend just 5 minutes listening to a Reiki meditation on my iPod. It gets the day off to a great start, and who knows" maybe it's one of the reasons I'm cancer-free, 8 years after treatment.

With 2010 just around the corner, are you willing to turn over a new leaf? If the list above seems daunting, pick just ONE of these 10 possible recurrence-reducers, and resolve to try it for a minimum of 1 month.

It can't hurt, right? And it could very well help you stay cancer-free. Good luck!