Treatment's over. You feel healthy again. What can you do to help prevent a repeat of your cancer experience?
You've been through breast cancer. You had a lumpectomy and radiation. Or maybe a mastectomy, reconstruction, and chemo. You've taken tamoxifen, or Arimidex - for 5 years, perhaps even 10. But that's all in the past now; your cancer treatment is in the rearview mirror, and retreating quickly.
What can you do, starting today - starting a new year - to keep cancer at bay?
Despite all the bits and pieces of information out there about reducing your risk of cancer recurrence, there's not a whole lot that's proven to work.
But there are two things you can vow to do this year to boost your chances of never having to visit your oncologist again - except for your yearly checkup. These two lifestyle issues have been proven in study after study to reduce cancer risk; the science is clear. So starting today, resolve this year to embrace these two goals:
Maintaining a healthy weight. And minimizing alcohol intake.
First, your weight. Fat is a source of estrogen; the more fat you carry, the more circulating estrogen there'll be in your bloodstream.
Since up to 80% of breast cancers are estrogen-sensitive - they need estrogen to grow and develop - minimizing estrogen basically starves any latent cancer cells out there looking for a chance to pick up where they left off: to grow and divide and form a new tumor.
And what, exactly, is a healthy weight? Well, a good place to start is BMI: body mass index. While not perfect, it's a quick and dirty indicator of whether or not you should look at losing weight. If your BMI is under 25, you're at a healthy weight; between 25.0 and 29.9, you're considered overweight. If it's 30.0 or over, you're classified as obese.
Do you know your current BMI? If not, here's a simple calculator to figure it out. If you don't want to go even that far, here are some rough numbers: a woman who's 5' 6" is overweight when she reaches 155 pounds, and obese at 186 pounds. Use this information to roughly calculate where you stand based on your own height and weight.
Of course there are all kinds of ways to maintain a healthy weight - and you've probably read (and perhaps tried) more than your share of diets. But at the end of the day, weight maintenance mostly has to do with calories in, calories out: what you eat, and how active you are.
Make fruits, vegetables, and whole grains (if you're not gluten-sensitive) a major part of your diet. They're filled with all kinds of healthy vitamins, minerals, and fiber; they're mostly lower calorie than other foods you might eat - higher-fat, higher-sugar foods like meat, full-fat dairy, and empty-carb snacks and sweets. And, because of their fiber, they help you feel full.
So, that's the "calories in" part. How about "calories out?"
Exercise. Yes, it's that guilt-inducing word we hate to hear. But exercise isn't limited to a workout at the gym. Exercise can be as simple as taking a flight of stairs at the mall instead of the escalator. Or remembering to get up from your computer once an hour and walk around for 5 minutes.
Sure, active sports, fitness classes, and exercise that gets your heart pounding and puts a sheen of sweat on your skin is really, really good. But if you can't make yourself do any of that, don't give up; do what you can, whenever you can. Refuse your partner's offer to carry in the groceries; walk the dog a little bit farther. MOVE.
Next: moderate your drinking.
We've known for awhile that alcohol and breast cancer aren't a good combination. Alcohol can damage DNA in our cells, and damaged cells are more likely to become cancerous. Alcohol also raises estrogen levels in the blood - and estrogen can feed cancer cells.
Finally, alcohol can reduce your folic acid level; folic acid is a vitamin that helps repair DNA. So it's all about keeping your cells healthy - and alcohol doesn't help.
Should you cut alcohol out of your diet entirely? Well, yes" and no. Red wine has been shown to reduce the risk of cardiac issues in older women. Are you more at risk for heart problems, or breast cancer? This is something to discuss with your doctor.
Should you reduce your alcohol intake? Current knowledge is that any amount of alcohol increases breast cancer risk - though obviously the less you drink, the smaller your cancer risk. So if you're absolutely devoted to a glass of wine at dinner or the occasional cocktail, weigh that pleasure against a potentially very small uptick in cancer risk.
But if you're binge drinking (having multiple drinks) several nights a week, cut it out - particularly if you're young. There's a strong established link between binge drinking when you're young, and breast cancer later in life.
Personally, I do enjoy the occasional TGIF glass of bourbon, or wine with dinner in a restaurant. I choose the pleasure alcohol gives me, in these circumstances, over the cancer risk it may represent. It helps lower my stress and make me feel good.
Which leads me to one more cancer-risk reduction strategy - this one my own. Like many other things you can try, this isn't slam-dunk for sure going to lower your risk of recurrence, based on years of data and clinical studies. But it makes a lot of sense to me, and it's something within your control -
Cancer is a disease; you need to be strong to fight off disease. Stress lowers your resistance. Less stress = higher resistance to disease. So figure out what keeps your calm - exercise, a glass of wine, laughing with friends, petting your dog - and make it part of your regular routine.
So, as 2015 dawns, resolve to do what it takes to remain a cancer survivor: maintain a healthy weight; drink less alcohol; and relax. The life you save may be your own