Survivorship

Staying Healthy and Active

Living a healthy lifestyle after treatment is just as important as when you were actively being treated for cancer. Although your nutritional needs may change as you move from cancer patient to survivor, eating right and exercising can offer multiple health benefits.

The American Cancer Society recommends that cancer survivors follow the same nutrition guidelines that are recommended to help prevent cancer. Choosing healthy foods appropriate for you will improve your strength and help you feel better.

Making Healthy Choices

Experts recommend a diet high in vegetables and fruits, whole grains and lean protein. However, after treatment, you may be limited on the types of foods you can eat. Some survivors have permanent lifestyle changes depending on the type of cancer and treatment they had. In general, try to consume fats from beneficial sources, such as olive oil, avocados, nuts and fish, and aim to eat five to nine servings of fruit and vegetables daily. Choose low-fat milk products, such as one-percent or skim milk, and lower-fat cheeses, such as mozzarella. Limit the amount of red meat and processed meat you eat to no more than three to four servings a week. It is also helpful to reduce your consumption of refined sugars. If you drink alcohol, try to limit your consumption to the recommended amounts of one drink per day for women and two drinks per day for men.

Most survivors can get all of the nutrients they need from a healthy, balanced diet. Studies have not found any strong evidence that dietary supplements help in the prevention or treatment of cancer. The National Comprehensive Cancer Network and other experts recommend that cancer survivors only take supplements when recommended by a doctor for a specific deficiency or health condition. Some supplements may be helpful for people who are not able to get or absorb all of the nutrients they need. Talk to your doctor to see if vitamins and supplements are right for you.

Maintaining a healthy weight is important for survivors, especially if treatment caused you to lose or gain weight. Whether trying to lose or gain weight, make sure to eat the essential nutrients, including carbohydrates, fats and protein. You might consider nutritional counseling with a qualified professional, such as a registered dietitian.

If you’re trying to control your weight, it’s important to watch portion size. One serving of meat, fish or poultry is about three to four ounces, which is approximately the size of a deck of cards. Substituting more fruits and vegetables, which are low in calories and high in fiber, for higher-calorie side dishes and snacks may help with weight control. No single food has all of the vitamins and nutrients necessary to maintain a healthy diet. Eat a variety of foods from all the food groups, including raw and cooked fruits and vegetables; whole wheat, grains and oats; and beans, lentils and peas so that you can get all of the nutrients your body needs from your food.

After being treated for cancer, your body may have difficulty absorbing the nutrients you need for optimal health. This can lead to a condition known as malnutrition, or malnourishment. In addition, side effects from treatment may have affected your taste, smell and ability to eat, but these are likely to improve after treatment ends, allowing you to resume eating a healthy diet.

A seemingly endless variety of specialized diet plans, each claiming extraordinary results, is marketed to consumers. Although these diets may include some legitimate approaches with a few proven benefits, beware of any plan that promises a quick fix or ignores basic nutrition. These diets are usually not sustainable over the long term, and you will see longer-lasting results if you shift your overall approach to nutrition.

Dietitians can discuss any restrictions you may have and help you set and reach nutritional goals, which may include weight loss, weight gain or just learning how to maintain a healthy diet and lifestyle after treatment. Your dietitian can help you create a nutritious, balanced eating plan, tailored specifically to you. A member of your health care team should be able to refer you to a dietitian in your area.

While you focus on gaining strength and feeling good, be aware of other health conditions that may need to be managed in survivorship, including obesity, heart disease and diabetes.

Obesity

Poor nutrition may lead to obesity, which has been linked to many cancers, as well as heart disease, diabetes and other diseases. Obesity is a condition in which a person has too much body fat in relation to lean body tissue, and consuming too many calories is among its causes. Although some people expect to lose large amounts of weight during cancer treatment, many discover that they actually added pounds during the process. In fact, about one in three people with breast cancer experiences more than a 5 percent weight gain in the two years after being diagnosed.

Many studies attempt to prove the connection between obesity and cancer. Excess body weight can increase the risk for several other types of cancer due to the effects that fat tissues and fat cells have on the body. The following are risks associated with obesity:

  • Increasing insulin levels and/or hyperinsulinemia (insulin resistance) may support tumor development.
  • Excess estrogen has been linked to breast, uterine and other cancers.
  • Chronic low-level inflammation is tied to an increased cancer risk.
  • The production of certain hormones may stimulate or inhibit cell growth.
  • Various proteins may influence tumor growth.

Losing weight can help regulate some of these issues and may lower your risk for cancer and recurrence. If you need help maintaining a healthy weight, talk to your dietitian or physician.

Heart Disease

Heart disease broadly refers to coronary heart disease, heart attack, congestive heart failure and congenital heart disease. A diet that’s high in fat, salt and cholesterol can contribute to the development of heart disease, as can obesity.

Although heart disease isn’t a risk factor for cancer, various treatments, including chemotherapy, radiation therapy and hormone therapy, can cause or worsen heart disease. People with heart or vascular conditions before they begin treatment are especially vulnerable. One study showed that women who had radiation to treat breast cancer had an increased risk of heart disease of 3 percent on average.

To combat the increased risk, it’s important for cancer survivors to follow the recommended nutrition guidelines, including limiting the consumption of red and processed meat. Protein can come from many healthy sources, so try to go meatless several days a week, incorporating other protein sources for your meals.

 

Ways To Add Nutrients To Your Diet

  • Choose brightly colored fruits and vegetables rather than colorless starches, such as rice and white potatoes. Use in soups and side dishes.
  • Drink juices, milk and premade nutritional beverages instead of soft drinks.
  • Look for the words “Excellent source of…” on food packaging, which means the food contains at least 20 percent of the recommended daily amount per serving.

 

 

Diabetes

Diabetes is a condition in which the body doesn’t make enough insulin, resulting in either high or low levels of blood glucose (sugar). There are two types of diabetes.

  • In Type 1, the immune system destroys the body’s ability to produce insulin, which results in an inability to convert glucose into energy. Type 1 diabetes cannot be prevented. It typically arises during childhood and accounts for 5 to 10 percent of all cases of diabetes.
  • In Type 2, the body either has too little insulin or cannot use insulin effectively. Among the causes of Type 2 diabetes are obesity, high blood pressure and a high-fat and high-carbohydrate diet. This type of diabetes occurs most often in adults and accounts for 90 to 95 percent of all cases of diabetes.

People with diabetes are at a significantly higher risk for many types of cancer, including liver, pancreatic and uterine cancers. A recent study linked diabetes to a higher risk of recurrence of colon cancer. If diabetes is left untreated and blood sugar levels remain high for an extended period of time, significant damage to the heart, eyes, kidneys and nerves can occur. To prevent this, limit the amount of sugar you consume, partake in regular physical activity and take prescribed insulin and blood sugar medications as recommended by your doctor.

Making Exercise and Physical Activity a Priority

Many people have to stop exercising or reduce the time and intensity of their exercise while they are in active treatment. However, experts recommend that survivors return to normal activity as soon as they are able and gradually advance their exercise program to achieve weight and fitness goals. A number of studies show that people with certain cancers who also maintain regular physical activity have a reduced risk of cancer recurrence. Exercise and physical activity are also important in the prevention and treatment of obesity, which may lead to diabetes, heart disease and osteoporosis. Combined with healthy eating, exercise can improve your overall fitness and may lead to a better quality of life.

Many experts recommend that cancer survivors take part in regular physical activity, aiming for at least 150 minutes of exercise per week, as well as strength training exercises at least two days each week. You should stay as physically active as possible and increase your activity level over time after treatment.

A Healthy Weight

Exercise can help you reach your weight management goals. Some people who start cancer treatment at a healthy weight may experience weight loss or gain from the treatment itself. Because significant weight changes from treatment may lead to a decreased chance of recovery, returning to a healthy weight once treatment ends is important.

Being overweight prior to treatment increases your risk of serious health problems, including high blood pressure, cardiovascular disease, diabetes and certain cancers. During treatment, your priority should be to maintain your weight, but once treatment ends, you should work toward reaching and maintaining a healthy weight.

Movement and Strengthening

Your exercise program should include activities to help maintain your muscle strength. These will help prevent loss of muscle mass that may occur from inactivity. Increasing your muscle mass will also raise your metabolism, helping you to burn more fat. Exercises that focus on stretching and flexibility will help your ease of movement and ranges of motion, which may also help you avoid injuries. Lower-body strength exercises can help improve your balance.

Rehabilitation and Side Effect Management

Rebuilding strength and flexibility are important for your recovery and to help prevent further injury. Being physically active can help decrease the side effects of cancer treatment, including fatigue, one of the most common treatment-related side effects.

Other side effects, such as lymphedema, may also be managed with the help of exercise. Certain activities can help regulate the flow of lymph by helping lymph vessels move fluid away from the affected area, reducing the swelling.

The Effect of Exercise on Mood and Energy

In addition to improving your physical health, exercise helps reduce anxiety, depression and fatigue. Physical activity is also a great way to reduce stress, which is important to your overall health. And, it's a natural way to boost your mood, offering drug-free relief for many of the emotional side effects of cancer and its treatment.

 

Green Smoothie

Ingredients:
1 cup fresh baby spinach
½ cup pineapple chunks or pears
½ cup green grapes
½ banana
½-1 cup of water
½-1 cup of ice
 
Directions:
Blend all ingredients together.
Makes: 1 large serving or 2 small servings
 
Add protein powder if desired.

 

Additional Resources

 

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