Can Diet And Lifestyle Reduce The Risk Of Recurrence
You may have heard that diet and lifestyle can affect the risk of breast cancer coming back, also known as recurrence.
The World Cancer Research Fund recommends that women who have had breast cancer follow advice to reduce their risk of cancer coming back. This includes eating a healthy diet that is high in fibre and low in saturated fats, being physically active, maintaining a healthy weight and limiting alcohol .
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The Bristol Whole Life Approach To Healthy Eating
The Bristol Whole Life Approach to healthy eating is a set of dietary guidelines for people living with and beyond cancer. The guidelines mainly focus on eating foods that have not been altered. For example, they suggest:
- Eating brown rice instead of white rice
- Including a range of different colour vegetables and fruit in your diet
- Animal products permitted only in small amounts
The Bristol Whole Life Approach to healthy eating aims to help people eat healthily and cope better with the physical and emotional impact of cancer. However, there is no evidence that following these recommendations will reduce the risk of breast cancer recurrence.
The recommendations were developed by Penny Brohn UK.
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Search Strategy And Selection Criteria
A systematic search strategy was developed by the research team and conducted through the Health Sciences Library at the University of North Carolina at Chapel Hill. A PubMed MEDLINE search conducted using two sets of search terms/phrases: estrogen AND diet* OR nutrition And breast cancer AND postmenopausal and estrogen AND exercise OR physical activity AND breast cancer AND postmenopausal. All initial studies from the two searches were uploaded to Covidence systematic review software . Duplicate citations were eliminated during the screening process. All titles and abstracts retrieved from the literature search were screened independently . Potentially eligible studies were retrieved in full and reviewed independently . Discrepancies were resolved by consensus between two researchers. Finally, a reference hand search was done of all included articles and relevant systematic reviews for additional studies.
Table 1 Summary of studies included for review.
Table 2 Demographics and clinical characteristics of the study participants of the eligible studies.
Table 3 Breast cancer risk and estrogen level changes assessed in dietary intervention studies.
Table 4 Breast cancer risk and estrogen level changes assessed in exercise intervention studies.
Table 5 Breast cancer risk and estrogen level changes assessed in dual intervention studies.
Smoking And Breast Cancer Recurrence
There is emerging evidence that smoking may affect the risk of breast cancer recurrence but further research is needed to find out more.
We know smoking causes a range of health conditions. If you want to stop smoking there are a range of programmes to help. Speak to your pharmacist, GP or practice nurse for advice.
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Prioritize Plants In Your Diet
Moving to a plant-based diet doesnt mean you have to become a vegetarian. It just means that fresh vegetables, fruits, and legumes make up most of what you eat. The nutrients in plant-based, non-commercially processed foods appear to inhibit inflammation and, because of relatively low carbohydrate and high fiber content, dont cause repeated sharp rises in blood insulin levels.
Think of plant-based foods as the main course and protein and high-fiber carbohydrates as the condiments. Thats the methodology behind the Mediterranean diet, which focuses on a menu of predominantly plants, as well as lean meats, fish, and plant-based fats like olive oil.
Who Is Most Likely To Receive Benefits From Phytoestrogens
The link between phytoestrogens and a decreased risk of developing breast cancer is most commonly seen in people who have been consuming phytoestrogens through their daily diet since childhood., Asian diets generally incorporate more soy products than Western diets do throughout childhood and adulthood, allowing for more exposure to a balanced diet including phytoestrogens and the potential benefits they produce with respect to breast cancer.,
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Subsample And Em Assay
A subset of postmenopausal women randomized to the screening arm of PLCO for whom information on serum EMs was available was utilized to derive the ERDP. Complete information on the nested study has been published elsewhere.16 Briefly, the nested study population was drawn from all 1,141 incident breast cancer cases diagnosed from the start of recruitment in 1993 through June 30, 2005, and a random sample of 1,141 control subjects. After excluding women who were not postmenopausal, were not using postmenopausal hormone therapy at baseline, or had prior diagnoses of cancer, the sample was reduced to 390 cases and 453 controls. For the purposes of the present analysis, cases who were diagnosed < 2 years after serum sample donation were excluded to avoid the possibility of disease processes affecting estrogen levels. Women without a valid DQX or with implausible EM levels were further excluded. The final analytic sample for the RRR procedure included 393 controls and 260 confirmed cases, with a mean of 5.25 years from sample donation to breast cancer diagnosis among cases.
Eating A Healthy Diet
Most research on possible links between diet and the risk of breast cancer coming back has looked at broad dietary patterns, rather than specific foods. In general, its not clear if eating any specific type of diet can help lower your risk of breast cancer coming back. Studies have found that breast cancer survivors who eat diets high in vegetables, fruits, whole grains, chicken, and fish tend to live longer than those who eat diets that have more refined sugars, fats, red meats , and processed meats . But its not clear if this is due to effects on breast cancer or possibly to other health benefits of eating a healthy diet.
Two large studies have looked at the effects of lowering fat intake after being diagnosed with early stage breast cancer. One study found that women on a low-fat diet had a small reduction in the risk of cancer coming back, but these women had also lost weight as a result of their diet, which might have affected the results. The other study did not find a link between a diet low in fat and the risk of cancer coming back.
While the links between specific types of diets and breast cancer coming back are not certain, there are clearly health benefits to eating well. For example, diets that are rich in plant sources are often an important part of getting to and staying at a healthy weight. Eating a healthy diet can also help lower your risk for some other common health problems, such as heart disease and diabetes.
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Food Inflammation And Cancer Risk
Were constantly learning new things about how different foods affect our health. For example, inflammation is a stress response and chronic inflammation is believed to cause DNA damage associated with cancer-causing genetic changes in normal tissues.
Certain foods stress the body more than others. Sugar and other carbohydrates can contribute to inflammation by causing blood glucose levels and, in response, insulin levels to rise. High levels of insulin which moves the sugar into the cells have been shown to stimulate cancer cell division. That activity is thought to support the growth and spread of cancer cells and may be part of the link between poor nutrition and cancer risk or relapse.
Increased fat deposition commonly observed in high-carbohydrate diets also can increase the amount of estrogen in the body, which can trigger cell division, especially in breast and uterine cells, which express the estrogen receptor. While carrying too much body fat is associated with insulin-resistance and inflammation, excess fat also produces estrogen.
How you prepare your food is important as well. Regularly consuming processed meats, such as hot dogs, sausages, and deli meats, has been shown to be associated with an increased cancer risk. And cooking foods at high temperatures, such as grilling or frying, can produce harmful compounds linked to increasing inflammation markers.
Diet And Breast Cancer Risk
Maintaining a healthy weight is linked to a lower risk of breast cancer after menopause .
However, only a few dietary factors appear to be related to breast cancer.
- Eating fruits and vegetables may be linked to a risk of breast cancer
- Drinking alcohol is linked to an increased risk of breast cancer
We also know some foods and beverages are not related to breast cancer risk. Others are under study for possible links to breast cancer.
This section gives a summary of the research on dietary factors and breast cancer risk.
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Development Of The Erdp
To identify foods that are correlated with serum levels of unconjugated E2 and the 2/16 ratio, RRR modeling was applied to the subsample of 653 participants with EM data. An approach using RRR determines linear functions of predictors, which in the present case are food groups, by maximizing the explained variation in multiple disease-specific response variables, comprised of E2 and the 2/16 ratio.21 In order to ensure RRR factors are based on how much variation in the outcome they explain, all intakes were centered and scaled so that their mean ± standard deviation is equal to 0 ± 1. Only the first factor was retained for development of the ERDP because it represented a dietary pattern that explained the largest variation in the EM. Initially, all 32 food groups were entered into the model at once. Those with a variable importance in projection statistic greater than 0.8 were retained and re-entered into the RRR model, as they represent the food groups which are the strongest contributors to RRR factors scores.22 The model weights were extracted from the final RRR model from PROC PLS using SAS version 9.4 . To calculate the ERDP score in the full analytic PLCO cohort food group intakes were centered and scaled, then multiplied by their corresponding model weights for each of the retained food groups. The total ERDP score was calculated by summing over the weighted intakes. This same calculation method was applied to score the ERDP for the full analytic cohort.
Maintain A Healthy Weight After Treatment
People with obesity have higher levels of estrogen circulating in their bodies than women who are in their ideal body weight range.
Many studies, including a one conducted by researchers from the Iranian Institute for Health Sciences Research in Tehran, Iran, have demonstrated an association between body mass size and breast cancer in postmenopausal women.
If youre overweight, Taylor recommends losing weight through a healthy diet and regular exercise once youve finished treatment.
Weight loss during treatment isnt typically encouraged, as this is often associated with undesired muscle loss, leading to fatigue, a suppressed immune system and a slower healing process.
Allow your body the nutrients it needs to fight cancer, she says.
Once your treatment is done, consider meeting with a dietitian for individualized recommendations to decrease recurrence risk and support a healthy weight.
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Eating Foods Rich In Phytoestrogens May Reduce Breast Cancer Risk
9 years ago |Cancer
The hormone estrogen plays an important role in a womans health throughout her life. It is necessary for the development and growth of breasts, ovaries and the uterus regulates the menstrual cycle and is essential for reproduction. Estrogen also plays an important role in having a healthy heart and bones.
The downside to all these benefits, however, is that a womans risk for breast cancer is associated with how much exposure she has to estrogen over the course of her life. It is believed estrogen plays a role in the development of breast cancer because of its:
- Role in stimulating breast cell division
- Work during the critical periods of breast growth and development
- Effect on other hormones that stimulate breast cell division
- Support of the growth of estrogen-responsive tumors
Minimizing exposure to estrogen naturally
Simple changes to diet may affect the levels of estrogen in a womans body and reduce her lifetime exposure to this hormone. Consuming a diet rich in phytoestrogens , for example, has been proposed as a way to decrease breast cancer risk. Foods rich in phytoestrogens include whole grains, fruits and vegetables as well as certain spices and herbs. Certain types of soy are generally touted as having phytoestrogens that reduce breast cancer. But the studies so far have not provided a clear answer.
Be proactive and enjoy your healthy life!
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After Treatment Maintain A Healthy Weight
Obese women have higher levels of estrogen circulating in their bodies than women who are in their ideal body weight range.
Many studies including a study conducted by researchers from the Iranian Institute for Health Sciences Research in Tehran, Iran, have demonstrated an association between body mass size and breast cancer in post-menopausal women.
If youre overweight, Taylor recommends losing weight through a healthy diet and regular exercise once youve finished treatment. Weight loss during treatment isnt typically encouraged, as this is often associated with undesired muscle loss, leading to fatigue, a suppressed immune system and a slower healing process.
Allow your body the nutrients it needs to fight cancer, she says. Once your treatment is done, consider meeting with a dietitian for individualized recommendations to decrease recurrence risk and support a healthy weight.
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Risk Factors For Breast Cancer
Signs of breast cancer include pathological changes in milk ducts and lobules, and both locations include changes with mild hyperplasia, atypical ductal hyperplasia, ductal carcinoma in situ or the invasive cancer. Recognized risk factors for breast cancer include: age over 50 years of age, the family burden, endo- and exogenous sex hormones, obesity, low physical activity, alcohol abuse, exposure to ionizing radiation and diet. About 5-10% of breast cancer cases are hereditary. A 56-85% risk of developing breast cancer occurs in women with mutations of suppressor genes BRCA1 and BRCA2 .
Another factor that may determine occurrence of breast cancer is primary immunodeficiencies, and especially ataxia telangiectasia syndrome which is characterized by mutations of the AT gene .
The oral contraceptives usage and its direct association with breast cancer is still a matter of debate. But a number of studies has demonstrated an increase in the risk of developing breast cancer in women taking these hormonal therapies .
Another factor increasing the risk of developing breast cancer is exposure to ionizing radiation, especially at a young age .
How Can I Improve My Immune System
Following a balanced diet and exercising regularly can help make sure your body is strong enough for treatment.
The following are other ways to support your body and immune system:
- Avoiding smoking or other tobacco use.
- Getting enough sleep.
- Managing your blood pressure.
- Washing your hands properly.
During chemotherapy treatment, its important to follow food safety precautions, such as cooking meats thoroughly and avoiding unpasteurized foods. This will help your body if your immune system cant fight off infections as well as it should.
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The Effects Of Diet And Exercise On Endogenous Estrogens And Subsequent Breast Cancer Risk In Postmenopausal Women
- 1Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- 2Nutrition Research Institute, University of North Carolina at Chapel Hill, Kannapolis, NC, United States
- 3Department of Supportive Oncology, Levine Cancer Institute, Atrium Health, Charlotte, NC, United States
Alcohol And Breast Cancer Recurrence
Studies have shown drinking alcohol increases the risk of getting breast cancer. Its less clear if drinking alcohol affects the prognosis of breast cancer.
NICE recommends people whove had breast cancer limit their alcohol intake to below 5 units a week.
You can find out how many units are in your drinks by using an online unit calculator. As a general guide:
- Half a pint of average-strength beer = 1 unit
- A 175ml glass of wine = 2 units
- A single 25ml measure of spirits = 1 unit
Its worth bearing in mind that alcohol is also high in calories.
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Foods That May Lower Breast Cancer Risk
Keep in mind that many factors are associated with breast cancer development. While improving your diet can improve your overall health and reduce your cancer risk in general, its only one piece of the puzzle.
Even with a healthy diet, you still need regular breast cancer screenings like mammograms and manual checks. After all, early detection and diagnosis significantly increase survival rates. Talk to your healthcare provider for advice about breast cancer screenings.
All the same, research suggests that these foods may lower your risk of this disease.
How Can I Avoid Highly Processed Phytoestrogens
Since highly processed and concentrated phytoestrogens may have different effects on breast tumor cells, it is best to avoid highly processed soy. Limit intake of concentrated isoflavones, including genistein, in favor of less-processed options such as tofu, edamame and tempeh.
Inflammopharmacology
Sakamoto, Takako et al. âEffects of diverse dietary phytoestrogens on cell growth, cell cycle and apoptosis in estrogen-receptor-positive breast cancer cells.â The Journal of Nutritional Biochemistry 21, 9 : 856-64. doi:10.1016/j.jnutbio.2009.06.010.
Andres, Susanne et al. âRisks and benefits of dietary isoflavones for cancer.â Critical Reviews in Toxicology 41, 6 : 463-506. doi:10.3109/10408444.2010.541900.
Seibold, Petra et al. âEnterolactone concentrations and prognosis after postmenopausal breast cancer: assessment of effect modification and meta-analysis.â International Journal of Cancer 135, 4 : 923-33. doi:10.1002/ijc.28729.
Rice, Suman, and Saffron A Whitehead. âPhytoestrogens and breast cancerâpromoters or protectors?.â Endocrine-Related Cancer 13, 4 : 995-1015. doi:10.1677/erc.1.01159.
Xiong, Xiang-Yang et al. âInhibitory Effects of Enterolactone on Growth and Metastasis in Human Breast Cancer.â Nutrition and Cancer 67, 8 : 1324-32. doi:10.1080/01635581.2015.1082113.
Shu, Xiao Ou et al. âSoy food intake and breast cancer survival.â JAMA 302, 22 : 2437-43. doi:10.1001/jama.2009.1783.
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