Are you looking for a holistic approach to breast cancer treatment? While conventional therapies for breast cancer are vital, they result in side effects that can greatly affect quality of life, self-identity, and impact recovery and remission. (1) Often times, patients are told that diet, exercise, and other activities won’t make a difference in the development or intensity of these symptoms. Nothing could be farther from the truth, and peer-reviewed research supports this. (2) Read on to see how you can adopt an integrative approach to breast cancer treatment!
Complementary therapies, exercise, nutrition and breast cancer treatment
Truth be told, there is no one magic bullet when it comes to perfect health, treatment or cures. This is particularly pertinent regarding breast cancer treatment. As mentioned above, a common perception is that diet, exercise and ancillary activities don’t have a significant impact on the mitigation of breast cancer. While this perception is misplaced, it is however of utmost importance that all patients use a safe and comprehensive plan during cancer treatment for best outcomes. Complementary therapies include but are not limited to naturopathic medicine (vitamins, minerals, herbal therapies), culinary nutrition, acupuncture, and massage therapy. We can achieve great benefits for patients when a holistic approach is managed by an expert team of licensed practitioners in conjunction with conventional therapies. (3) Cancer treatment depletes certain important nutrients. Studies by the National Cancer Institutes have found that nutrition and in particular specific foods can affect outcome, and even help or hurt short and long-term side effects. Patients receiving nutritional counseling before, during and after cancer treatment have better outcomes, quality of life, and experience significantly fewer side effects. (4) Furthermore, certain nutrients control the onset of specific side effects from treatment. There are several good studies that validate the importance of nutrition in prevention and remission of breast cancer. One such study, a 2013 survey, demonstrated the need of cancer patients and survivors regarding diet, exercise and weight management. James-Martin and his team found that patients thought there was a lack of information regarding diet and exercise during and after conventional treatment. (5) As mentioned, those receiving nutritional counseling during and after treatment had better outcomes and reduced side effects. Other holistic interventions also play a significant role in cancer treatment outcomes and the prevention of cancer progression. We know research from the National Cancer Institute and the European Prospective Investigation into Cancer (EPIC) study demonstrates that exercise is the number one factor correlated with remission and cancer prevention. (6)
Did you know? Exercise — both aerobic and resistance training— is important for preventing and decreasing the side effects associated with cancer treatment like muscle wasting, fatigue, osteoporosis, and self-esteem.
Physical activity has a palpable impact on breast cancer treatment; it can directly affect tumor growth by modulating inflammatory responses in the tumor mass microenvironment. This is an extremely important finding as it relates to recurrence and remission. There are other long-term symptoms that can be addressed by exercise as well. Fatigue, muscle loss, circulation, decreased stamina and bone loss associated with cancer treatment is simultaneously associated with loss of overall muscle mass. Fatigue associated with muscle loss is in turn associated with increased risk of developing osteopenia and osteoporosis.
Did you know? Hormone treatments using aromatase inhibitor like Anastrozole put patients at high risk of developing osteoporosis. (7)
Role of mind-body therapies
Patients can respond in many ways to being diagnosed, treated and living with breast cancer. They can feel a wide range of emotions. I have some patients that are very emotionally expressive throughout treatment and others that metaphorically hold their breath until therapy is done. All patients could benefit from counseling and other mind-body therapies to help restore mental peace of mind. I’ve observed that patients who wait until treatment ends to discuss or deal with feelings usually have the most issues with anxiety and depression. It is important to remember that any response to diagnosis is individual, and is a normal response. With professional help or direction, these feelings transform, improve, or go away with time. Though it might feel uncomfortable, it is of vital importance that these stressors be recognized and addressed. Stress of this sort has been shown to lead to later presentations of cancer, decreased medical compliance, and increased chance of development of additional illnesses. Increase in psychological stress may increase blood levels of epinephrine and norepinephrine, resulting in increased heart rate, increased blood pressure, and blood sugar levels, which can predispose you to developing diabetes, metabolic syndrome, and put you at a higher risk of developing cancer or recurrence.
Why you need to invest in immune cell activity
I can’t stress how important robust immune cells are in fighting cancer. All immune cells play a role in the fight against cancer, but four in particular must be working well. These cells are Natural Killers (NK) cells, macrophage, CD8 cells and T Helper 1 cells. Normally, these circulate in every person and remove precancerous and cancer cells. They can be overwhelmed or suppressed by various factors, including external and internal stressors, and even cancer treatment. My plans are always geared to support the immune system during and after cancer treatment to increase quality of life and promote remission. Let’s now take a general look at what happens to the immune system when we are stressed. Significantly, when we’re stressed there is an elevation of the stress hormone cortisol. This is one of the hormones secreted by the adrenal gland involved in the fight or flight mechanism. Other hormones include adrenaline and epinephrine. In the presence of these hormones— especially when these are secreted chronically—the immune system’s ability to fight off antigens and cancer is suppressed. Chronic suppression leaves the body vulnerable to cancer, but also to infection and to other disease processes.
Did you know? High and chronic stress levels also can cause depression and anxiety, again leading to higher levels of inflammation.(8) Sustained high levels of inflammation lead to an overworked, over-tired immune system that can’t properly protect you.
The creation or exacerbation of additional illnesses when you are dealing with cancer also puts a burden on your immune system. Psychological stress is involved in altered immune functioning in many diseases. Altered immune function can cause symptoms of both physical and psychological illnesses. For example, in irritable bowel syndrome, high levels of cortisol can create an increase or exacerbation of gastrointestinal symptoms. Overall, the immune system must be bolstered to achieve the best outcome and remission for breast cancer. Using a variety of therapies to decrease stress works well for most patients.
Understanding the role of exercise during treatment
A well-rounded exercise plan that includes physical activity at least five days a week delivers solid health benefits for breast cancer patients and survivors. Physical activity decreases inflammation, boosts the immune system, and stimulates loss in body fat. All these are associated with a decrease in breast cancer risk. Exercise has been shown to affect treatment outcome and overall quality of life for patients. Studies show that there is an inverse relationship between exercise and the development, or recurrence of cancer. (9) There are multiple reasons for good treatment outcomes, side effect prevention and reduction for breast cancer patients, and improved quality of life. (10) Exercise enhances physical function and can slow and stop bone mass loss. This is particularly important for patients who have been diagnosed with hormone-sensitive cancers and who are placed on hormone-blocking therapies, and especially for younger cancer patients. Bone loss and osteoporosis are common long-term side effects of treatment. However, studies have shown that weight-bearing exercise, including resistance training, can slow or prevent bone loss. Exercise that targets the upper body can improve range of motion that may have been affected by surgery or radiation. Exercise when initiated early after surgery is associated with a decrease in the development of lymphedema. (11) Patient using chemotherapies that are cardiotoxic, like Adriamycin, can decrease the effects using aerobic exercise. (12) Other side effects such as nausea, pain, fatigue, and depression can be reduced with an exercise regimen. In addition, other anti-inflammatory proteins are released that help the immune system in its fight against cancer.
Did you know? Exercise causes the release of endorphin, enkephalins, and serotonin. These are all hormones that act to reduce pain and increase the sensation of feeling good.
Exercise results in a reduction in estrogen and progesterone and a reduction in adipose (fat) cells. Adipose tissue manufactures and secretes estrogen. That’s why having a higher amount of muscle to fat is better for cancer patients and is associated with a decreased risk of occurrence. Exercise also helps to regulate the body’s level of insulin secretion and other hormones linked to cancer growth and aggressiveness. In summary, exercise is extremely important for breast cancer patients and survivors. I believe it should be a prescription!
Make diet an ally in your cancer treatment plan
Understanding why it’s important to eat an anti-inflammatory diet is helpful to compliance. The National Cancer Institute continuously updates its database on several aspects affecting cancer remission and prevention. (13) Many of these recommendations are specific, like reducing intake of red meat to three servings per week. American Cancer Society links fat with cancer treatment, “Early results of one large study of early-stage breast cancer survivors suggested that a low-fat diet may lower the chance of the cancer coming back. This effect was strongest in women whose cancers were estrogen receptor negative”. (2)
These findings and others are based on the nutritional contents of foods that we consume and their inflammatory effects. For example, both cow dairy and red meat contain a higher amount of something called omega 9 fatty acids. These are not ‘bad’ fats per say (here are some examples of fats that are good for you) but if we consume too many of them, we can tip the balance toward inflammation in our bodies. Inflammation can create damage and reactions that beget more inflammation, causing the cycle to continue.
Did you know? When the damage caused by inflammation exceeds the body’s ability to ‘clean’ it up, we begin to get damage at a cellular level. Damaged cells can turn into cancer. (14)
Another example of the importance of eating an anti-inflammatory, whole foods diet has to do with insulin sensitivity. Many people mistakenly attribute sugar as being the culprit in feeding cancer cells. This is not entirely correct. It is the insulin surges that are related to some solid tumors’ aggressive growth. Insulin is a hormone that is secreted in response to glucose, or sugar, levels in the bloodstream. Insulin presence signals to the cells to grow and divide. Normal cells consume the glucose at a normal rate, divide, and then have a mechanism to turn themselves off. Research shows that some solid tumor cells more aggressively take up glucose, given the signal by insulin, and they do not contain the mechanism to turn off growth or slow down growth.
Eating a diet containing complex carbohydrates and whole foods causes the blood sugar and insulin levels to maintain a steady state, that is, no big ups or downs in insulin. Eating this way with whole foods is the foundation of an anti-inflammatory diet. The easiest way to adhere to an anti-inflammatory diet is first to be conscious of what we are eating. Take a week or two to just assess what you are eating:
- How many boxed and processed foods am I eating?
- How many times a week am I eating out and what kinds of foods am I eating?
- How much processed sugar and simple carbohydrates am I eating per day?
- How many whole foods do I have in my diet?
Once you have assessed this, make steps to trade out one thing at a time. For example, maybe you eat lunch out at a fast food restaurant five times a week. The first step could be that you eat out four times a week and bring a healthy meal from home once per week. Or you could choose to eat at a healthier venue that offers lean meat, salads and healthy soup options. Small changes, for many, add up to long term compliance. Of course, some people are very successful in making a 180-degree change in their diet once diagnosed with cancer. That’s okay as well!
Key takeaways: Dietary suggestions for complementary care
A better diet during cancer treatment and beyond should be one guided by studies and your own personalized cancer treatment (because each protocol causes specific deficiencies or side effects). In general, however, we want to follow these guidelines (you should always check with your doctor before starting a dietary regime):
- Limit red meat intake to 3 times or less per week
- Limit cow milk/dairy to 4 times or less per week
- Limit simple sugar intake to 20 grams or less per day
- Protein intake should be at least 50 grams per day (Plant based)
- Fruit and vegetable goals should be 6 to 8 servings per day
- Diet should consist of 80% whole foods if not more
- Alcohol should be limited to less than 4 drinks per week (though new studies show any increases risk in folks with cancer) (15)
Meals and snack should be determined by their mineral, vitamin and fiber content, first and secondly, their flavor. But wait — remember there are so many wonderful tasting foods to choose from that really taste and flavor shouldn’t be an issue!
Treatment nutrition tips prior to chemotherapy
Included here are a few tips that I give to my patients to get through chemotherapy treatments a little better:
- Bone or vegetable broth: Drink 1 cup of bone broth or vegetable broth daily. Many chemotherapies are depleting in major minerals. These deficiencies can either produce or exacerbate side effects. Bone broth is an excellent way to replenish. Drink this throughout the entire period of treatment even when you are not getting an infusion.
- Coconut water: During infusion, drink 8 to 16 ounces of cold coconut water. The cold of the drink will help to protect your mouth and taste buds, thus decreasing loss of taste, as well as helping to decrease mouth sores. Coconut water also contains a good amount of potassium and other wonderful electrolytes.
- Protein and good fats: Prior to infusion, make sure you have a breakfast with a good amount of protein with good fats before treatment. Protein and good fats will help your blood sugar levels, and somewhat counteract the effects that steroids have on it. This will help to decrease nausea and fatigue.
6 helpful and safe supplements during cancer treatments
Always check with your healthcare provider and oncologist if you are a patient, and if you are a provider, make sure you understand the mechanism of action of the conventional treatment your patient is receiving to make sure these supplements do not interfere or decrease the effectiveness of cancer treatment.
Chemotherapies have different mechanisms of action and some herbal therapies and supplements can be contraindicated. Also, try to apply supplements specific to treatment goals.
Generally safe supplements during treatment (barring co morbidities):
- Omega fatty acids
- Calcium magnesium
- Digestive Enzymes
- L-glutamine or Carnitine
Supplements used with consideration of conventional therapeutic:
- Pyridoxal 5 phosphate
- Turkey Tail
- Lion’s Mane
- Vitamin B12 and Folic Acid
Be it nutrition, diet, or mindful supplementation, complementary cancer care is very useful and helpful if implemented in a knowledgeable and thoughtful way.
Drop us a line to tell us how you plan to adopt complementary cancer care!