Dietary and Lifestyle Considerations
This section will briefly summarize some important dietary and lifestyle considerations for women with breast cancer. However, Life Extension recommends that women fighting breast cancer, and those in remission, consult a credentialed nutrition professional to develop a healthy eating plan, as maintaining a healthy diet is one of the most important considerations for cancer patients. Cancer care centers and oncology medical teams should typically either include a credentialed nutrition professional or be able to offer a referral.
Eat a Minimally Processed Diet Emphasizing Plant-Based Foods
A typical Western diet, characterized by reliance on animal products, refined carbohydrates, and unhealthy fats like processed vegetable oils, may promote an inflammatory environment in the body. A pro-inflammatory diet has been associated with an increased breast cancer risk and a higher risk of death from breast cancer (Fowler 2017; Tabung 2016; Shivappa 2015; Schottenfeld 2006; Cavicchia 2009; Stoll 1998a; Stoll 1998b; Link 2013; Nicholson 1996).
The American Cancer Society and the American Society for Clinical Oncology recommend that women diagnosed with breast cancer drink no more than one alcoholic beverage daily and eat a diet that emphasizes unprocessed vegetables, fruits, whole grains, legumes, and fish (Runowicz 2016). A diet emphasizing unprocessed, plant-based foods has been associated with reduced breast cancer risk in several studies (Penniecook-Sawyers 2016; Chang, Hou 2017; Catsburg 2015; Harvie 2015). This dietary strategy will naturally provide plenty of cancer-fighting phytochemicals. Phytochemicals are specialized compounds found in plants that have health benefits, including anti-cancer effects (Dalasanur Nagaprashantha 2018; Forcados 2017; Kapinova 2017; Shoaib 2016). A diet that emphasizes unprocessed plant-based foods will also be low in saturated fat, high intake of which has been correlated with increased breast cancer risk and worse outcomes for women with breast cancer (Kroenke 2005; Chlebowski 2017; Brennan 2017; Slomski 2017; Kroenke 2013). Finally, an unprocessed diet will contain very little added sugar—greater sugar consumption has been correlated with increased breast cancer risk (Sulaiman 2014).
A good “general” rule to help ensure you are buying healthy ingredients is to obtain most ingredients from the outside isles (or perimeter) of the store. In most stores, the outside isles are where fresh, unprocessed items can be found: produce; dairy; fresh seafood, meat, and poultry; etc.
Cooking Methods – Especially Important for Meat
When meat is cooked at high temperatures with dry heat, cancer-causing compounds such as polycyclic aromatic hydrocarbons are formed (Diggs 2011; Gammon 2004; White, Bradshaw 2016; White, Chen 2016). Consumption of high amounts of grilled, barbecued, or smoked meats has been associated with increased breast cancer risk, especially among women who consume few fruits and vegetables (Steck 2007; Kim, Lee 2017). Furthermore, a recent study found that meat cooked at high temperatures (eg, grilled) may decrease the chances of survival after diagnosis with breast cancer. In that study, women who continued consuming grilled meat after diagnosis were 31% more likely to die during the study’s average 17-year follow-up period (Parada 2017).
Life Extension Magazine® published an article in 2013 titled “Are You Cooking Yourself to Death?” that further explores the potential problems associated with high-temperature cooking and reveals which cooking methods can help avoid these pitfalls.
Soy and Breast Cancer
Soy-based foods, such as edamame, tofu, miso, and soymilk, are a traditional component of many Asian diets. Although soy has not been a significant part of Western diets in the past, soy consumption is steadily increasing in the United States (Soyfoods Association 2014).
The association between soy and breast cancer is very controversial. The controversy arises because constituents in soy, particularly isoflavones, can exert estrogen-like activity in the body. When researchers first discovered these properties of soy, concern arose that soy might promote the growth of estrogen-sensitive breast cancers. Indeed, in some animal models suggested that isoflavones stimulate the growth of implanted breast tumor (Allred 2001; Ju 2006). However, the metabolism of soy isoflavones varies across species (Gu 2006), so findings from animals models of the effects of isoflavone supplementation may not be applicable to humans (Messina 2016).
Moreover, considerable epidemiological and clinical data have found that soy food consumption (not necessarily supplementation with isolated isoflavones) is associated with lower breast cancer risk and better outcomes after diagnosis (Guha 2009; Messina 2016). Several large cohort studies have found that a diet rich in soy is associated with reduced risk of breast cancer recurrence (Nechuta 2012; Shu 2009; Zhang, Kang 2012; Zhang, Haslam 2017). In one study, Chinese women who ate at least 15 grams of dietary soy protein per day were 32% less likely to have a breast cancer recurrence (Shu 2009). A second study enrolled 9,514 Chinese and American women previously diagnosed with breast cancer. Women from either country with at least 10 mg of isoflavones (from soy-based foods) in their diet every day had a 25% lower risk of recurrence (Nechuta 2012).
A meta-analysis that combined data from many studies also found that including soy foods in the diet after a breast cancer diagnosis significantly improved chances of survival and reduced risk of recurrence. The effect appeared to be strongest among postmenopausal women, women with estrogen-receptor-negative tumors, and women with tumors positive for both estrogen and progesterone receptors (Chi 2013).
Each woman should decide for herself whether she is comfortable consuming soy-based foods. It is worth noting that most conventional physicians will advise against consuming soy because not enough data are available from which to draw unequivocal conclusions.
Choose Healthy Beverages
Aside from the importance of drinking plenty of water daily, other beverage choices are also important. As mentioned previously, women concerned with breast health should drink no more than a single alcoholic beverage daily. But other considerations related to beverage choice may influence breast health as well. For instance, coffee contains several compounds such as polyphenols (eg, chlorogenic acid) and diterpenes that may prevent or fight breast cancer (Bhoo-Pathy 2015). Studies suggested drinking 2‒4 cups of coffee per day is associated with reduced breast cancer risk (Oh 2015; Grosso 2017; Jiang 2013). Also, in a large study with almost one million women, a two-cup-per-day increase in coffee consumption was associated with a small reduction in the risk of dying from breast cancer (Gapstur 2017).
Green tea is another good choice. Like coffee, it contains health-promoting polyphenols, the most famous of which is epigallocatechin gallate (EGCG). Green tea is a rich source of EGCG, and 12 months of green tea extract supplementation has been shown to reduce breast density in younger women (Samavat 2017). Many laboratory studies have shown that tea constituents can kill or slow the growth of breast cancer cells, inhibit their metastasis, and reduce their ability to recruit new blood vessels to supply blood and nutrients to metastatic tumors. Also, a number of observational studies has associated green tea consumption with reduced breast cancer risk, and several clinical trials have shown that green tea supplementation reduces biomarkers of breast cancer progression (Sinha 2017).
Maintain a Healthy Weight and Exercise
Maintaining a healthy weight goes hand-in-hand with a healthy diet. And studies have shown that losing weight reduces breast cancer risk. In a huge meta-analysis of data on over 4 million subjects from 139 studies, weight loss was associated with an 18% relative reduction in breast cancer risk. This same large analysis also found that exercise, which is often part of a weight loss program, led to a 22% relative risk reduction (Hardefeldt 2017). Other studies suggest physical activity can help alleviate some of the side effects of conventional cancer therapy. For instance, 16 weeks of resistance and high intensity interval training reduced cancer-related fatigue and symptom burden in breast cancer patients being treated with chemotherapy (Mijwel 2017). Another study found that exercise one day before chemotherapy (doxorubicin) treatment improved mood and reduced musculoskeletal side effects of the treatment (Kirkham 2017).
The American Cancer Society recommends that adults get 150 minutes of moderate-intensity physical activity (such as walking or leisurely bicycling) or 75 minutes of vigorous physical activity (such as running or swimming) each week. Ideally, this activity should be spread throughout the week, rather than lumped together.
Managing Stress and Maintaining a Support Group
Receiving a cancer diagnosis and progressing through treatment can be an emotionally tumultuous and highly stressful experience. It is important to not neglect mental health during this time. Maintaining a positive outlook and emotional wellbeing throughout this process is an important but often underemphasized aspect of cancer care. Ongoing stress after breast cancer diagnosis has been shown to predict bothersome physical symptoms and lower quality of life (Harris 2017).
The American Cancer Society recommends that patients include caregivers and family members in consultations with the medical team (Runowicz 2016). This informed support network can help support critical treatment decisions and share the burden with the patient (Wallner 2017). Meditation, mindfulness programs, peer-counseling, and other tools can help reduce stress, anxiety, and depression and improve sleep and quality of life (Yun 2017; Johns 2016; Giese-Davis 2016; Haller 2017). More information about managing stress is available in the Stress Management protocol.