Avril Harry RN, BSc Oncology Nursing (UWI), As part of our thrust to support women interested in comprehensive breast health, nutrition is one of the common areas of inquiry by patients who have been diagnosed with breast cancer or people who are trying their best to prevent it.
This concern is an absolutely important one as it has a cascade effect on surgical and post-surgical outcomes. In fact, patients who have adopted healthy lifestyles pre diagnosis tend to have a much better prognosis and their overall survival are much more successful.
No doubt, the issue of nutrition is a global one. This was one of the hot topics at the 9th Annual Royal Marsden Breast Cancer Meeting in London, which I attended in October of this year. Although breast cancer care and treatments are very individualized there are some facets of health and nutrition that we can glean from that provide immense benefits to our breast cancer patients: the newly diagnosed, those preparing for surgery, those having treatment (chemotherapy, radiation therapy or endocrine therapy), and survivors alike.
For people undergoing chemotherapy we must acknowledge some of the inherent challenges associated with these medications: namely loss of appetite, taste changes, inability to eat due to mucositis and such, and in these instances having guidance from your oncology team is useful. If this is you, I recommend you start a diary and document the changes you experience so that effective monitoring and appropriate interventions can be implemented.
Gone are the days in which a person undergoing treatment for breast cancer looks emaciated, rather many of the breast cancer treatments cause weight gain. Inherent in most breast cancer treatments are changes to one’s body composition and this has significant implications particularly after treatment. Of note, people overweight or obese are at an increased risk generally of developing cancer, as is commonly seen in post-menopausal breast cancer.
Today, we have numerous evidence-based dietary guidelines.
In 2014 the WHO Research fund evaluated 45 studies and assessed women at varying stages of treatment.
Body fat was assessed for women who had less than 12 months of treatment and prior to diagnosis, and those found to be overweight did not have a good prognosis for breast cancer, higher mortality, and were more likely to develop secondary primary cancers.
It is recommended that women during treatment aim to be as close as possible to their ideal weight. In essence, what we are emphatically stating is that being overweight is not good. As mentioned earlier, some treatment modalities, mainly endocrine therapies, cause weight gain.
Our admonition to all breast cancer patients and women as a whole is to consider the following practical recommendations:
•Physical activity and exercise to maintain lean body mass (within the limits or specifics of your oncology team—for people undergoing breast cancer treatment).
•Increase dietary fibre—studies over the years continue to demonstrate that by incorporating high dietary fibres tends to reduce all forms of mortality. Consume more plant-based foods, fruits and vegetables, and whole grain cereals.
•It is understandable that eating and drinking more calories is easier this time of year— though surrounded by choices concentrated in calories stay portion aware.
•Use smaller plates—studies show that the larger your plate the more food you will put on your plate and the more you will eat. Conversely, by using a small plate you will eat less.
•When out shopping limit fast foods. Try pre-packaged healthy snacks eg, baby carrots, nuts, granola or fruit.