Breast cancer survival rates are increasing. Medical advances, early detection, and increased awareness mean that more women (and men!) are surviving breast cancer. As of 2016, the 5-year survival rate for breast cancer patients was 91%. It’s wonderful that breast cancer survival rates are increasing, but for those who have lost loved ones, 91% is still much too small of a number. For those who do make it through breast cancer, the focus shifts to limiting the risk of recurrence.
It doesn’t seem right that cancer, once beaten, might return. But it’s estimated that 30% of people diagnosed with early-stage breast cancer will develop metastatic cancer later on. While there is no way to guarantee that cancer will not return in some form, there are strategies for reducing your risk.
Unfortunately, the best ways of reducing risk of cancer recurrence are also the hardest: losing weight and exercising.
In a University of California study, fat loss was found to be one of the best methods for decreasing the chance of facing cancer a second time. Female breast cancer survivors who perform moderate weekly exercise have a significantly reduced rate of recurrence. A consistent exercise routine can help reduce recurrence risk by 20% to 80%. That’s huge. And losing even a small amount of weight can make a difference in recurrence risk—not to mention your overall health. But even losing a small amount can be a big challenge.
What We Know For Sure
Weight loss is hard. It’s really, really hard. It’s easy to throw statistics around and talk about what we should do, but it’s harder to make a life-long change. And for cancer patients, weight loss may be even harder.
Steroid treatment often leads to weight gain, and even if steroids are discontinued, the extra weight is hard to lose. Chemotherapy can cause women to start menopause early, and that can lead to weight gain. Hormone therapy can lead to weight gain, because decreased hormone levels, while helpful for cancer treatment, can lower metabolism, increase fat, and decrease muscle.
Even if treatment itself doesn’t cause weight gain, the stress and schedule of treatment and disease can lead to extra pounds. Keep in mind that during treatment, weight loss will likely not be your goal, as your body needs all its energy focused on fighting cancer. When treatment is over, it’s time to decide how you’ll live your best, healthiest life and if weight loss and/or exercise should be a part of that.
Reasons to get and stay healthy after cancer treatment
Tim Byers, M.D., M.P.D, authored a study that followed early-stage breast cancer survivors for 2 years. The study found that, given the proper information and motivation, breast cancer survivors can lose weight. Not surprisingly, the study participants who received more support lost more weight than the group that received only information, but both groups were successful in their efforts. Dr. Byers said, “We don’t need to focus on getting to the ‘ideal’ body type, whatever that may be. If we can prove that modest weight loss improves the chance of better outcomes after breast cancer, we need to encourage and support that.”
Fat cells make estrogen, and estrogen can cause hormone-receptor-positive cancer cells to grow. Increased fat cells mean increased estrogen and increased risk. Extra fat cells can also cause low-level chronic inflammation, and this inflammation has been linked to increased recurrence risk. This is great motivation for getting extra fat cells off our bodies, but it’s not the only reason to get moving.
Exercise relieves stress and boosts your mood. Exercising is an excellent confidence builder (apart from weight loss), and it’s often a great way to build a social support group. For tips on how to best stay active after cancer treatment, click here.
But we already know that exercising and maintaining a healthy weight are important, right? The problem is that it’s not as simple as walking a mile and waiting for the extra pounds to come off. Long-term, healthy weight loss is slow, steady, and tough. But it can be done, and cancer survivors already have a double-dose of toughness.
How big a change do I need to make?
While stories of mega-weight loss are inspiring, slow and steady wins the race when it comes to sustainability. The U.S. Department of Health and Human Services recommends 150 minutes of moderate-intensity aerobic exercise a week. That’s 30 minutes a day, 5 days a week. It’s doable, but be encouraged that even small amounts of activity are better than none. 10 minutes is better than zero minutes, and 20 minutes is better than 10. Small steps lead to success!
Muscle strengthening exercises are also recommended, as these strengthen bones, boost metabolism, and build lean body mass. They also make you feel strong and powerful! Remember, start small and build gradually. Don’t use up all your enthusiasm on day one. Think it’s too late for you to start a weightlifting program? This weightlifting granny begs to differ!
As far as numbers go, the American Cancer Society says that losing as little as 5%-10% of your body weight can increase your health. That certainly sounds reasonable. For a 200-pound person, a 10% weight loss is 20 pounds. That sounds a little more difficult, but remember that it happens one day at a time. A 5% weight reduction for the same person would only be 10 pounds, and a healthy, sustainable weight loss is a half-pound to a pound per week until you hit your goal.
If you decide you want to lose 20 pounds and you stay steady at a half-pound of weight loss per week, then in a little under 10 months, you will have hit your goal. No, it’s not overnight, but in that amount of time you will have established better habits that will be hard to break. A healthy lifestyle is a marathon, not a sprint (though you don’t have to run marathons to maintain a healthy lifestyle).
There is no way to guarantee that cancer won’t come back. Someone could work out every day and eat nothing but healthy food and still have their cancer return. Cancer isn’t a sign that someone didn’t work hard enough or that they did something wrong.
We can identify risk factors, take preventative measures, and hope for better outcomes, but there is no way to guarantee cancer will stay away for good. Exercise and weight loss should be seen as a way to decrease your risk of recurrence, but also as a way of treating your body well and living your life to the fullest every day. Exercisers who see working out as part of their healthy lifestyle will enjoy it more than those who exercise only to lose weight or reduce health risks.
Beginning a weight loss journey and exercise plan is hard—sustaining one is even harder! Even small steps can be tough. We encourage you to celebrate every victory and to be kind to yourself. Find motivation in small things and in big things, and never accept that it’s too late to get healthy. Keep fighting, friends!
Katie Taylor started writing in 5th grade and hasn't stopped since. Her favorite place to pen a phrase is in front of her fireplace with a cup of tea, but she's been known to write in parking lots on the backs of old receipts if necessary. She and her husband live cozily in the Pacific Northwest enjoying rainy days and Netflix.