Three steps on the way to fight­ing can­cer

Los Angeles Times - - MIND & BODY - By Lily Dayton health@la­times.com

Ex­er­cise, men­tal health, nu­tri­tion — th­ese are all ar­eas that can af­fect how some­one lives dur­ing and af­ter can­cer treat­ment.

Heal­ing ex­er­cise

Be­fore Gabriela Dow’s can­cer di­ag­no­sis, her sched­ule, which in­volved jug­gling pro­fes­sional com­mit­ments with moth­er­hood, left lit­tle time for work­ing out. But when her on­col­o­gist rec­om­mended that she ex­er­cise dur­ing treat­ment, she started walk­ing. “I learned early on that mov­ing made me feel so much bet­ter, es­pe­cially be­fore the tired­ness re­ally set in,” says Dow.

Not only does ex­er­cise make peo­ple feel bet­ter, fit­ness is cor­re­lated with mor­tal­ity, says Dr. Arash Asher, direc­tor of Can­cer Sur­vivor­ship and Re­ha­bil­i­ta­tion at the Sa­muel Oschin Com­pre­hen­sive Can­cer In­sti­tute at Cedars-Si­nai Med­i­cal Cen­ter.

Re­search shows that regular, mod­er­ate ex­er­cise also re­duces re­cur­rence rates of sev­eral types of can­cer, in­clud­ing col­orec­tal, prostate and ovar­ian. The protective ben­e­fit may be man­i­fold: phys­i­cal ac­tiv­ity re­duces in­flam­ma­tory chem­i­cals, body fat and in­sulin sen­si­tiv­ity, all of which may fuel can­cer pro­gres­sion and re­cur­rence.

Can­cer re­hab may also in­clude “pre­ha­bil­i­ta­tion”: tar­geted ex­er­cises de­signed to op­ti­mize a treat­ment’s out­come that pa­tients can do be­fore the treat­ment be­gins. For ex­am­ple, pre­op­er­a­tive lung can­cer pa­tients may do breath­ing ex­er­cises, such as blow­ing up bal­loons, pros­trate can­cer pa­tients may do pelvic floor ex­er­cises and neck can­cer pa­tients may do swal­low­ing ex­er­cises.

Good nu­tri­tion

Nu­mer­ous stud­ies have shown that breast can­cer sur­vivors who eat abun­dant fruits and veg­eta­bles are less likely to have a re­lapse and to die of the breast can­cer. A 2014 study found that breast can­cer sur­vivors with bet­ter post-di­ag­no­sis di­ets also had a lower risk of death from non-breast can­cer causes in­clud­ing car­dio­vas­cu­lar dis­ease and other can­cers — both of which pose a dis­pro­por­tion­ately high risk for sur­vivors.

“We rec­om­mend a va­ri­ety of dif­fer­ent-colored fruits, veg­eta­bles and whole grains be­cause dif­fer­ent colors mean dif­fer­ent phy­to­chem­i­cals,” says Ar­lene Pro­vi­sor, clin­i­cal nu­tri­tion co­or­di­na­tor at the Oschin in­sti­tute. Phy­to­chem­i­cals are nat­u­ral com­pounds in plants, such as al­licin in onions and carotenoids in car­rots, that may stim­u­late the im­mune sys­tem, slow the pro­lif­er­a­tion of can­cer cells and pro­tect against DNA dam­age.

The Amer­i­can Can­cer So­ci­ety rec­om­mends con­sum­ing phy­tonu­tri­ents and vi­ta­mins in whole foods rather than try­ing to ob­tain them from di­etary sup­ple­ments.

Not only can sound nu­tri­tion pre­vent can­cer from com­ing back, but a health­ful diet be­fore treat­ment helps pa­tients heal more quickly from surgery and bol­sters the body against the nu­tri­tional detri­ments of chemo­ther­apy and ra­di­a­tion.

“When we first meet with pa­tients, we like to make sure they fo­cus on high-pro­tein foods, and we al­ways stress lean sources such as chicken, fish, legumes and nuts,” says Pro­vi­sor. “Pro­tein is the main build­ing block for cells, and the modal­ity for chemo­ther­apy and ra­di­a­tion is break­ing down cells. So it’s im­por­tant to get enough pro­tein from the diet to make new cells.”

She adds that many peo­ple strug­gle to keep weight on dur­ing can­cer treat­ment due to food aver­sion or nau­sea. “If they are only able to eat small amounts, we en­cour­age them to eat things high in calo­ries and pro­tein so they can have a high den­sity of nu­tri­ents per bite.” She sug­gests nu­tri­ent-rich foods such as

eggs, Greek yo­gurt and nut but­ters.

Mind-body con­nec­tion

“It’s easy to get de­pressed when you have can­cer. Your hair falls out, you look like a zom­bie and you’re afraid you’re go­ing to die,” says Dow, who par­tic­i­pated in mind­ful­ness train­ing through UC San Diego Moores Can­cer Cen­ter. A prac­tice of med­i­ta­tion, grat­i­tude and even mind­ful eat­ing helped lift her spir­its and get through treat­ments with a hope­ful at­ti­tude.

Many sur­vivors strug­gle with stress, anx­i­ety and de­pres­sion. Yet re­search shows that th­ese men­tal states are detri­men­tal to the body’s abil­ity to fight can­cer. Both de­pres­sion and chronic stress in­crease in­flam­ma­tory chem­i­cals that im­pair the im­mune sys­tem and may in­crease tu­mor devel­op­ment, while stress hor­mones can stim­u­late can­cer pro­lif­er­a­tion by in­creas­ing blood sup­ply to tu­mors.

Asher rec­om­mends that can­cer sur­vivors stay con­nected to loved ones through­out can­cer treat­ment, both to mit­i­gate the ef­fects of lone­li­ness and to have some­one to help re­mem­ber ap­point­ments, ask doc­tors ques­tions and help with er­rands.

Many sur­vivors also make mean­ing­ful con­nec­tions through can­cer sup­port groups.

In ad­di­tion to regular ex­er­cise, mind-body ex­er­cises such as tai chi or yoga can help re­lieve stress and lift mood, says Asher. An­other vi­tal fac­tor for men­tal health is rest, says Asher. “Re­ally in­vest in your sleep; it can help your fa­tigue and mood. Plus, sleep is im­por­tant for max­i­miz­ing your im­mune sys­tem’s func­tion.”

Tom Mer­ton Getty Images / OJO Images

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