Lifestyle Changes

A few simple changes since as walking 20 minutes 3x/week, practicing meditation and getting enough rest can go a long way yo creating a healthy lifestyle.

Pack Your Sneakers & Get Moving

Today’s tip is also a simple one but requires more motivation. Now that you’ve brought your lemon/lime water bottle to work or prepared it to enjoy during the day at home like I do, get your sneakers or comfortable walking shoes on. Exercise is something that can become an enjoyable habit, especially if you recruit a walking buddy. I recruited my husband and it’s a time in the day when we’re not distracted by the television or cell phones.

Walking is the simplest form of exercise and one that can be achieved anywhere.

One thing that’s helpful is the purchase of an inexpensive pedometer. It’s fun to keep track of progress and is a great motivational tool. Aim for 10,000 steps per day or 30 minutes of brisk walking. No need for expensive gym memberships, although going to the gym would be an excellent choice, but walking is cheap, easy and effective.

According to the Long Island Breast Cancer Study Project for example, (many studies are available on the internet on this topic), statistics show that walking three hours per week, or a half hour per day, improves breast cancer survival rates by as much as 50% and reduces risk of developing the disease by 30%. This is an easy goal to achieve, and matches the minimum exercise levels recommended by the US Centers for Disease Control and Prevention. Walking for a half hour per day will also reduce risks for other cancers, Type II Diabetes, heart disease, and stroke.

According to cancer.gov:

Researchers have established that regular physical activity can improve health by:

Helping to control weight

Maintaining healthy bones, muscles, and joints

Reducing the risk of developing high blood pressure and diabetes

Promoting psychological well-being

Reducing the risk of death from heart disease

Reducing the risk of premature death

Guidelines recommend working up to a “brisk walk” which equates to 3-4 miles per hour. Of course walking outside is preferred, not only for esthetic reasons, but to take advantage of health benefits of the vitamin D gained from sunshine. When the weather is bad, create an indoor path in your home. This is when a pedometer is especially helpful for measuring progress, distance and maintaining motivation.

Maintain a Healthy Weight

There is now substantial evidence that being overweight and/or obesity and/or weight gain are risk factors for the development of postmenopausal breast cancer. In addition, obesity and/or elevated body mass index at breast cancer diagnosis has a negative impact on prognosis for both premenopausal and postmenopausal women.

Understanding the mechanism of how obesity affects the the development of breast cancer is an important health issue. Elevated serum estrogen levels as well as enhanced local production of estrogen are considered primary mediators of how increased body weight promotes breast cancer development in postmenopausal women. Excess body fat is dangerous since estrogen is stored in fat cells.

Having more fat tissue can increase your chance of getting breast cancer by raising estrogen levels. Also, women who are overweight tend to have higher levels of insulin, another hormone. Higher insulin levels have also been linked to some cancers, including breast cancer, but the connection between weight and breast cancer risk is complicated.

Studies suggest the risk appears to be increased for women who gained weight as an adult but may not be increased among those who have been overweight since childhood. Also, having extra fat in the waist area may raise risk more than having extra fat in the hips and thighs.

Limit Alcohol

There’s a lot of controversy about breast cancer and alcohol use. Some studies say one glass of red wine per day is recommended for heart health, while more than 3 drinks per week increases breast cancer risk significantly. Conflicting evidence can be very confusing. What seems to be accepted is that if you do drink, red wine is the best choice. Worst on the list is hard liquor.

I must admit I do enjoy a glass of red wine, but I have limited my alcohol use significantly since my diagnosis. Red wine, although listed as good for your heart, must be limited to 4 oz./day or you compromise any benefits and increase breast cancer risk. Four ounces is not very much compared with the average serving.

Current studies suggest an increased breast cancer risk by as much as 40% if the 4 oz/day alcohol limit is exceeded. Recent guidelines also suggest no more than 3 drinks per week. Some studies even go so far as to say none is best, but this is perhaps not realistic.

The chemistry behind the problem is that alcohol is converted into acetaldehyde, which acts as a carcinogen in the body. Acetaldehyde boosts cancer risk by inflicting oxidative stress that damages DNA, prevents DNA repair, and triggers a pro-inflammatory reaction.

Damage can be offset by adding a few foods and plant-based compounds to one’s diet. There is scientific evidence that adequate consumption of Vitamin B-9 (folate or folic acid) may eliminate or reduce risk of breast cancers associated with drinking alcohol. An exhaustive review of the research evidence has found that women who drink alcohol and have a high folate intake are not at increased risk of breast cancers compared to those who abstain from alcohol. Foods rich in folate include citrus fruits, citrus juices, dark green leafy vegetables, dried beans, and peas. Most daily multiple-vitamin tablets also contain Vitamin B9.

So if you’re going to drink, always indulge in folate-rich foods or take a folic acid supplement beforehand. As always, moderation is the key.

The Power of Positive Thinking

Positive thinking: a simple idea but a seemly insurmountable task when you’ve just been diagnosed with breast cancer, or face any one of life’s many crises. A positive attitude is so important because it helps your body de-stress and focus on recovery. If you have breast cancer, once you’ve completed your surgery and treatment, it will become much easier. The value of positive thinking has been proven to make a difference, but is much easier said than done.

Once you have survived cancer, every day is a good day, but coping with feelings often requires strategies. We all need to learn to reduce stress whenever possible. This is true whether you have cancer, or are trying to keep your body and immune system healthy to prevent the disease. Here are a few strategies from my book that help reduce stress.

• Relaxation techniques. I downloaded Belleruth Naparstek’s guided imagery program for cancer patients onto my iPod. After my mastectomy surgery, I tried to use it at least once a day. It helped a lot with positive thinking. You can download it in MP3 format or buy the DVD. Here’s the website: http://www.healthjourneys.com/Product_Detail.aspx?id=115 .

For those who are trying to prevent cancer, relaxation is just as important. Our culture is moving so fast we have no time to stop and smell the roses. I lived in England for four and a half years and they would refer to our fast-paced society, and our work hours of 60 hours plus per week in stressful jobs as “uncivilized”. There many different DVDs available for relaxation. One other simple idea that works for many people is simply downloading some of your favorite music on an IPod and taking a few minutes while you eat lunch or walk to listen to music and think positive thoughts.

• Qigong –Dana Farber offers introductory classes for patients as part of their complimentary therapy department. Since Dana was too far for me to travel on a regular basis, I purchased a book by Dr. Nan Lu. You may read about his recommendations for breast cancer support using Traditional Chinese Medicine on this site: http://www.breastcancer.com. I found the qigong exercises on the website to be a way of relaxing.

• Yoga – I purchased a yoga DVD made specifically for breast cancer patients. It’s by Susan Rosen and is titled: Yoga and the Gentle Art of Healing: A Journey of Recovery After Breast Cancer. My Lymphedema therapist reviewed this DVD and also said it was very good. My neighbor Suzy also convinced me to sign up for classes with her. At our studio, a fellow survivor actually offered a free class for women recovering. I enjoyed that class not only for the exercise but for the camaraderie. Yoga is a great way to distress your body when jobs, children and everyday life become overwhelming.

Vitamins: Raw is Best

Many people ask, "Are vitamins necessary, and what kind is best?" I have always taken vitamins, although I have to admit I never took them religiously. Even when I did, I thought the generic daily vitamin was enough. Until I got sick, I never gave a thought as to whether or not these vitamins were being effectively absorbed by my body. The idea to look for a raw food vitamin had never occurred to me. The fact is I was taking the most affordable and most popular synthetic vitamin.

Most of the vitamins you find on the pharmacy shelves these days are made synthetically through chemical processes. Synthetic vitamins are made in a laboratory setting and are cheaper to produce than natural vitamins. Nutritionists specializing in holistic and preventive medicine believe synthetic vitamins are useless and ineffective. Orthodox doctors and even some nutritionists argue that synthetic vitamins have a molecular chemical structure identical to the natural vitamin and that they are just as effective. So who’s right and who’s wrong?

Preventive medicine authorities believe the best multivitamin supplement must come from nature— not from a test tube! Raw vitamins contain nutrients that are found in nature (Think plants!) that we need for optimal wellness. Raw foods are rich in enzymes and many other phytochemicals that processing and heating destroy. Studies have found a link between enzymes and longevity. Enzymes are needed for good health so when they are depleted, health suffers. The body can produce only so many enzymes endogenously (internally), and people realize food enzymes are as necessary to health as any vitamin. In most cases processed foods (and vitamins) lack such enzymes due to heat and other processing.

These enzyme molecules are only produced when food is in its natural state or fermented with beneficial bacteria. Fermented foods such as yogurt, miso, and even coffee, deliver an incredibly diverse supply of antioxidants.

Supplements, as the word clearly states, are meant to supplement a highly varied diet of whole, unprocessed foods. As an example, you can get bioflavinoids from citrus fruits, but you can’t know exactly how much vitamin C you are getting. Supplements are a way of assuring you enough nutrients to keep your body healthy. Where to get RAW vitamins? You can purchase them at a health food store, WholeFoods stores, Trader Joe’s and online. Be sure before you purchase that it clearly specifies RAW on the label.

Get Your Beauty Sleep

Our brain’s melatonin production is one of the keys to a good night’s sleep; and the lack of it, can result in just the opposite. Melatonin is a hormone produced in the pineal gland of the brain. It’s best known for its role in the regulation of the sleep/wake cycles. Researchers have also found that low levels of melatonin stimulate the growth of estrogen receptor positive breast cancer cells.

Prior to my breast cancer diagnosis, I was having a lot of trouble sleeping. I would often wake up at 4 am and was unable to get back to sleep. My doctor said it was possibly due to my pre-menopausal condition and offered me a sleep aide. I mistakenly declined and continued to spend many hours lying awake at night.

Once diagnosed, I simply could not sleep at all. I began to research natural sleep aides and discovered that melatonin was an extremely effective one. I also learned there had been studies conducted on melatonin and its ability to enhance the effectiveness of Tamoxifen as an estrogen receptor inhibitor. I reviewed these findings with my nutritionist and oncologist, and asked permission to take a melatonin supplement. Since the results were not universally accepted as protocol in 2009, they advised me to only take three milligrams each night, although the studies suggested up to twenty. Current recommendations as a result of accepted studies now suggest 20 to 50 mg .

Unfortunately, I had just missed the opportunity to enroll in a clinical trial on melatonin and early stage estrogen receptor positive breast cancer at Dana Farber in Boston. Based on all of these studies, melatonin may potentially become an important addition to the future treatment protocol of ER+ breast cancer.

How Important is Melatonin?

There have been many studies on the effects of melatonin production and its effect on estrogen receptor positive breast cancer. Here are the conclusions of a few of these studies.

1. Low levels of melatonin have been associated with breast cancer occurrence and development. Women who work predominantly at night and are exposed to light, which inhibits melatonin production and alters the circadian rhythm, have an increased risk of breast cancer development (Schernhammer et al. 2003).

2.Melatonin appears to work as an anti-estrogen on tumor cells. although differently than Tamoxifen. When the two are combined, the result is better than Tamoxifen alone. (Lissoni et`al., 1995.)

3. Melatonin demonstrates growth inhibitory effects by inducing differentiation (“normalizing” cancer cells)(Cos et al. 1996) as well directly inhibits breast cancer cell proliferation (Ram et al. 2000) and boosting the production of immune components, including natural killer cells (NK cells) that have an ability to kill metastasized cancer cells.

Of course, you should always check with your doctor as I did before taking any supplements. My choice is to continue to take melatonin each night. I know my cells need their beauty sleep!