▎ WuXi AppTec content team editor
Once upon a time, cancer was considered by many to be a "terminal illness", and having cancer meant death.
Nowadays, with the development of medical technology, the improvement of cancer treatment protocols, the application of targeted therapies and immunotherapy, and early screening, the mortality rate of many cancers has been significantly reduced, and the life span of patients has been extended. In the United States, the overall 5-year relative survival rate for cancer patients has reached 68%.
At the same time, scientists have found that in addition to treatment, many factors that can be changed can also affect the survival and health of cancer patients.
Recently, the American Cancer Society (ACS) released the 3rd edition of the Nutrition and Physical Activity Guideline for Cancer Survivors (hereinafter referred to as the Guidelines for Cancer Survivors) in the CA: A Cancer Journal for Clinicians ,known as the "Divine Journal". Advice is provided on how cancer patients can reduce the risk of death and extend their lifespan through modifiable factors such as diet and physical activity.
Screenshot source: CA: A Cancer Journal for Clinicians
Guidelines state that survival and health after cancer depend on a variety of factors, including the type, stage, treatment, and personal health of the cancer. There is also growing evidence that improving diet, physical activity, and related factors can help cancer patients live longer, reduce the risk of cancer recurrence, complications, and reduce treatment-related side effects to improve overall health.
Guidelines recommend that the following recommendations should be followed after cancer diagnosis, during treatment, and after treatment to help prolong survival and improve overall health.
Pay attention to diet and nutrition
Guidelines recommend that all patients undergo a professional nutritional assessment and consultation as soon as possible after the cancer is diagnosed. The purpose of this is to prevent or treat nutritional deficiencies, maintain muscle mass, and manage side effects of treatment that may affect nutrition and diet, such as nausea, vomiting, and loss of appetite, thereby preventing nutritional deficiencies and muscle mass loss caused by these side effects.
During treatment, the nutritional needs of cancer patients are strongly related to the type of cancer they develop, the type of treatment they develop, and the side effects of treatment. At this time, in order to ensure adequate and comprehensive nutrition, it should be done:
Don't be afraid to eat new foods, some foods that have never been eaten or liked before, may taste more flavorful and nutritious during treatment;
Choose a variety of plant foods as much as possible and eat less animal foods;
Eat more fruits and vegetables every day, colorful vegetables and fruits and other plant foods, containing many natural, health-promoting substances;
Limit or minimize the consumption of pickled or smoked foods;
Limit or avoid eating red and processed meats.
Image credit: 123RF
During the treatment, patients may experience some dietary problems, such as loss of appetite, problems with chewing, swallowing or digestion, and feeling tired after treatment. If these problems occur, it will affect the absorption and utilization of nutrients, causing harm to treatment and health. At this time, medical personnel or nutrition experts should be consulted in time to take measures to avoid nutritional deficiencies.
After treatment, cancer survivors follow healthy dietary patterns, such as the Mediterranean diet, the Deshu diet, or the vegetarian diet. Overall, healthy eating patterns have the following characteristics:
Eating more nutritious foods to help achieve and maintain a healthy body weight (body mass index [BMI] is between 18.5 kg/m2-24.9 kg/m2);
Eat a variety of vegetables, including dark green, red and orange vegetables, beans rich in dietary fiber, etc.;
Eat more fruits, especially complete fruits of various colors, rather than juices;
Eat more whole grains, limit or reduce refined grains;
Eat less red and processed meats;
Avoid drinking sugary drinks;
Try not to eat ultra-processed foods.
Sit less and move more
Guidelines recommend that all patients undergo a professional physical activity assessment and consultation as soon as possible after the diagnosis of cancer. The goal is to prepare for treatment, improve treatment tolerance, manage symptoms associated with cancer, and side effects associated with treatment.
Multiple studies have found that many cancer patients can engage in appropriate physical activity before, during, and after cancer treatment, which can help improve anxiety, depressive symptoms, fatigue, physical functioning, lymphedema, and health-related quality of life, bone health, and sleep.
Other studies have found that physical activity after diagnosis of cancer helps improve survival rates in patients with breast, colorectal and prostate cancers.
Although most cancer patients can be physically active during and after treatment, given the cancer itself and the impact of treatment on the body, guidelines recommend a professional assessment before starting activity to ensure safe and moderate physical activity and prevent the harm caused by inappropriate activity.
When it is safe to do physical activity, the guidelines recommend the following:
Move more, sit less, and do 150 to 300 minutes of moderate intensity (can talk, but cannot sing) physical activities per week, such as brisk walking, yoga, leisurely cycling, etc.;
Or 75 to 150 minutes of high-intensity (unable to speak, or feeling breathless) physical activity per week, such as running, swimming, playing tennis, etc.;
Or a combination of moderate and high-intensity physical activity;
At the same time, at least 2 days a week, do strength training or resistance exercises, such as weightlifting, exercise belts, push-ups, squats, etc.
It is important to note that cancer patients should also take precautions during and after treatment, while performing physical activities, including:
Gradually, slowly increasing the frequency and time of physical activity, even if you can only be active for a few minutes a day, will have a beneficial impact on health and survival;
Extend your activity time as much as possible, don't force yourself to do a lot of physical activity at the beginning, especially when you feel very tired, start with 10 minutes of light physical activity a day and then gradually increase;
When performing physical activity, choose a flat road surface to prevent falling;
If you feel dizzy or your feet are unstable, you should stop physical activity immediately;
When performing physical activity outdoors, choose a safe and well-lit place, and wear appropriate clothing according to the temperature and apply sunscreen;
When immunity is low and the risk of infection is high, avoid physical activity in gyms and crowded places;
When swimming, for patients receiving radiation therapy, medical staff should be consulted before swimming; people with ulcers on the body, cannot swim; rinse after leaving the pool to reduce the risk of skin irritation;
When doing physical activity, it's best to be with friends or family, or bring a cell phone, and respond to unexpected situations in a timely manner.
Maintain a healthy weight
The guidelines state that many people know the effects of being overweight (25 kg/m2≤ BMI≤29.9 kg/m2) or obesity (BMI≥30 kg/m2) on cancer risk. However, the impact of weight on the health and survival of cancer patients is little known. Studies have shown that obese women have a higher risk of breast cancer recurrence and death.
Guidelines recommend maintaining a healthy weight through diet and physical activity, avoiding overweight or obesity, and maintaining or increasing muscle mass during and after cancer treatment.
Side effects of cancer treatment can lead to changes in taste and smell, causing loss of appetite or digestive disorders, which can lead to weight loss, muscle mass loss, and nutrient deficiencies, especially in patients with cancers of the digestive tract, where the risk of weight loss is greatest. At this time, adequate calories should be ensured to prevent malnutrition; increase protein intake, improve muscle mass; and engage in appropriate physical activity to promote appetite.
In addition, weight gain should be prevented after treatment, and the occurrence of overweight or obesity should be avoided to reduce the risk of cancer recurrence or the emergence of a second primary cancer and improve survival.
Avoid alcohol
The guidelines note that while the effects of alcohol consumption on most cancer patients are unclear, studies of people with head and neck cancer and liver cancer have shown that people who drink alcohol have a higher risk of death and a shorter lifespan.
Guidelines recommend that during cancer treatment, it is best for patients not to drink alcohol, especially if they are undergoing chemotherapy or radiation therapy to the head and neck.
If it is true to drink alcohol during and after treatment, the amount of alcohol should be limited, do not exceed 2 drinks per day for men and 1 cup for women. Of course, not drinking alcohol is the best option.
The guidelines conclude by emphasizing that following the above 4 recommendations will not only help cancer patients reduce the risk of death and improve survival, but also help reduce the risk of other chronic diseases, such as heart disease, stroke and diabetes, which will further improve overall health and quality of life, and prolong life.