Presentation on theme: "Maximizing Your Health During and After Breast Cancer Treatment"— Presentation transcript:
1 Maximizing Your Health During and After Breast Cancer Treatment Julie R. Gralow, M.D.Associate Professor, Medical OncologyUniversity of Washington School of MedicineFred Hutchinson Cancer Research CenterSeattle Cancer Care Alliance
2 Regular Physical Activity and Good Nutrition Can Help Reduce: Heart diseaseHigh cholesterol levelsHigh blood pressureObesityNicotine addictionDiabetesDepressionCancerOsteoporosisInsomniaAge-related declines in muscular strength
4 Exercise During Cancer Treatment Maintaining an exercise program throughout cancer treatment is not only safe, but also an effective way to manage fatigue, depression, and treatment side effects
5 Exercise Benefits Physical Health Improved healing and recovery from surgeryDecreased lymphedemaHigher energy levels, less fatigueWeight loss/prevent weight gainDecreased nauseaLess painDecreased heart disease and osteoporosis
6 Exercise Benefits Emotional Health Improved body and self-imageDecreased anxietyImproved social interactionBetter sense of controlImproved depression and moodBetter sleep patterns
7 Fatigue and Quality of Life Outcomes of Exercise During Cancer Treatment Mock V et al, Cancer Pract 9:Patients: 52 breast cancer patients randomized to home-based walking program or usual care during adjuvant chemotherapy or radiation therapyResults: Women who exercised > 90 minutes per week (divided over 3 or more days) reported significantlyLess fatigueLess emotional distressHigher functional abilityBetter quality of life
9 Exercise and Survival After Breast Cancer Diagnosis Holmes MD et al, JAMA 2005 Prospective observational study2987 nurses in the U.S. Nurses’ Health Study diagnosed with stage I, II or III breast cancerPhysical activity categories:< 3 MET hours (metabolic equivalent tasks) per week3-8.9 MET hours/weekMET hours/week> 24 MET hours/week3 MET hours per week is equal to walking at an average pace of 2-3 miles /hour for 1 hour
10 Exercise and Survival After Breast Cancer Diagnosis Holmes MD et al, JAMA 2005 Results:Compared to women with < 3 MET hours/week, risk of dying of breast cancer was:20% less for 3-9 MET hours/week40-50% less for > 9 MET hours/week of exerciseConclusion:Physical activity after a breast cancer diagnosis may reduce the risk of death from this diseaseThe greatest benefit occurred in women who performed the equivalent of walking 3-5 hours/week at an average pace
11 What About Lymphedema (Arm Swelling After Lymph Node Surgery)?
12 Weight Training and Lymphedema in Breast Cancer Survivors Ahmed RL et al, J Clin Oncol 2005 Patients: 45 breast cancer survivors following axillary lymph node dissectionStudy: Randomized to weight training program or notWeight training sessions 2x per week for 6 monthsFor upper body, initially used no weights or only wrist weights, weight gradually increased if no symptoms of lymphedema developedResults:None of the women in the weight training program experienced a noticeable change in arm swellingFrequency of new lymphedema, or worsening of existing lymphedema, was similar in both groups
13 Nutrition, Body Weight and Breast Cancer -Maintain good body weight-Low fat diet-High fiber-Increase fruits and vegetables-Limit alcohol
14 Nutrition and Survival after the Diagnosis of Breast Cancer: A Review of the Evidence Rock CL et al, JCO 20: , 2002Being overweight or obese is associated with poorer prognosis in a majority of studiesTreatment-related weight gain influences survival, quality of life, other diseasesDietary fat: 5 of 12 studies showed inverse relationship with survivalFruits and vegetables: majority of studies showed favorable relationship with survival
15 Breast Cancer and Alcohol More than 2 drinks/day associated with increased breast cancer risk!
16 Women’s Intervention Nutrition Study (WINS) Chlebowski R et al, JNCI 98, 2006 Patients: 2,437 postmenopausal women with early stage breast cancer (age 48-79)Intervention: Randomized within 1 year of surgery to:dietary intervention (8 biweekly counseling sessions by nutritionists and support throughout)versus controlResults:Fat intake/day at 12 monthsIntervention group 33.3 gms (+/- 16.7)Control group gms (+/- 24.4)
17 Relapses (60 month follow-up) Women’s Intervention Nutrition Study (WINS) Chlebowski R et al, JNCI 98, 2006Results (cont.):Relapses (60 month follow-up)Group Diet ControlAll pts 96/975 (9.8%) 181/1462 (12.3%)24% reduction in breast cancer recurrence in diet intervention groupConclusion: Lifestyle interventions can reduce recurrences in breast cancer patients
18 Optimizing Health After Breast Cancer Diagnosis and Treatment Exercise regularlyAvoid obesity, control weightEat a healthy diet: low fat, high fiber, low alcoholAvoid smokingWear sunscreenReduce stressControl known diseases: high blood pressure, diabetes, high cholesterol, osteoporosis
19 Optimizing Health After Breast Cancer Diagnosis and Treatment The majority of breast cancer patients can look forward to a long life after cancer diagnosis and treatmentCancer patients should not forget about all aspects of health and well-being
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