Exercise & Diet in the Cancer Patient

CURE, Fall 2005, Volume 4, Issue 3

While weight loss is a common cancer side effect, some patients may gain weight during treatment, especially those with breast, prostate or ovarian cancers. Chemotherapy and steroids may increase cravings for high-fat foods and cause treatment-related weight gain. Fatigue and lack of physical activity can also contribute.

Anne McTiernan, MD, PhD, works with cancer patients in exercise and diet intervention studies at Fred Hutchinson Cancer Research Center in Seattle. The Health, Eating, Activity and Lifestyle (HEAL) trial, which studied postmenopausal women’s weight and body fat for three years after a breast cancer diagnosis, found that over two thirds of patients gained weight.

Studies show an average 4- to 13-pound weight gain after a breast cancer diagnosis. “If patients are careful to not overdo the calorie-dense foods, and instead increase intake of vegetables and fresh fruits, they can avoid a lot of the weight gain,” Dr. McTiernan says. “Even short walks may help.”

She suggests eating comfort foods when experiencing extreme nausea, but on “good” days try to eat low-fat protein foods, whole grains and vegetables. Walking every other day for 15 to 30 minutes will help fatigue, weight maintenance and mobility. “For exercise, I’d recommend taking slow walks or even yoga,” Dr. McTiernan says.

After treatment, begin an exercise program and slowly increase the workout to avoid injury. Some gyms and cancer centers have programs for cancer patients, and many oncology practices provide access to a nutritionist with oncology experience.

In the past, many physicians advised patients to rest and eat comfort foods, but recent studies show exercise and a healthy diet may increase survival, lower the risk of cancer recurrence and stave off cancer-related depression.

The Women’s Intervention Nutrition Study showed for the first time that a dietary fat reduction in postmenopausal breast cancer patients lowered recurrence risk and prolonged survival.

“We now have a preliminary signal suggesting diet may influence breast cancer recurrence, but this requires confirmation,” says Rowan Chlebowski, MD, PhD, who presented the data at the 2005 meeting of the American Society of Clinical Oncology. When compared with the general population, women in the study had an overall lower dietary fat intake before the study and many exercised regularly, which may also play a role in the decreased risk.

But even with recent studies showing improved survival, most patients still aren’t receiving the message. “Exercise and a healthy diet should be considered a major part of their recovery and should be carefully thought about,” says Shine Chang, MD. “A lot of people feel lacking in power over their own health and their lives during this whole process, and what a wonderful way to empower a patient by giving them a way that will improve their physical being and mental well-being.”