Healthy Living Cuts the Odds That High-Risk Breast Cancer Will Return
High-risk breast cancer patients can take action to help stop their disease from coming back or killing them.
The same healthy habits that leading cancer organizations recommend to prevent cancer appear to make a big difference in heading off its return in these patients, new research shows.
Following cancer-prevention guidelines before, during and after chemotherapy was associated with a 37% lower risk of repeat disease and a 58% lower risk of premature death, the study found.
“We were very excited to learn that strongest collective adherence to these lifestyle recommendations, before, during and after treatment was associated with significant reductions in breast cancer recurrence" and death rates, said first author Rikki Cannioto. She's an epidemiologist at Roswell Park Comprehensive Cancer Center in Buffalo, N.Y., which led the study.
To investigate, researchers at 11 medical centers relied on data from an earlier study of the impact of dietary supplements on cancer outcomes in early-stage, high-risk breast cancer.
In the latest study, researchers assigned points for patients' adherence to seven lifestyle factors. These are things people could do, by choice, to take care of themselves.
They included maintaining a healthy weight, eating a variety of fruits, vegetables and whole grains, and being physically active. Others included not smoking, and limiting or avoiding alcohol, sugar-sweetened beverages and red and processed meats.
These steps are typically recommended for cancer prevention by both the American Cancer Society and the American Institute for Cancer Research.
Cannioto noted that all of these habits are linked with cancer risk, but it wasn't known whether they could improve survival outcomes of high-risk patients.
The new study found that these choices had an impact even in patients with more aggressive types of breast cancer. Exercising and not smoking contributed most to positive outcomes, the researchers found.
They said it's not clear what underlying mechanisms in these habits prevent cancer recurrence.
But patients should know that even adhering to them a little makes a difference, Cannioto said.
“The message is, really, do the best you can, because it might be associated with improved survival, and there are multiple pathways which could be contributing, whether it's better patient-reported outcomes, feelings of well-being or improved sleep. I'm sure it's multifactorial," Cannioto said. "There may be some biological mechanisms that are underpinning these associations as well.”
There were 1,340 patients in the study, at average age of 51. About two-thirds had hormone-receptor-positive breast cancer. More than 80% were white.
The researchers said they would like to further investigate the impacts of these lifestyle habits in a more diverse group of patients and in those with different types of tumors.
“The next step that we're interested in, of course, is intervention: Can we through lifestyle intervention improve survival outcomes in our patient population?” Cannioto said, noting that researchers would also like to identify how this works.
Dr. Arif Kamal, chief patient officer for the American Cancer Society, said making these lifestyle changes is something that is understudied and not talked about enough.
When patients ask what they can do, often their doctors' focus is on making sure they take follow-up medications and get screenings or lab work.
“I think we have to pivot to saying, 'here's what you can do as it relates to accessing health care, but here's what you can do in terms of how you live every day,'" Kamal said. “And that calling those two things out as both being important, I think, is the evolution we have to make.”
Sometimes cancer care impedes some of these healthy lifestyle recommendations, he noted. For example, a patient may be getting fluids and steroids during treatment and wind up gaining weight as a result.
That isn't to say that people should make it hard on themselves with aggressive, daily exercise in order to reach these goals, Kamal said.
“It's not all or none. It's really a composite risk that happens over time," he said. "These are about how you live, not how you treat a specific week or month.”
Study findings were published May 4 in JAMA Network Open.
The U.S. National Cancer Institute has more on cancer prevention.
SOURCES: Rikki Cannioto, PhD, epidemiologist, Roswell Park Comprehensive Cancer Center, Department of Cancer Prevention and Control, Buffalo, N.Y.; Arif Kamal, MD, oncologist and chief patient officer, American Cancer Society; JAMA Network Open, May 4, 2023