ACS Releases New Nutrition and Activity Advice for Survivors
Getting to a healthy weight, exercising, and eating lots of fruits and vegetables are just as important for cancer survivors as for people who've never had the disease, according to a new guide released by the American Cancer Society.
"Nutrition and Physical Activity During and After Cancer Treatment" is designed to help survivors make smart food and activity choices so they can feel better during treatment and perhaps reduce their risk of the cancer coming back.
"Living a healthy lifestyle is especially important for cancer survivors because they may be at increased risk for other cancers, heart disease, and diabetes," said Colleen Doyle, MS, RD, director of nutrition and physical activity at ACS and first author of the new guide. "These recommendations provide survivors with the most up-to-date information on how eating well, being active, and maintaining a healthy weight can not only improve their health, but their quality of life as well."
Weight is one of the most important factors for cancer survivors -- and being too thin is sometimes as much of a concern as being too heavy.
Many cancers and cancer treatments can cause changes in eating patterns (because of side effects like nausea or vomiting, changes to taste and smell, or mouth irritation that makes eating painful) that can lead to drastic weight loss and even malnutrition. Overweight patients may have more complications from certain treatments and may also have a higher risk of cancer recurrence.
For these reasons, the guide recommends getting survivors to a healthy weight and helping them stay there. Nutritionists who specialize in cancer nutrition can help those who are too thin find ways to eat enough and get the nutrients they need. Likewise, they can help survivors who need to lose weight do so safely, even during treatment.
Eating lots of fruits and vegetables is key to getting to a healthy weight, the guide says. There hasn't been much research looking at whether these foods can keep cancer from coming back; still, eating at least 5 servings of vegetables and fruits each day has other health benefits that can help cancer survivors. Whole grains also have important nutritional benefits.
Cancer survivors should cut back on sugar and fat, the guide says, and stick with low-fat protein choices like fish, poultry, lean meat, and beans. A vegetarian diet can be healthy but isn't necessary.
Cancer survivors may also benefit from taking a multivitamin that provides about 100% of the daily requirement of essential vitamins and minerals, the guide says. However, the authors caution against taking high doses of any vitamin, especially antioxidants. That's because it's possible that high doses may interfere with treatment or have other unforeseen consequences. The guide says survivors should talk with their doctor about any supplements they want to take.
Whatever they eat, cancer survivors need to pay special attention to food safety, especially during treatment, when their immune system may not be in top form. Germs that may not harm a healthy person could make someone with a compromised immune system very sick.
It's important to wash hands thoroughly before cooking or eating. Raw fruits and vegetables also need to be washed carefully, as do knives, cutting boards, or other tools that come in contact with raw meat. For some people, it may be best not to eat raw foods at all.
Store foods at cold temperatures to keep bacteria from growing, and cook meat, poultry, and seafood thoroughly to kill any bacteria they may harbor. The guide also recommends staying away from restaurant foods that could be sources of harmful bacteria: salad bars, sushi, and raw or undercooked meat, fish, shellfish, poultry, and eggs.
Exercise is another essential part of keeping cancer survivors healthy. Physical activity can improve anxiety, mood, and depression, boost self esteem, and relieve fatigue in survivors.
Those who can should strive to get 30-60 minutes of moderate to vigorous physical activity on 5 or more days a week -- the same amount of exercise recommended for the general public for cancer prevention. Survivors who weren't active before diagnosis may want to consult with an exercise specialist for personalized recommendations on how much to do and how often to do it.
However, there are some situations that survivors need to watch out for, the guide notes. For instance, people with anemia (low red blood cell counts) may need to wait to exercise until it is under control. People treated with radiation should avoid swimming pools to prevent irritation from the chlorine; those with permanent catheters should keep out of pools to avoid bacterial infection in the catheter. These survivors also need to be careful not to dislodge the catheter by strenuous lifting.
The guide lists specific recommendations for some of the most common types of cancer including breast, colorectal, lung, prostate, and head and neck cancer, as well as blood cancers and those treated with stem cell or bone marrow transplants. It also answers questions about specific foods and nutrients.
The full guide is published in the ACS journal CA: A Cancer Journal for Clinicians.
Citation: "Nutrition and Physical Activity During and After Cancer Treatment: An American Cancer Society Guide for Informed Choices." Published in the Nov./Dec. 2006 CA: A Cancer Journal for Clinicians (Vol. 56, No. 6: 323-353). First author: Colleen Doyle, MS, RD, American Cancer Society.
