Lifestyle Strategies for Cancer Care
Mark Pettus MD
Advances in the treatment of cancer are one of the great success stories of the last generation. Cancer has shifted profoundly from an historical dark and doom diagnostic category to one that most survive with as a chronic disease. It is also widely recognized that lifestyle choices play an enormous role in the risk-development and treatment success of all cancers. While genetics clearly play an important role in ones cancer risk-prognosis, our environment e.g. how we eat, move, interpret and respond to stress, manage toxic exposures, cultivate meaning, sleep, and interconnect with others plays an even greater role. In the emerging field of epigenetics we are coming to see that lifestyle can potentially trump our genetic predispositions. Here are few examples of what we currently know that can improve the oncometabolic (cancer promoting) landscape in the challenging environment we now navigate.
Nutrition: Two of the greatest metabolic risks for cancer are inflammation and insulin resistance, sometimes referred to as metabolic or lifestyle syndrome. This takes the form of an increased waistline (35 or greater in women and 40 or greater in men), high triglycerides, low HDL (good cholesterol), and a high c-reactive protein (blood marker for inflammation). So what foods place one at greater risk for a revved up immune system and insulin resistance?
- Sugar in all its forms, especially in processed foods, baked goods and soft drinks
- Refined grain flour, especially from wheat. There are carb dense foods that wreak havoc with our weight and health. This includes many breads, cereal grains, pasta, bagels, chips, pretzels, white potatoes, white rice, crackers, pastries, etc. etc.
- Frequent consumption of process vegetable oils, especially when cooked at high temperatures (above 350) e.g. corn, soy, safflower, sunflower, soy and canola oil. Trans fats (aka hydrogenated oils) in packaged foods are bad news. Fresh grass-fed butter is always better than margarine and other butter substitutes.
- Insufficient fiber to feed the healthy critters in our guts ecosystem. Ideally these sources would include fruits (berries are best), vegetables, beans, legumes, and some whole grains e.g. quinoa, buckwheat, and more ancient wheat grains i.e., emmer or einkorn. Modern wheat, even whole wheat raises sugar and insulin and for those sensitive to gluten (about 10% adults), wheat in all its forms can be a problem.
- If possible, grass-fed eggs and meats are more nutrient-dense and have fewer toxins than those that come from industrial feed-lot sources or are heavily processed e.g. many packaged lunch meats.
- Healthy fats e.g. grass-fed butter, olive oil, coconut or MCT oil (medium chain triglyceride), fatty fish i.e., salmon, sardines, herring, trout, mackerel, anchovies, nuts, eggs, and avocados reduce inflammation unlike their unhealthy counterparts noted above.
- Vitamin D: I recommend everyone have blood levels checked. The sweet spot is between 25-40 and most that live in the Berkshires require supplementation, on average 2,000 4,000 units/day. Sensible sun exposure for 20 three days/week during summer and more at other times is also helpful.
Movement: Any epidemiological study ever published demonstrates activity to be a major protector of all chronic complex diseases including cancer. Walking for many is easiest e.g. 30 minutes, 5 days/week. Resistance e.g. light weights 15lbs twice/week is very important to build-maintain muscle mass which often becomes depleted in people treated for cancer. As I like to say, motion is the lotion. It will reduce inflammation and insulin resistance very effectively independently of any weight loss. Make it fun by being with friends, a pet, outdoors whenever possible or with music that makes you happy!
Stress: We all know how powerfully stress impacts our lives. Continuous stress provokes inflammation, takes away our energy, our joy, and our capacity to remain in the moment we are in. Stress happens and there will never be stress-free days in our complex modern lives. The opportunity is exploring different ways to interpret and respond to the stressors in our lives. Before we react to a set of circumstances that stresses us, a question to ask Is my response going to raise or lower my inflammation? How we think, feel, and ultimately behave is often driven by the deeply entrenched patterns that uniquely define who we aresometimes for the better and sometimes not. A few easy steps to consider:
- When you start to feel overwhelmed, catch yourself and press the pause button.
- Gently close your eyes and picture someone, something, or some place you absolutely love and adore.
- Slow your breath by inspiring through your nose if able over a count of 5-seconds, hold that breath for 5-seconds, and slowly exhale through your mouth for 5-seconds.
- Do this for 3-minutes whenever you need to decompress. This gift is there for you, always.
Sleep: As many as 40-50% adults state they do not sleep well through the night and often wake up NOT feeling restored. While there are many reasons for this, chronically disrupted sleep also is a major contributor to inflammation. Consider some simple sleep hygiene steps>
- Try to establish a daily rhythm-routine for rising and for going to bed.
- Make your bedroom as dark (cover any small lights including your alarm clock) so that you should not be able to see your hand when placed outstretched in front of you.
- Keep your room cooler e.g. 62-64.Brrrrrr yes, but better for sleep and metabolic healing.
- Try some simple breath and guided imagery.
- No caffeine after 2pm
- Gratitude journal: place three entries of things you are grateful for that day and mindfully reflect on them as you relax in anticipation of a good nights sleep.
- Relaxing teas e.g. Chamomile, Valerian, and passion flower.
- In am, a full spectrum light box for 30-minutes can help reinforce circadian rhythm and be particularly helpful over the long, dark winter season for mood, energy, and well-being.
While helpful for cancer care, these strategies improve our metabolic landscape in a way that improves health, vitality, and the capacity to thrive!