Diet & Exercise

Eating right and being physically active are two ways women can take control of their health for themselves

Eating right helps women feel better and more energized, while also helping women to be proactive and take control of their health. So whether you have always eaten healthy or are motivated to so, know that your risk of other health problems, and even some long-term effects of your treatment, may be made better by a healthy diet.

Diet

National Cancer Institute research suggests that postmenopausal women who eat healthy after a breast cancer diagnosis are less likely to die from breast cancer or any other cause. A healthy diet after breast cancer can also help women lose any weight they may have gained during treatment, as well as reduce fatigue and improve body image. Good diet choices include adding more fruits and vegetables to your diet, eating leaner cuts of meat, adding more poultry and fish, and choosing dairy products and cooking oils with low fat. Drink at least 64 ounces of water per day, and more if you exercise, drink any alcohol, or if the weather is very hot. Try adding more natural and organic foods, and less processed foods to your diet. Be sure to see “Eating Healthy” on this site.

Healthy Eating (Three main guidelines):

1) Moderation. Moderation means that you don’t eat too much or too little of any food. You need food from each of the five food groups. Your diet should never consist of only food from certain groups and no food from others.

2) Variety. Variety not only makes what you eat more interesting, but allows your body to get the different nutrients that are in different foods within a group. For instance, if you eat many servings of the same fruit day after day, you may not be getting all the nutrients that you need.

3) Balance. Balance in your diet means that you eat moderate amounts of the foods from each group. You should also aim to have the right amount of calories for how active you are.

There are five basic food groups. A healthy diet for the average person should include these groups of food and about the amounts listed by each group. If your weight is above or below average, the amounts will vary. Also if you are very active or not active at all, this will affect how much from each group that you need.

The Five (5) Food Groups:

1) Grains: 6 oz each day. Grains include foods that are made from wheat, rice, oats, barley, cornmeal or other grains. Breads, pasta, cereals, and tortillas are in this group. Try to get 3 oz of whole grain foods. Whole wheat breads and brown rice have many potent antioxidants which have been linked to cancer prevention.

2) Vegetables: 2 ½ cups a day. Vegetables include 100% vegetable juice. This group also includes raw, cooked, canned, frozen, fresh and dried vegetables. In this group are green, orange, and starchy vegetables. Also in it are dry beans and peas. Two large studies suggest relationship between increased folate intake and decreased breast cancer risk. Some foods rich in folate are: spinach, kale, romaine lettuce, Swiss chard, other dark green vegetables.

3) Fruits: 1 ½ cups a day. Fruits include 100% fruit juice. This group also includes fresh, canned, frozen and dried fruits. Eat different fruits and go easy on the juices.

4) Milk and Dairy: 3 cups a day. This group includes all of the liquid milk products and foods made from milk that keep their calcium. Puddings, yogurt and cheeses are in this group. Cream cheese, cream and butter are not. Always go for the lowfat or fat-free and hormone-free items in this group.

5) Meat and Poultry: 5 ½ oz a day. Includes meat, poultry, fish, dried beans, eggs, nuts and all foods that are made from them. Lean, low fat cuts of meats are best. Add more fish, beans, peas and nuts and go easy on the red meats. As a breast cancer survivor, you want to make sure your diet includes plenty of low-fat protein such as cold-water fish (salmon, sardines, mackerel), beans, nuts, and white meat chicken or turkey. Protein rebuilds muscle and tissue which is particularly important after undergoing chemo, surgery, and radiation. Protein also helps some medications work better.

A Word about Oils (Fats): Use less than 6 teaspoons a day. Some foods that fall into this group are oils, butter, margarine, nuts, animal fat and shortening. Most of your intake from this group should come from fish, nut and vegetable oils. Limit solid fats like butter and shortening, and consider using healthy alternatives such as olive oil.

Tips for Eating Healthier (United States Department of Agriculture):
  • Make half your grains whole.
  • Vary your veggies.
  • Focus on fruit.
  • Get your calcium-rich foods.
  • Go lean with protein.
  • Find your balance between food and physical activity.
  • Read nutrition labels.
  • If you are on a limited income, consider buying produce in season when it’s cheaper, buying frozen fruits and vegetables, or gardening.
Tips for Eating Out (United States Department of Agriculture):

There are times when you will be eating out. Plan ahead to allow for the meal. Avoid the “all you can eat” buffet. If you have planned ahead and thought about where you will go, and what might be a healthy choice there, chances are that you will eat healthier.

A Note About Bone Health

Keeping your bones strong is vital after treatment for breast cancer. You can check your bone health with a bone mineral density test (after age 50). To improve bone health, women should add more calcium to their diet and exercise on a regular basis.


Exercise

Exercise has been shown to help your quality of life, heart health, fatigue, body image and happiness. Exercise should include both strength training and aerobic exercise. Exercise has also been shown to lower body weight and change the body’s makeup to include more lean muscle mass and less fat. Walking, even for short periods of time (such as 30 minutes five days a week) has been shown to be good for those who have had breast cancer.

  • Order an appetizer or side dish instead of an entrée.
  • Share a main dish with a friend.
  • Take leftovers home in a “doggy bag.”
  • The moment your food arrives, set aside half of it to take home.
  • Resign from the “clean your plate club.” When you have eaten enough, leave the rest.
  • Ask for your salad dressing on the side, so you can use only what you want.
  • Avoid ordering foods that have creamy sauces or gravies.
  • Add little or no butter to your food.
  • Choose fruits for dessert.
  • Order water to drink, or low fat milk or a drink without added sugar.
  • Order steamed, grilled, or broiled dishes instead of those that are fried or sautéed.
  • Ask for whole wheat bread for sandwiches.
  • Start your meal with a salad packed with veggies, to help control hunger.
  • Use smaller plates.
Two Active Focus Areas:

1) Aerobic. Aerobic exercise is any activity that makes your heart beat faster and makes you breathe more rapidly, but not so much that you can’t sustain the activity for more than a few minutes. Some activities that fall into this group are walking, biking, dancing, and swimming.

2) Strength. Strength exercises are aimed at improving the strength and flexibility of certain muscles.

Getting active is a process and will take time. The US Surgeon General suggests that you get about 30 minutes of medium to intense exercise at least five days a week for at least 150 minutes a week. This can be done 10-15 minutes at a time and total 30 minutes in a day. If you have not been very active, it may take several weeks to work up to this level. You should talk with your doctor about any activities that you plan to try. Never start a new exercise program without getting your doctor’s approval.

You may know what you want to do to try to get more active. For instance, you may know that you want to walk. You may have no idea where to start.

Activity Goals for Breast Cancer Survivors:
  • Better movement and strength in the affected side.
  • Lowering your risk of Lymphedema.
  • Improving your endurance.
  • Reducing your risk for bone loss.
  • Improving your heart health.
  • Increase your feeling of well-being.
The Power of Walking

Walking is a very easy way to get fit. It takes very little planning. You can do it in the area where you live or somewhere else. You can vary where you walk. You don’t need a lot of costly gear to walk. It may be easy to get someone else to walk with you. You are not limited to a certain time of the day. You can start out with a short distance and slow pace. Over time, you can work up to faster, longer walks.

  • Reduces stress.
  • Gives you more energy.
  • Tones muscles.
  • Burns more calories.
  • Strengthens bones and muscles.
  • Lowers your chance of getting other health problems.
  • Makes you feel better!
Before Starting a Walking Program:
  • Check with your doctor. Make sure that there are no medical reasons that would make it unwise to start walking.
  • See that you have good shoes. You need proper support for your feet to prevent injury. When you go to purchase walking shoes, wear the socks that you plan to use. Also walk around the store to make sure that they are the right shoe for you.
  • Don’t forget to stretch. As we age, the need for stretching, warming up and cooling down becomes greater. The best way to avoid pain is to prevent it.
  • Always warm up. Walk the first five (5) minutes slowly before picking up the pace.
  • Think about your heart rate and your breathing. You should be able to talk while walking.
  • Use good posture. Swing your arms. Keep your head up and stand up straight and tall.
  • Keep track of the length of time you walk or the distance that you go.
  • Carry water if it is hot or you plan to walk for a long distance.
  • Change the scenery. Walk in a different area some of the times.
  • Find a buddy or some good music to accompany you on your walk.
  • Don’t forget to make it fun! You’re more likely do an exercise if it’s fun for you.
  • Change up your exercise. The more times you do a certain type of exercise in a row, the fewer calories you will burn. Try something new or rotate exercises every few weeks.
  • Try something new! Running in a pool is a better workout than running on land, and has much less impact on joints.

If you have given it some thought and done the things listed, it is time to start. Put on those shoes and leave the house. Set a time or distance to go on your first day out. Some people start with five (5) minutes out and five (5) minutes back. That means that you go five (5) minutes and then turn around and come back. Always start out slowly and warm up. Then get your pace up to where you feel a little warm and are breathing a little more frequently than at rest. Try to do this about four (4) times a week. Adjust your pace and distance as you need. A good guideline to use to increase what you are doing is to add 10% a week. If you are walking 10 minutes the first week, then add one (1) minute and walk 11 minutes each day of the second week. Keep on doing this until you have reached your goal. You will find that over time you are able to walk at a brisker pace.

Other Activities
  • Yoga has been studied and shown to have a great impact on quality of life in breast cancer survivors, including decreased pain and fatigue. There are many videos available to do yoga in your own home, but remember it’s important to use correct form and to avoid doing moves that cause sharp pain.
  • “Eat less, move more.” As we age, weight can creep on and the goal is to maintain your level of activity.
  • If you cannot exercise comfortably while standing, consider exercises you can do while sitting.
Burn Those Calories

Check out how many calories you are burning just doing everyday chores or things you like to at HealthStatus: For example:

  • Gardening can be a great way to add activity into your day, burning about 60 calories every 10 minutes.
  • Doing housework burns around 30 calories every 10 minutes
  • Ironing clothes and shopping burn around 25 calories every 10 minutes.
  • Playing cards burns around 15 calories in 10 minutes
  • Carrying a baby can burn around 40 calories in 10 minutes.
  • Sleeping burns about 10 calories in 10 minutes.
  • Water aerobics burns 45 calories in 10 minutes
  • Mopping the floor burns 50 calories in 10 minutes.
  • Calisthenics, such as jumping, hopping or pushups burn 50 calories in 10 minutes.
  • Playing with kids can burn 45 calories in 10 minutes.
  • Cycling or spinning can burn 80 to 130 calories in 10 minutes, depending on the intensity.
  • Dancing can burn 30 to 60 calories in 10 minutes, depending on the speed of the dance.
  • Gentle stretching can burn up to 45 calories in 10 minutes.
  • Yoga burns anywhere from 30 to 80 calories in 10 minutes depending on the intensity of your workout
Stretches and Exercises

Breast cancer patients often complain of headaches, neck pain, shoulder pain or low back pain after surgery and treatment. Poor posture and a more sedentary (inactive, seated) lifestyle can lead muscles to become tight and out of balance, which can increase this pain and achiness.

Therefore, we recommend stretching and exercises that can gently improve your posture and help build your endurance and strength. The following exercises are simple, and easy to perform pretty much anywhere. But as we always advice, please make sure your surgeon has released you for exercise before attempting.


Chin Tuck
  1. With spine straight, shoulders relaxed and eyes looking forward, slowly begin to tuck chin.
  2. Perform tuck by visualizing mouth moving backward towards spine.
  3. Hold stretch for five (5) seconds, perform 10 times.
  4. Try to do it five to seven (5-7) times throughout the day.

Standing Flexor Compartment Stretch
  1. Stand with hand on the wall, forearm pointing up and fingers pointing down.
  2. Straighten your elbow and then slowly take a step away with your opposite leg. Turn your neck and body away from your arm.
  3. Stretch can be felt from your fingers to your armpit and chest.
  4. If there is considerable stretch and pulling felt at surgical site and/or implant, you can block the stretch with your hand. Stretch will be felt in hand and arm.
  5. Perform stretch five (5) times, hold five (5) seconds each.
  6. Do two (2) times a day.

Shoulder Blade Squeezes
  1. Sitting or standing upright, gently squeeze your shoulder blades together
  2. Shoulders should remain relaxed and down from your ears
  3. Hold for five to 10 (5-10) seconds, repeat five to 10 (5-10) times

Low Rows
  1. Wrap the armband around the opposite side of the door handle and then close the door.
  2. Grab hold of both ends of the armband. Stand with legs apart, knees bent and facing the door.
  3. Pull bands back, squeezing your shoulder blades together. Remember to keep shoulders down.
  4. Hold for a count of one. Do desired number of repetitions.

Shoulder External Rotation
  1. Stand perpendicular to the door. Hold the band with outer arm (elbow bent to 90 degrees), place a towel under elbow to keep arm at side.
  2. With shoulders back, slowly pull the band away from body, rotating at the shoulder.
  3. Then slowly control the band and your hand back to the starting position.
  4. Continue as far as you are able, pause, and return to the starting position.
  5. Do desired number of repetitions.

Lunges
  1. Keep your upper body straight, shoulders back and relaxed, chin up.
  2. Step forward with one leg, lower your hips until both knees are at about a 90-degree angle.
  3. Make sure your front kee is directly above your ankle – not past it and that the other knee is not touching the floor.
  4. Hold stretch for five (5) seconds and do five (5) times.
  5. Perform two (2) times a day.
  6. To increase the stretch, raise the arm of the kneeling leg overhead.

Relaxation Techniques

If you’re feeling anxious or stressed, try the following relaxation techniques.

Easy, Quick Fixes:
  • Tighten your fists, breathe in deeply and hold your breath for a moment. Breathe out slowly and let your arms and hands go limp like a rag doll.
  • Yawn. Yes, it really can help you relax.
  • Listen to peaceful music or relaxation tapes, such as classical music or nature sounds. Try and listen to them in a place that is peaceful and comforting to you.
  • Try slow, steady, controlled breathing.
  • Sit in a comfortable position and relax all your muscles.
  • Close your eyes or focus on a distant object if you prefer to keep them open.
  • Breathe in and out slowly and comfortably through your nose. Count up from one to four (1-4) as you breathe in, and back from four to one (4-1) as you breathe out.
  • Feel yourself relax and go limp each time you breathe out.
Muscle Tension and Release
  • Lie down in a quiet room.
  • Take a slow, deep breath.
  • As you breathe in, tense one muscle or group of muscles. For example, clench your teeth or stiffen your arms or legs.
  • Keep your muscles tense for a second or two while holding your breath.
  • Then breathe out, release the tension, and let your body relax completely.
  • Repeat the process with another muscle or muscle group.
  • Try Progressive Relaxation, following the steps above, starting at your feet and slowly moving up the body’s muscles until you have completely relaxed.
Mental Imagery
  • Close your eyes, breathe slowly, and feel yourself relax.
  • Imagine a ball of healing energy, the hand of God or some other healing force inside your body.
  • When you see the healing force, slowly breathe in and blow it to any part of the body where you feel pain, tension or discomfort, such as nausea.
  • When you breathe out, picture the air moving the force away from your body, taking with it any painful or uncomfortable feelings.
  • Keep the force moving toward you and away from you each time you breathe in and out. You may see it getting bigger and bigger as it takes away more and more tension and discomfort.
  • Try visualization, which is similar to imagery. Create an inner picture that stands for your fight against cancer. You might visualize a battle scene with soldiers or knights fighting off the cancer in your body, or a video game where you shoot the cancer cells as they approach.
Biofeedback

With training in biofeedback, you can control body functions such as heart rate, blood pressure and muscle tension. Starting out, you will be connected to a machine that will sense and alert you when your body shows signs of tension, while also providing feedback when you relax. Over time, you should no longer need the machine to control your relaxation responses. Your health care team can likely refer you to someone trained in teaching biofeedback if you think this method might benefit you.

Other Healthy Behaviors

  • Stop smoking.
  • Limit alcohol intake (the recommendation is that women should limit themselves to one alcoholic drink per day).
  • Limit how much time you spend in the sun and use sunblock. Some cancer treatments put you at higher risk for development of skin cancers.
  • Be screened for other cancers like colon, cervical and skin cancers.
  • Be screened for any other health issues for which you may be at risk.

When Do You Need To Seek Help?

Talk to your health care team about how to best maintain your health, from getting advice on the best diet and exercise regimen to any concerns you have about your recovery.


Useful Websites:

Diet

BreastCancer.org/Nutrition:

HealthCastle.Com/Breast Cancer Diet & Nutrition Manual:

Exercise

American Cancer Society/The Power of Exercise in Breast Cancer Survivors:

Prevention/How To Exercise When You Have Had Breast Cancer:

Medicine.net/Breast Cancer Survivors: Nutrition and fitness tips:

BreastCancer.Org/Yoga:

Dana-Farber Cancer Institute/What Are The Best Yoga Poses for Breast Cancer Patients:

Yoga for Breast Cancer-Introduction:

Guided Meditation for Deep Relaxation/Sleep Video:

Breast Cancer.Org: Progressive Muscle Relaxation:

Cancer Care:


Videos to Watch:


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Cooking with Cancer – YBCS Workshop 2017

Dr. Luis Pineda, founder of Cooking with Cancer, gives an overview of alternative options for cooking with cancer.

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Nutrition & Cancer

Dr. Pineda discusses nutrition components survivors need to pay attention. He cites websites with reliable source of information for good nutrition and breast cancer.

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Louisiana's Young Breast Cancer Survivor Network

Young women with breast cancer face unique issues. And in the South, there are more young women overall facing breast cancer. In Louisiana, young African-American women are significantly more likely to suffer from breast cancer.

That is why SurviveDAT is here. Part of the Gulf States Young Breast Cancer Survivor Network, SurviveDAT's mission is to help improve the quality of life for young breast cancer survivors, as well as their family and friends, by providing continuing resources and support.

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