Understanding the Best Diet and Lifestyle During Breast Cancer

You may be wondering if you should make any changes to your lifestyle and eating habits to best care for yourself while coping with breast cancer.

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The latest research shows us that eating a balanced diet containing fruits and vegetables, exercising regularly, and caring for your mental health can help people with breast cancer feel as good as possible. Quitting smoking will improve your quality of life and lower your side effects of treatment.

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Read on to learn more about how to take the best care of yourself during and after breast cancer treatment.

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Exercise

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It’s important to allow yourself time to rest during breast cancer treatment. We recommend you take it easy by preserving your energy for the things most important to you. However, we don’t recommend that you give up physical activity altogether. Becoming inactive can cause you to lose muscle mass, strength, flexibility, or cardiovascular fitness.

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Exercising is normally safe during and after breast cancer treatment. You may need to make changes based on your energy levels and how you feel. Your medical team can help you set your exercise goals and figure out what kinds of exercise might work best for you given your medical history, treatment plan, and interests.¹

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A little exercise every day, whenever you can fit it in, can help you feel as good as possible. Research shows that exercise can improve your quality of life and lessen side effects during and after breast cancer treatment.²

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We recommend that you stay as active as you can within the limits of your energy level. You may feel more fatigued on some days than others. If you were already active before your diagnosis, you can maintain the same exercise habits if it feels good. If you’re new to exercise, start slowly and gradually increase in duration or exertion level over time.²

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We also recommend that you exercise outside whenever possible. This might look like taking a walk around your neighborhood or doing some yoga in a park. Natural light can improve your energy levels and help you sleep better. It can also reduce fatigue during breast cancer treatments like radiation and chemotherapy or while recovering after surgery. Even on a cloudy day, outdoor light is more effective than even the brightest indoor light.

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Doing a variety of exercises can help keep your bones, muscles, and heart healthy and strong during and after treatment.

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Cardiovascular exercise

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Cardiovascular exercise (or cardio for short) involves increasing your heart rate. When your heart is beating faster, it’s pumping more oxygen to the different parts of your body. This helps keep your heart and lungs strong and healthy. Cardio can reduce the risk of breast cancer recurrence as well as heart disease, diabetes, and osteoporosis.³

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You don’t have to do high-intensity exercise to experience the benefits of cardio. You should aim for an exertion level where you can still talk but it becomes a little hard to sing.

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Cardio exercises can include:

• walking
• dancing
• tennis
• biking
• swimming
• golf

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We recommend that people who have finished breast cancer treatment get 30 minutes of moderate-intensity exercise at least five days a week. You don’t have to exercise for 30 minutes at once; instead, you can break it down into smaller chunks. This might look like doing 10 minutes of exercise at three different points throughout your day.

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If you’re an avid runner, you may be wondering if you can still run or jog during treatment. You can still run during treatment but remember to listen to your body and let your energy levels guide you.

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Strength and resistance exercises

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Strength and resistance exercises can help you retain your muscle mass and bone strength. They can also help your muscles repair after breast cancer surgery.³

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These exercises may involve:

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• using external weights (weightlifting with dumbbells, for example)

• using your body weight as resistance (push-ups, squats, planks, lunges, or sit-ups)

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Now is not the time to do heavy or intense weightlifting especially if this is something you weren’t doing before. You can start with light weights and gradually increase them over time if you feel you’re able to.

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You don’t need much time or equipment to do strength exercises. Try to fit in some simple movements throughout your day. You could do some quick push-ups against a wall to strengthen your chest and arms or take the stairs to strengthen your pelvic and thigh muscles.

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In a recent study of breast cancer survivors, researchers found that those who did strength exercises had less pain and fatigue and improved quality of life.⁴

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Flexibility exercises

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Flexibility exercises can help you improve your range of motion and comfort during daily activities. In general, we lose flexibility over time. Practices like yoga and stretching can help you maintain your flexibility. You might like to do these exercises when you wake up, before you go to bed, or whenever you can fit them in throughout your day.

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Staying flexible can help with muscle aches and pains from breast cancer treatments like hormonal therapy. These exercises can also help you improve any muscle stiffness or posture problems after breast cancer surgery or radiation.³

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Balance exercises

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In general, we start to lose our balance as we get older. Some breast cancer treatments like chemotherapy may also affect your balance.⁵ Doing balance exercises can improve your mobility and help you to prevent injuries by reducing your risk of falling.

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You can improve your balance through exercises like:

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• sitting on an inflatable ball

• walking on a balance beam at a park

• walking heel to toe as if you are on a tightrope ⁵

• standing on one foot ⁵

• raising and lowering one heel or calf at a time ⁵

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Diet

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Maintaining a healthy and balanced diet is beneficial for everyone. Eating foods rich in nutrients can help you feel as good as possible during and after breast cancer treatment.

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Fruits and vegetables

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Colorful foods like fruits and vegetables tend to be rich in micronutrients your body needs.

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In a study of women with Stage I-III breast cancer, researchers found that those who ate more fruits and vegetables after their diagnosis had an improved survival rate. This was especially true for:

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• leafy green vegetables

• cruciferous vegetables (kale, cabbage, broccoli, cauliflower, Brussels sprouts)

• fruits and vegetables high in vitamin C

• vegetables high in beta-carotene ^(6-7)

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Eating more blueberries was associated with a reduced risk of death by any cause, and eating more strawberries was associated with a reduced risk of breast cancer-related death.^(6-7)

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Researchers also noted that those who drank more fruit juice (except orange juice) had lower survival rates than those who drank less. This was especially true for apple juice.^(6-7)

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We recommend that you avoid fruit juices as they tend to be high in sugar and calories.

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Carbohydrates

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Research suggests that limiting the amount of carbohydrates (carbs) you consume and being careful about what kinds of carbs you eat may improve survival for people with breast cancer.^(7-8)

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Carb-containing foods are rated on a scale called the glycemic index. Foods with a high glycemic index cause your blood sugar to increase rapidly.⁹ The glycemic load is another scale. It measures how much a serving of food will raise your blood sugar.⁷ Researchers found that eating a diet with a higher glycemic load and index was associated with a lower survival rate in people with breast cancer.^(7-8)

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The following foods have a high glycemic index and should be avoided or eaten in moderation:

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• processed foods

• sugary drinks like soda

• white bread

• fast food (cheeseburgers, fries, pizza)

• cereal (except whole grain)

• potatoes ⁹

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Foods with a low glycemic index include:

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• fruit

• vegetables

• chickpeas

• beans

• milk

• yogurt

• nuts ⁹

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The researchers of the study mentioned above also found that those who ate foods with more fiber had higher survival rates.^(7-8)

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Foods high in fiber include:

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• whole-wheat pasta

• chickpeas

• berries

• brussels sprouts

• pears

• chia seeds

• carrots

• celery

• granola bars

• quinoa

• almonds ¹⁰

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To prevent cramping or bloating, it’s best to increase fiber in your diet slowly and increase your water intake.¹⁰

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Taste changes

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Chemotherapy treatment can change the way foods taste. You may like things you didn’t before, or your favorite foods may taste different. Listen to your body and try things that sound good to you.

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If food tastes metallic or you have a metallic taste in your mouth, you can try using alternatives to metal silverware such as bamboo, plastic, or compostable silverware. Some people find that chewing gum or sucking on citrus- or mint-flavored hard candies can help with the metallic taste.

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If water tastes metallic, you can squeeze citrus fruits like lemons, limes, and oranges into a glass of water.¹¹ Squeezing citrus fruits on food can also help if it tastes bland. Marinades, salt, spices, herbs, or other seasonings can help add flavor to your food as well. ¹¹

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If you’re having a hard time adapting to these changes or others during chemotherapy treatment, a nutrition specialist can help you develop a diet plan that works for you. A nutrition specialist may be part of your medical team for cancer treatment, and services are often covered by insurance.

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Weight changes

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Some people gain weight during treatment because they’re less active or eating more comfort foods. Others might see weight loss as nausea or taste changes decrease their appetite.

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Being mindful of what you eat and staying active can help you maintain a healthy weight and get the nutrients you need. A registered dietician can help you meet your nutritional goals during treatment.

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Supplements or Vitamins

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Before taking any supplements or vitamins, consult your medical team. They can give you high-quality information about whether taking these supplements is advisable during treatment. There is no evidence that supplements can prevent or treat breast cancer.

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Some supplements or vitamins can make breast cancer treatments less effective. We recommend that you don’t take antioxidants if you’re getting chemotherapy. Chemotherapy works by oxidation; antioxidants undo that process and can decrease its effectiveness.

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One exception is Vitamin D. Most people are deficient in Vitamin D, and it’s hard to get from food. We make Vitamin D through our skin, but our bodies become less efficient at making it over time. Wearing sunscreen can also decrease the absorption from sun rays (but the benefits of wearing sunscreen outweigh the risks of not wearing it). Taking a Vitamin D supplement may be advisable if you live in the northern hemisphere or don’t get much sun exposure.

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We also recommend that you don’t take tablets, shakes, or powders that contain soy. Dietary soy (the normal amounts you eat in your meals) is not a risk for people with breast cancer. Soy contains phytoestrogens (different from the human hormone estrogen). While phytoestrogens found in a balanced diet are not dangerous for people with breast cancer, trying to increase the levels of phytoestrogens in your body is not advisable.

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Smoking

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Research shows that quitting smoking after being diagnosed with breast cancer can improve your odds of survival.¹⁴ Smoking can also affect how your body responds to breast cancer treatment. There is evidence that quitting smoking before starting radiation therapy can substantially reduce your risk of long-term side effects of radiation therapy such as lung cancer or death due to heart disease. For long-term smokers with breast cancer who continue smoking during radiation therapy, the risk of these late side effects may outweigh the benefit of radiation therapy.¹⁵

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In a study of cancer patients receiving chemotherapy and/or radiation therapy, researchers observed that those who smoked experienced a higher symptom burden during treatment. They suggested that this may lead to reduced dosages or treatment interruptions that make treatment less effective. Six months after treatment, people who smoked reported higher levels of severe side effects. They also experienced a smaller decrease in symptoms six months after treatment, which suggests that smoking may slow recovery after treatment.¹⁶ Quitting smoking can improve your quality of life during breast cancer treatment and recovery.

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Caring for your mental health

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Coping with a breast cancer diagnosis can be overwhelming, and cancer treatments can affect how you feel physically and emotionally. Give yourself permission to prioritize your own needs and reach out for support.

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Having people to support you on your cancer journey can make a big difference. This might include friends, family, people in your community, and people on your care team. You may also wish to talk with a counselor, psychologist, social worker, or another specialist who can help you care for your mental health during this challenging time. If your family is not supportive, reach out to the social worker on your team to help you find support in other places.

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Research shows that social support can improve both your physical and emotional well-being.¹² Scientists believe that social support may even improve cancer outcomes by protecting you from stress that can cause tumor growth.¹³

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Do your best to make time for self-care and the things you enjoy. Self-care might look like practicing meditation, getting some exercise, reading a good book, or diving into one of your hobbies. Self-care looks different for everyone and can take many forms.

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Summary

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Being kind to yourself and taking care of your body can help you feel as good as you can during and after breast cancer treatment. We recommend staying active through different kinds of exercises, including cardio, strength, balance, and flexibility, and eating a nutritious diet filled with colorful fruits and vegetables.

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References

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1. Acheson S. Exercising safely during breast cancer treatment: What to know. Cancer.Net. https://www.cancer.net/blog/2022-10/exercising-safely-during-breast-cancer-treatment-what-know. Published October 27, 2022. Accessed December 11, 2022.

2. Potter M. Exercise and breast cancer. Johns Hopkins Kimmel Cancer Center. https://www.hopkinsmedicine.org/kimmel-cancer-center/cancers-we-treat/breast-cancer-program/treatment-and-services/exercise-and-breast-cancer. Published May 31, 2022. Accessed December 11, 2022.

3. DePolo J. Types of exercise. Breastcancer.org. https://www.breastcancer.org/managing-life/exercise/types. Published November 29, 2022. Accessed December 11, 2022.

4. Montaño-Rojas LS, Romero-Pérez EM, Medina-Pérez C, Reguera-García MM, de Paz JA. Resistance training in breast cancer survivors: A systematic review of Exercise Programs. International Journal of Environmental Research and Public Health. 2020;17(18):6511. doi:10.3390/ijerph17186511

5. Michaels C. Balance exercises after cancer treatment. Cancer.Net.
   https://www.cancer.net/blog/2016-02/balance-exercises-after-cancer-treatment. Published February 9, 2016. Accessed December 11, 2022.

6. Farvid MS, Holmes MD, Chen WY, et al. Postdiagnostic fruit and vegetable consumption and breast cancer survival: Prospective analyses in the Nurses’ Health Studies. Cancer Research. 2020;80(22):5134-5143. doi:10.1158/0008-5472.can-18-3515

7. Nelson MR. Two new studies suggest diet can help breast cancer survivors live longer. American Institute for Cancer Research. https://www.aicr.org/news/two-new-studies-suggest-diet-can-help-breast-cancer-survivors-live-longer/. Published March 18, 2021. Accessed December 11, 2022.

8. Farvid MS, Tamimi RM, Poole EM, et al. Postdiagnostic dietary glycemic index, glycemic load, dietary insulin index, and insulin load and breast cancer survival. Cancer Epidemiology, Biomarkers & Prevention. 2021;30(2):335-343. doi:10.1158/1055-9965.epi-20-0764

9. Glycemic index and how it affects your diet. Cleveland Clinic.
   https://health.clevelandclinic.org/glycemic-index/. Published October 21, 2021. Accessed December 11, 2022.

10. 11 high-fiber foods you should be eating. Cleveland Clinic.
    https://health.clevelandclinic.org/11-best-high-fiber-foods/. Published February 11, 2022. Accessed December 11, 2022.

11. Taste changes. Cancer.Net. https://www.cancer.net/coping-with-cancer/physical-emotional-and-social-effects-cancer/managing-physical-side-effects/taste-changes. Published January 2020. Accessed September 26, 2022.

12. NCCN Clinical Practice Guidelines in Oncology: Older Adult Oncology. NCCN. https://www.nccn.org/professionals/physician_gls/pdf/senior.pdf. Published July 12, 2022. Accessed October 6, 2022.

13. Kadambi S, Soto-Perez-de-Celis E, Garg T, et al. Social support for older adults with cancer: Young International Society of Geriatric Oncology Review Paper. Journal of Geriatric Oncology. 2020;11(2):217-224. doi:10.1016/j.jgo.2019.09.005

14. Singareeka Raghavendra A, Kypriotakis G, Karam-Hage M, et al. The impact of treatment for smoking on breast cancer patients’ survival. Cancers. 2022;14(6):1464. doi:10.3390/cancers14061464

15. Taylor C, Correa C, Duane FK, et al. Estimating the risks of breast cancer radiotherapy: Evidence from modern radiation doses to the lungs and heart and from previous randomized trials. Journal of Clinical Oncology. 2017;35(15):1641-1649. doi:10.1200/jco.2016.72.0722

16. Peppone LJ, Mustian KM, Morrow GR, et al. The effect of cigarette smoking on cancer treatment–related side effects. The Oncologist. 2011;16(12):1784-1792. doi:10.1634/theoncologist.2011-0169