Which lifestyle changes help prevent breast cancer relapse?

3 minute read

Exercise showed significant improvements, BMI and cutting out meat and alcohol did not.

Exercise showed significant improvements, BMI and cutting out meat and alcohol did not.

Patients at high-risk of breast cancer recurrence who adhere to lifestyle recommendations are 37% less likely to experience a relapse and 58% less likely to die from the disease than those who don’t, a new US study reveals.  

“Education and implementation strategies to help patients adhere to cancer prevention recommendations throughout the cancer care continuum may be warranted,” noted the authors.  

The findings, first published in JAMA Network Open, provide some of the first data detailing the compounding influences of BMI, exercise, diet and smoking before, after and during chemotherapy.  

Survival analysis data found patients who maintained strict adherence to some lifestyle recommendations had the longest periods of both overall and disease-free survival.

The prospective cohort study consisted of 1300 women with pathologic stage I to III high-risk breast cancer.

Researchers used a Lifestyle Index Score (LIS) to track strict adherence, partial adherence or nonadherence to lifestyle recommendations from the American Institute for Cancer Research and American Cancer Society, before and after diagnosis, followed by one and two years post-treatment.  

For example, patients in the normal BMI range were classified as adherent, overweight patients were semi-adherent and obese/ underweight patients were classified as non-adherent. In relation to alcohol consumption, individuals who abstained from drinking were categorised as fully adherent. Moderate adherence was defined as consuming one or fewer standard drinks per day. Consumption exceeding this limit was classified as non-compliant. 

Baseline characteristics, namely age, menopause status, number of positive cancer nodes, hormone receptor status, tumour subtype, physical activity, smoking status, alcohol consumption and LIS, were significantly associated with mortality and disease outcomes.  

“In examining the role of individual lifestyles, strongest adherence to recommendations for smoking, PA, fruit and vegetable intake, and sugar-sweetened beverage consumption were associated with [the most] significant reductions in recurrence and mortality,” the authors wrote.  

Never smoking and meeting the physical activity guidelines were the most effective interventions, with strict adherence to either dropping the risk of death by 45% and the risk of recurrence by 35% compared to those who were least adherent. 

Patients who were most adherent to fruit and vegetable intake advice benefited from a 31% reduction in death over the study period and 36% reduction in recurrence.  

And avoiding sugar-sweetened drinks led to a 44% reduction in deaths and 27% reduction in recurrence.  

However, the association between adherence to BMI, red and processed meat consumption and alcohol-related guidelines did not yield significant results.  

“[L]ifestyle interventions could be a safe, inexpensive, and feasible ancillary strategy for delaying and preventing recurrence and death from the most common cancer in the world. Such developments could be especially impactful for patients diagnosed with more aggressive tumours that do not respond well to current therapies,” the authors concluded. 

JAMA Network Open 2023, online 4 May  

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