Having a healthy lifestyle is important for everyone, but even more so for cancer survivors. Healthy habits can help you feel better, regain your strength and energy, and reduce your risk of developing complications – including a recurrence or development of a second cancer.
The American Cancer Society publishes nutrition and physical activity guidelines for cancer survivors each year that are evidence-based and cancer-specific. The experts at Atlantic Health System follow these guidelines when providing cancer care.
To simplify the information, Nicole Stawicki, MS, RDN, CNSC, an outpatient oncology dietitian with Atlantic Health System, explains the top 3 ways to protect your health after cancer treatment. She calls these action steps, “The Big 3”.
Achieve/Maintain a Healthy Weight
Achieving and maintaining a healthy weight is important to staying healthy. Studies show that people who are overweight with a body mass index (BMI) over 30 have a greater risk of developing cancer. They also have higher rates of recurrence than those with a normal BMI (18.5-24.9).
Being underweight isn’t ideal either. If you become sick, you won’t have the necessary body fat stores to fight off infections, and you could become malnourished.
However, Nicole cautions that BMI calculations may not be an accurate representation for all populations today, as they were originally designed for young, healthy, white men. “It’s best to work with your healthcare team to determine what’s a healthy weight for you personally,” she says.
To get to a healthy weight, focus on the next two action steps in “The Big 3” — being physically active and following a healthy eating style.
Be Physically Active
After cancer treatment, your energy levels are lower and you’ve most likely lost muscle mass. It’s important to add daily movement back into your routine.You may have heard that sitting is the new smoking. And while that sounds extreme, there’s some truth to it. Sitting and being sedentary for long stretches of time each day negatively impacts your health. Daily movement and weekly strength training not only helps with weight loss and maintenance, but it also improves your cardiovascular (heart) and bone health.
Nicole recommends aiming for 150-300 minutes of moderately intense exercise or 75-150 minutes of vigorous exercise per week, plus at least two strength training sessions (with dumbbells, resistance bands or even bodyweight) per week.
Moderate exercise includes activities like:
- Yoga
- Pilates
- Walking
- Dancing
- Golfing
- Cycling
- Water aerobics
- Doubles racquet sports, like tennis or pickleball
- Gardening and/or yard work
Vigorous exercise examples include:
- Jogging or running
- Spinning
- Aerobic dancing (like Zumba)
- Hiking uphill
- Swimming laps
- Jumping rope
- Singles racquet sports
- Circuit weight training, including CrossFit
Remember, what’s moderate to one person, may be vigorous for another. Start simple and work your way up. You don’t have to join a gym or buy fancy equipment. Take a walk around the block after dinner, get up and move during TV commercial breaks, or scroll social media while you walk slowly on a treadmill or ride a recumbent bike. The key is to find something you enjoy doing so you stick with it, and to go slow at first.
“The important thing to remember is to ease into it,” says Nicole. “Even if you were an athlete before your diagnosis and treatment, don’t expect to jump back in where you left off. Increase your intensity and duration gradually, and if something doesn’t feel right, don’t just ‘power through.’ Talk to your doctor.”
Follow a healthy diet pattern
While there is no one diet to follow, Nicole does encourage all cancer survivors to focus on plant foods as the basis of a healthy pattern of eating. This includes plenty of vegetables, whole fruits, beans and legumes, whole grains, and nuts and seeds.
Vegetables
- Aim for at least 2-1/2 cups per day.
- Include a variety of colors, everything from dark, leafy greens to red bell peppers and white cauliflower.
- Limit starchy vegetables, like potatoes.
Fruit
- Aim for at least 1-1/2 cups per day.
- Include a variety of colors (think blueberries, cherries, oranges, etc.).
- Prioritize whole fruit and limit fruit juices.
Beans, lentils and legumes
- These foods are an excellent source of protein and fiber.
- Eat in moderation, as some stomach upset is common if eaten in large quantities.
- Choose unprocessed soy, like edamame and tofu (not factory-made alternatives).
Whole grains
- Choose whole grains that are labeled as “100% whole wheat” or “100% whole grain.”
- Options include oatmeal, whole grain pastas, and long grain, wild, or brown rice.
- Limit products made with refined flours (such as most baked goods, pastries and snack foods).
• Avoid if you have celiac disease or are allergic, sensitive to or intolerant of gluten.
Nuts and seeds
- A good source of healthy fats, fiber, protein, and some vitamins and minerals.
- Look for raw, sprouted or dry roasted versions without added salt, sugar or processed oils.
- Limit quantities to a handful or less, as it’s easy to go overboard.
Nicole also recommends drinking plenty of water, avoiding processed meats and fast foods, limiting the amount of added sugar (not counting naturally occurring sugar found in fruits and vegetables) to less than 10% of your total daily calories, and cutting back on alcohol (no more than one drink per day for women, and two per day for men).
“Diets are very bio individual. Everyone has different calorie needs and preferences,” says Nicole. “While I don’t typically recommend avoiding entire food groups, sometimes it’s necessary to limit certain foods for medical reasons. For example, people who are diabetic need to watch their sugar and carb intake, while someone with celiac disease needs to avoid gluten.”
BONUS: Adopt other healthy habits
Staying healthy isn’t just about diet and exercise. Other healthy habits promote overall wellness, too. Nicole recommends the following behaviors to everyone, not just cancer survivors:
- Manage your stress.
- Prioritize good, quality sleep.
- Apply sunscreen daily.
- Stop smoking.
- Address other health conditions and comorbidities, like diabetes, heart disease and osteoporosis.
She also reminds cancer survivors to continue taking all medications as prescribed, go to all scheduled appointments, and follow up with your doctor, even when you’re feeling better.
To stay healthy after cancer treatment, you don’t have to be perfect, and you don’t have to overhaul your entire lifestyle overnight. Nicole suggests picking one or two things to focus on at first, like adding in one extra serving of vegetables or walking for 10 minutes each day. Then, build from there.
“Once that one action becomes a habit and no longer feels like a chore, add in something else,” Nicole advises. “Don’t put too much pressure on yourself to do it all at once. Little changes over time can have a big impact.”
Be Proactive About Your Health
To stay safe and healthy, it's good to have a primary care provider who knows and understands your health history and wellness goals.