“Breast cancer recurrence” means the disease came back, and every person who fought tooth and nail to recover fears the day they relapse. The question on every survivor’s mind is, would it be possible to prevent recurrence? This article tackles it all, from the causes of recurrent breast cancer to the lifestyle modifications necessary to stay in remission.
Why Does Breast Cancer Come Back?
Although most recurrences happen during the first five years after treatment, cancer can return even after 10, 15, or 20+ years. The primary causes include:
- Initial tumor characteristics: The larger and more advanced the primary tumor was, the more likely for cancer to recur.
- Genetic factors: Gene mutations like BRCA1 and BRCA2 can contribute to breast cancer reappearance.
- Residual cancer cells: Even after successful surgery, chemotherapy, radiation therapy, or targeted therapy, tiny cancer cells may remain unnoticed in the body. These cells can grow, multiply, and cause a recurrence.
- Micrometastases: The breasts might be cancer-free, but microscopic cancer cells may have escaped detection and reached the lymph nodes or other areas of the body. These micrometastases can cause recurrence over time.
- HER2 status: HER2-positive breast cancer may recur if it was not effectively treated with targeted therapies or if resistance to these drugs develops.
- Hormone replacement therapy: Research suggests that some hormone therapies can raise the risk of breast cancer relapse.
In addition, several studies conclude that an unhealthy lifestyle contributes to initial breast cancer diagnosis. Therefore, it makes sense that living a “no holds barred” lifestyle plays a leading role in breast cancer recurrence, too.
The Ideal Lifestyle for Preventing Breast Cancer Recurrence
Survivors of breast cancer often worry about facing their disease again, or worse – developing a second cancer in a different area. To better cope with the aftermath of breast cancer treatments and reduce the likelihood of recurrence, here is everything a survivor should know about healthy living after breast cancer.
1. Get your heart pumping and break a sweat!
After spending several months or years within the confines of a medical ward, the body will crave movement, exercise, and sweat. Regular physical activity is “the most important lifestyle factor when it comes to decreasing your risk for recurrence,” says Ellen Warner, MD, a professor of medicine at the University of Toronto and a staff medical oncologist at Sunnybrook Research Institute since 1993.
Science Behind Exercise and Breast Cancer Prevention
Countless studies demonstrate that physically active women have a considerably lower risk of breast cancer than inactive or sedentary women. In a 2016 meta-analysis of 38 independent studies, the most physically active women had a 12% to 21% reduced risk of breast cancer than the least active women. Similarly, regular exercise reduces breast cancer risk in premenopausal and postmenopausal women. Increasing physical activity may also protect menopausal women against breast cancer.
The American Cancer Society warns against long-term physical inactivity, encouraging survivors to return to normal daily activities as soon as possible. They should take it slow and start with light-intensity activities like:
- Casual walking
- Cycling (less than 5 mph)
- Light weight training
- Light yard and housework
Over time, as cancer survivors recover their strength and endurance, they may build up 150 to 300 minutes of moderate-intensity weekly exercise. These activities include but are not limited to:
- Brisk walking (3 to 4.5 mph)
- Cycling (5 to 9 mph)
- Weight training
- Housework involving intense scrubbing and cleaning
Alternatively, cancer survivors may engage in 75 to 150 minutes of vigorous-intensity activities such as:
- Running or jogging
- Mountain or rock climbing
- Cycling (over 10 mph)
- Swimming laps
- Martial arts training
- High-impact dancing or step aerobics
Remember to seek a doctor’s guidance and approval before engaging in any physical activity. Exercising too soon or too much can result in weakness, overexertion, and injuries, potentially impeding recovery. Gradual, supervised exercise is advisable.
2. Drink responsibly–or don’t drink at all!
Giving up alcoholic beverages can be challenging for many, but limiting consumption or cutting out alcohol completely may reduce breast cancer risks.
Science Behind Alcohol Reduction and Breast Cancer Prevention
Data from the Institute of Medicine (IOM) and the Interagency Breast Cancer and Environmental Research Coordinating Committee (IBCERCC) listed alcohol as a leading risk factor for breast cancer, and the IOM asserted that alcohol is a carcinogen with one of the most evident relationships to the malignancy.
Reducing alcohol intake or quitting drinking can lower the risk of breast cancer by safeguarding or preventing the following:
- Hormone levels: Alcohol consumption alters hormone levels in the body. For example, it can increase estrogen levels in women, which can stimulate the growth of HER2-positive breast cancer cells. Reducing alcohol intake may help lower estrogen levels and reduce the risk of developing this invasive disease.
- DNA damage: Alcohol can metabolize into acetaldehyde, a chemical that can irreversibly damage DNA and cause mutations. DNA damage is critical in the development of cancer, including malignant breast tumors. Cutting back on alcohol reduces exposure to this toxic substance.
- Oxidative stress: Oxidative stress occurs due to an overabundance of free radicals in the body, which can overwhelm the natural defense mechanisms. This imbalance can result from various factors, including exposure to toxins, poor lifestyle choices (such as alcohol consumption), and inflammation. Over time, oxidative stress can damage DNA, cells, and proteins, leading to genetic mutations and cell abnormalities that increase the risk of cancer development.
- Immune function: Chronic alcohol use impairs the function of immune cells, making the immune system less capable of detecting and fighting diseases.
- Higher calorie intake: Alcoholic beverages can be high in calories and low in nutrients. Reducing consumption can help maintain a healthy weight, as excessive calorie consumption and obesity are risk factors for breast cancer.
While it’s better not to drink at all, drinking in moderation minimizes the health consequences of alcohol consumption.
The National Cancer Institute recommends no more than one drink a day for women. A “drink” is either 2 ounces of beer, 5 ounces of red or white wine, or 1.5 ounces (a shot) of liquor. The type of alcohol also matters. Beer, wine, and liquor have about half an ounce of alcohol per serving. The higher the alcohol content (ABV), the less a person can safely consume.
3. Pursue a tobacco-free present and future!
Just because a survivor is now cancer-free does not mean they can pick up their smoking habits again. In fact, cigarette smoking probably caused their initial diagnosis.
Breast cancer is not like chicken pox, which typically happens once. Cancer can come back, and taunting it with tobacco smoke increases overall risk. Generally, women who have been smoking for more than a decade have a 10% higher risk of breast cancer than those who have never smoked in their life. This bad habit ups the chances of recurrence and the risk of acquiring a second cancer.
Science Behind Smoking and Breast Cancer
Tobacco smoke contains as many as 7,000 chemicals, some of which are carcinogenic, including polycyclic aromatic hydrocarbons (PAHs) and aromatic amines. These chemicals can enter the bloodstream and potentially damage DNA in breast cells, leading to genetic mutations that may initiate cancer. Smoking also weakens the immune system, impairing its ability to locate and attack cancer cells. This reduced immune function can contribute to cancer development and progression.
Unlike alcohol consumption, there is no workaround or band-aid solution for smoking. Even the mere exposure to secondhand smoke increases breast cancer risk by 24% regardless of age. The only option is to quit smoking today.
4. Try the anti-recurrence benefits of intermittent eating!
We have some bad news to share with those who love midnight snacking. Intermittent fasting or taking prolonged breaks from food might be an ally against breast cancer recurrence.
Science Behind Intermittent Fasting and Breast Cancer Prevention
A study published in the journal of JAMA Oncology found that not eating for 13 hours or longer per night contributed to a significant drop in recurrence risk compared to people who did not practice intermittent fasting. To support this conclusion, a 2023 systematic review of available studies uncovered that fasting for less than 13 hours per night is associated with a 36% greater risk of recurrent breast cancer. In other words, survivors may need to reduce the number of times they visit the pantry at night.
Intermittent fasting is a straightforward process: Allot 13 hours or more between dinner at night and breakfast the following day. To do so successfully, stop eating by 7 PM and have breakfast at 8 or 9 AM to meet the studies’ fasting requirements. For survivors whose day starts earlier or later, simply adjust the eating schedule to the most appropriate time.
5. Shift toward high-fiber eating!
According to the World Cancer Research Fund, breast cancer survivors should eat a healthy diet high in dietary fiber, which has shown promising results in reducing recurrence.
Another key aspect of a healthy eating plan for preventing breast cancer recurrence is maintaining a healthy weight. Obesity increases the risk for recurrent breast cancer and other malignancies, so focusing on portion control and consuming nutrient-dense, high-fiber foods can be beneficial.
Science Behind High-Fiber Diets and Breast Cancer Prevention
A paper published in Harvard T.H. Chan mentioned that breast cancer risk was 12% to 19% lower in women who consumed more dietary fiber in early adulthood. High fiber intake in adolescence was also correlated with a 16% reduced risk of overall breast cancer, as well as a 24% lower risk of malignant breast tumors before menopause.
In addition, fiber may prevent recurrence by reducing circulating estrogen in the body. Although the female body is responsible for producing estrogen, the hormone also acts as a stimulus for cancer growth by spurring tissue division and proliferation in the breast.
Dietary fiber is a non-digestible carbohydrate in foods. Good choices include:
- Whole grains: Barley, brown rice, and buckwheat
- Fruits: Pears, strawberries, avocado, and apples
- Vegetables: Carrots, broccoli, beets, and leafy greens
- Legumes: Pinto beans, black beans, split peas, and lentils
- Nuts and seeds: Chia, flax, pumpkin seeds, and almonds
Incorporating the above into daily meals is essential, and health authorities recommend women eat 25 grams of fiber per day. These plant-based picks are full of vitamins, minerals, and fiber that can support the body’s immune system and help fight against cancer cells.
It’s important to note that no single food or diet can guarantee the prevention of recurrent breast cancer. However, pursuing a healthy eating plan inclusive of fiber-rich foods as part of an overall lifestyle approach may reduce recurrence risk. It’s always best to consult a healthcare provider or registered dietitian specializing in oncology nutrition for personalized guidance based on individual needs.
6. Inhale relaxation, exhale stress!
Battling breast cancer is a stressful experience in itself, and achieving remission may not always cancel out the stress involved in recovery. According to Johns Hopkins Medicine, finding healthy ways to cope with stress improves overall survival. As such, it is crucial to find practical ways to deal with stress, including exercising or playing sports, joining support groups, discovering new hobbies, massage therapy, meditation and yoga, mental health counseling, taking vacations, and many more. The idea is to find a stress reliever that works best for each individual.
Science Behind Stress and Breast Cancer Recurrence
Stress hormones can manipulate the behavior of specific neutrophils (a type of white blood cell) within the body, potentially leading to the reactivation of dormant cancer cells. Another theory is that norepinephrine (a stress hormone), may stimulate new blood vessels to form. This process, known as angiogenesis, is usually a normal part of growth and healing. Though, in some cases, it can play a role in disease occurrence, such as by giving tumors the oxygen and nutrients they need to speed up the spread of cancer (metastasis).
7. Say goodnight to working at night!
Women who work overnight shifts for an extended period, like nurses and flight attendants, may face higher risk of getting breast cancer or experiencing recurrence.
Science Behind Shift Work and Breast Cancer Recurrence
In our article about shift work and breast cancer incidence, we analyzed a study involving 1,134 individuals with breast cancer and 1,179 without breast cancer. The women were similar in age, had varied occupations, and were either from Kingston, Ontario, or Vancouver, British Columbia. To recap our article, the researchers found no apparent increase in the risk of breast cancer for women who had worked night shifts for up to 14 years or between 15 and 29 years. However, to our surprise, the breast cancer risk of women who had worked night shifts for 30 years or more was twice as high.
The link between working at night and breast cancer development may result from the inhibition of melatonin synthesis. Other factors, including disrupted body rhythms, differences in lifestyle, sleep disturbances, and low vitamin D levels, may also play a major role in the heightened risk.
Since humans naturally feel tired and sleepy at night, working during the day may be easier and more convenient. If possible, people working the night shift should consider switching their schedules for improved health and wellness.
8. Give your breasts extra attention once a month!
Breast self-exams are highly effective in detecting benign or malignant growths. As it happens, 71% of breast cancers in women younger than 50, as well as 50% of cases in women aged 50 or older, met with an oncologist after finding a lump or mass in their breasts.
Although monthly self-examinations cannot stop breast cancer recurrence, they can help detect cancerous growths before they progress into advanced, difficult-to-treat stages. Therefore, each month, starting at age 20, check for signs of breast cancer. Keep an eye on any changes in skin texture, the shape and outline of each breast, and if the nipples turn inward. Discuss all findings with a breast cancer specialist as soon as possible.
9. Schedule regular breast screenings!
Early detection often leads to more promising treatment results and a higher chance of survival. Fortunately, mammograms can identify tumors that are still too small to feel through self-exams or by a doctor.
Women who are 50 to 74 years old should undergo a mammogram every two years, while those at very high risk should schedule annual screenings. Women between 40 and 49 should talk to their healthcare providers about when to begin and how often to get a mammogram.
Is It Back? Address Breast Cancer Recurrence Now
Did you feel a lump while examining your breast? Are there clear changes in the skin around it? Or perhaps, have you been unusually ill, such as experiencing persistent headaches, breathing difficulties, or pains in your right shoulder? Have you been losing a significant amount of weight without trying? If you say yes to any of these potential signs of breast cancer recurrence, check with a doctor for an accurate diagnosis.
If diagnosed with recurrence or a second cancer, do not hesitate to contact New Hope Medical Center at 480-666-1403 for alternative cancer therapies. Our treatment providers specialize in complementary and alternative medicine in cancer care, including mind-body therapies, manipulative and body-based practices, biologically based techniques, and other therapeutic interventions.