Strategies for wellness during and after cancer treatment

By Miles J. Varn, M.D., Chief Executive Officer at PinnacleCare

The number of people in the U.S. who are cancer survivors continues to grow as new treatments and early detection increase. The American Cancer Society projects that by 2026, there will be 20 million cancer survivors in this country. And while treatment has advanced in both the number of options available and effectiveness, there still has been relatively little attention directed to helping people who survive cancer achieve optimal wellness in the months and years after treatment ends.

To address this gap, the Institute of Medicine recommended that when active treatment ends, patients receive a survivorship care plan designed to address several issues, including:

• Long-term side effects of treatment
• Prevention of recurrence
• Physical and psychological wellbeing

Although the American College of Surgeons mandated that physicians provide a survivorship care plan in 2012, the advice most patients receive is fairly general and, according to some studies, the plans increase patient concerns and anxiety rather than allay them.

Lifestyle changes for greater wellbeing during and after treatment

Integrative healthcare practitioners can be a good resource for people who want to develop and follow an approach to cancer survivorship the not only helps them achieve optimal physical and psychological wellness, but also helps to reduce their risk of the cancer’s recurrence. The plan should focus on several areas, including:

• Diet: A Mediterranean diet has been associated not only with reducing the risk of gastrointestinal, prostate, breast, and other cancers but also with better health overall. The diet focuses on eating more vegetables, fruits, healthy fats and whole grains and eating less meat, cheese, and sugary foods and drinks. Some researchers have also found that a Mediterranean diet may lower the risk of some of the side effects of cancer treatment. For example, the diet has been associated with a lower risk of cognitive decline in older people, which has led some researchers to posit it may play a similar role in protecting against the cognitive and psychological side effects some people experience as a result of chemotherapy and radiation such as “chemo brain” and depression.
• Exercise: During cancer treatment, exercise can help reduce fatigue. In fact, the National Comprehensive Cancer Network found that people who took part in moderate exercise during treatment had 40% to 50% less fatigue than people who were not active and other studies support that finding. Studies have also found that exercise helps people undergoing treatment sleep better and it reduces the risk of depression. Exercise has also been associated with reduced cancer risk. In light of that risk reduction, the American Cancer Society recommends all Americans take part in at least 150 minutes of moderate exercise each week.
• Stress management: Some studies have linked chronic stress with an increased risk of cancer progressing and spreading. Mindfulness can help people undergoing cancer treatment and those who are cancer survivors better manage stress. In addition, some studies have found an association between mindfulness practices and less pain, anxiety, depression, and insomnia in people who have survived cancer.
• Avoiding environmental toxins: Common chemicals present in polluted air, water, and soil, as well ingredients in some plastics, body care and cleaning products, can disrupt the endocrine system. These disruptions have been associated with a greater risk for some types of cancer, especially those fueled by hormones such as breast and prostate cancer. Survivors can reduce their exposure to many of these chemicals, and possibly their risk of recurrence or developing a new type of cancer, by carefully reading product labels and swapping commercial cleaning products for home made ones that use ingredients like white vinegar, baking soda, and lemon juice instead.
• Social support: Some researchers have found an association between psychological wellbeing and survival for people who have been diagnosed with cancer. A strong support network as well as a sense of meaning and purpose all contribute to that wellbeing, which can take many forms — from the support of friends, partners, and family to cancer support groups and connections with faith communities.