By Dr. Jessica Moore, ND (LivePure Spring 2022)
According to a recent study published in the Journal of Oncology, patients with breast cancer may have improved survival outcomes when offered support with complementary and lifestyle therapies, in addition to their standard conventional cancer treatment.
- 103 oncologists, at 103 institutions, participated in data collection for 173 patients with breast cancer.
- Oncologists reported the level of integrative services offered concurrent with standard treatment.
- Reports were scored based on the level of education, support and provision to patients for 12 integrative modalities including: nutrition, exercise, support groups, spiritual services, mental/emotional support, massage, meditation, yoga, acupuncture/acupressure, music/art therapy, reiki/therapeutic touch, and tai chi/qi gong.
- Scores were used to categorized institutions as low, low-mid, mid-high or high level of education and support involvement for integrative therapies.
- Integrative therapy involvement was assessed in relation to 5-year survival.
- Low-mid involvement was associated with a 3x better 5-year survival outcome.
- Mid-high involvement was associated with a 48% improved 5-year survival outcome.
- This suggests that even a moderate level of integrative support may improve survival outcomes for patients with breast cancer.
Of the 12 modalities considered, six were especially highlighted in the authors recommendations to include as part of an integrative therapy education/support offering.
These are exercise counselling, nutrition counselling, psycho-oncology support, chaplain services, patient support groups and meditation.
The findings are good news for patients with breast cancer. Cancer treatment is advancing towards more scientific breakthroughs in personalized medicine, genomic testing and precision treatments.
While looking to the oncologist for these high-level primary treatment therapies, patients can also be reminded and taught about the modifiable diet and lifestyle factors that they have control over and the integrative therapies available to them in their community.
Patients living with breast cancer have more control over their survival outcomes and quality of life than are generally discussed.
This is not to minimize the severity or potential for complications or mortality related to such a diagnosis.
Rather, the goal of integrative cancer care is to empower patients to become an active participant in their wellness and longevity.
There are many evidence-supported mind-body practices, natural products, and/or lifestyle modifications to assist in this goal.
Unfortunately, data shows that fewer than half of cancer survivors have had adequate teaching with their physician on basic integrative support such as diet, exercise, smoking or other lifestyle changes.
Meanwhile, well-placed evidence-informed integrative therapies can be strategically used to:
- Reduce side effects from conventional cancer treatment
- Minimize treatment interruptions (chemotherapy, radiation toxicity, surgery-related issues etc.)
- Optimize immune function
- Balance metabolism and hormones
- Reduce inflammation
- Improve functional capacity/performance status
- Reduce pain
- Reduce fatigue
- Support detoxification
Beyond quality of life and supporting conventional therapy, integrative approaches can also be used to improve metabolic health.
Cancer is now considered a metabolic disease; restoring balance to cellular energy metabolism may improve chances of tumor eradication and decrease chances of recurrence. In the setting of all types of breast cancer three very important metabolic factors should be considered:
Prolonged stress, or stress that is perceived as negative, can act as a carcinogen. It can increase inflammation, spike blood sugar, impair immune function, disrupt circadian rhythms, impede digestion and even aid in promoting angiogenesis (the development of new blood supply to tumors).
Studies link cancer incidence, progression, metastasis and mortality to unhealthy levels of stress. While we usually can’t just turn stress off or treat stress overnight, patients can work towards improving stress over time, identifying coping strategies, modifying current stressors, and healing after trauma. It’s important to identify and address the root cause.
Acupuncture, counselling, psychotherapy, massage, exercise, nutrition and targeted supplementation are frequently used to assist with stress management goals. A critical place to start is often in restoring healthy sleep.
Insulin and blood glucose
Metabolic syndrome, body composition, and biomarkers are not only risk factors for breast cancer but can worsen within 4–5 years post-breast cancer treatment and impact survival. At minimum, patients should be assessed for these risk factors including biomarkers such as:
- Cholesterol levels
- Inflammatory markers
- Glucose metabolism (HOMA-IR, insulin, IGF-1 and A1C)
- Body composition (Muscle mass, body fat percentage)
High insulin is linked to an increased risk of recurrence and death in women, especially with early-stage breast cancer, even in the absence of diabetes.
Elevated IGF-1 may also have a role in the development of breast cancer and is known to encourage the growth and proliferation of breast cancer cells.
Testing is done through simple blood work and non-invasive bioelectric impedance analysis. Should these tests come back abnormal, they are highly actionable through diet, lifestyle, supplements and in some cases, medication.
A systematic review of 16 studies in breast cancer survivors found a 27% risk reduction for breast cancer mortality if exercising prior to the diagnosis and a 38% reduction after the diagnosis.
Survival was also incrementally tied to the amount of exercise. Survivors who increased their physical activity by any level from pre-diagnosis to post-diagnosis showed a decreased total mortality risk compared to those who did not. Other single studies report risk reduction of up to 50% or more.
Muscle uses up insulin and helps regulate blood sugar. Muscle contraction leads to better bone density, improved circulation, improved strength/functionality, lower stress, better sleep and the production of myokines that are anti-inflammatory.
This article is for educational purposes only. Please ensure you discuss any changes to diet, lifestyle or any natural products with your naturopathic physician or healthcare provider before implementing them.
Dr. Jessica Moore, ND, has an integrative cancer focused clinical practice at Connect Health in Vancouver BC.