Lighter Steps On A Longer Path
Body mass index can affect the risk of breast cancer recurrence
As cancer treatments and outcomes continue to improve, the path of survivorship for women who have overcome breast cancer is fortunately growing wider and longer. These women must allow themselves plenty of rest on this long road, but they also need to keep their bodies moving as well. Exercise is one way for breast cancer survivors to lower or maintain their body mass index (BMI). Research has shown that a lower BMI may reduce the risk of recurrence of breast cancer for survivors.
Healthy eating is, not surprisingly, another essential way for breast cancer survivors to lower or maintain their BMI, according to Theresa Montoya-Houser, MD, a doctor of internal medicine at St. Joseph’s/Candler’s Primary Care located on Eisenhower.
“Breast cancer patients will benefit from making healthy food choices, as well as developing a regular physical activity program after treatment,” Montoya-Houser says.
A person’s BMI is determined by her height and weight. It does not differentiate between fat and muscle mass, but for the general population BMI is considered a simple and quick indicator of whether a person may be overweight. It works by assessing the discrepancy between a person’s actual body weight and the weight that is considered normal in relation to a particular height.
Medical research has discovered a relationship between a woman’s BMI and breast cancer risk both before diagnosis and after treatment.
“A BMI increase of five points or more in women between age 20 and postmenopausal age—55 to 74 years—created nearly twice the risk of developing postmenopausal breast cancer compared to women who maintained their BMI during the same time period,” Montoya-Houser says.
The range between 18.5 to 24.9 BMI is considered normal. From 25 to 29.9 BMI, a person is considered overweight, and from 30 to 39.9 they are considered obese (40 BMI or above is considered morbidly obese). A woman who has a 30 BMI when she is first diagnosed will have a higher risk of recurrence than a woman in the normal range. Why? If body fat, rather than muscle, is causing the higher BMI, that same fat is likely to cause inflammation and hormonal changes.
“Some studies have found that among women who gained weight after breast cancer diagnosis, each 11-pound gain was shown to be associated with a 13 percent increase in breast cancer-specific death,” Montoya-Houser says.
Aerobic exercise and strength training, as well as stretching exercises that improve range of motion, are all recommended by Dr. Montoya-Houser for breast cancer survivors, within their new level of ability.
Healthier fats, such as monounsaturated fats and omega-3’s, should become part of a breast cancer survivor’s diet, according to Toni Conner, a registered dietician in St. Joseph’s/Candler’s Wellness Center. An increase in fiber is also recommended, as well as a decrease in simple sugars like those found in candy and soda. Conner doesn’t believe that a survivor creating her new normal should cut those pleasures out entirely, though.
“You don’t have to take the favorite foods from your old life off the table, but you have to be smart about the portions and the frequency,” Conner says. “We don’t want to change more than we can maintain or we risk gaining the weight back. That kind of consistency—not pushing yourself beyond your long-term ability—is important in your exercise plan as well.”
Survivors will need to honestly assess their energy level and talk with their physician before beginning any work on their BMI. They will be faced with other choices during this recovery period—about things like work, social relationships, and symptoms that may persist even after their treatment is done. Though all of these challenges can be met successfully, it must be done under new terms.
“How we begin depends on our age, our condition, and what we are trying to achieve,” Conner says. “Once you have reached that first peak, you will naturally want to continue that forward motion.”