Research on Health for Advanced Cancer

I had been invited to talk at the Mount Hospital to a group of advanced breast cancer survivors, but that got cancelled. I have already put together my findings, so I figured I'd post them here (they're after the jump). Let me highlight a couple things here to help explain the research.

First, there's still very little understanding about the behavior and physiology of advanced cancers. Second, there's even less research into exercise or nutrition specifically for advanced cancer. On the exercise side, one reason for the lack of info is that clinicians are genuinely scared to work with this population as they're afraid exercise may do more harm than good. Lastly, and I can't stress this enough, advanced cancer survivors should ONLY take nutritional advice that is specifically prescribed to them after a thorough assessment of their needs and cross-examination with their treatment regimens, and this should ONLY come from a qualified nutritionist who specializes and has lots of experience in oncology.

Research findings on physical and mental health in advanced cancer survivors

Exercise

• Exercise is safe
• Studies have used walking, yoga, gym programs like Curves, and personal training in a hospital (no details given, but generally well rounded program) and none have had adverse effects
• Main concern during exercise: putting stress on a bone or joint with metastases present
• Frequency and duration
• 3-5 hours weekly
• one intervention did 2x/week, 60 min/session and still found benefit (this was the one like Curves)
• Goals and limitations
• Bone metastases may limit activity choices
• ER- tends to be more complicated: do not be frustrated by only maintenance rather than improvement

 Nutrition

• #1 rule: need to work with a nutritionist to meet specific needs based upon treatment regimens
• Block center in Chicago: “diet emphasizes whole grains, fruits and vegetables with low GI, and proteins from plants, fish, dairy alternatives and egg whites.”
• Also used wide range of supplements
• Meta-analysis of nutritional evidence for progression and recurrence
• Limiting alcohol, maintaining a healthy weight (BMI 20-24) only factors with strong research evidence
• Moderate evidence for limiting fat and red meat
• Not enough evidence to support a wide range of common recommendations, including
• Preferring vegetable fat over animal fat
• Many supplements, including omega 3 fatty acids
• Fruit and vegetable consumption
• Limiting phytoestrogen consumption
• Increasing the part of slowly absorbed glucids

 Mental well being

• Acceptance of things out of control while “maximizing control and engagement with life”
• Importance of expression emotions
• Allow yourself some times for escapism/avoidance
• Amongst ER- patients, those who participated in a supportive-expressive group therapy program survived 20 months longer than a control group