(Title image: Photo by Hermes Rivera on Unsplash)
Many cancer patients complain of feelings of helplessness after their diagnosis, and I can certainly relate to that. As a result, I’m particularly interested in research that explores whether patients can gain control over the success of their treatments.
The most recent study I’ve come across includes breast cancer patients undergoing treatment at Yale and Dana Farber Cancer Centers.
This study appeared in the Journal of Clinical Oncology (Sanft et al., 2023). Researchers examined the effect of diet and exercise on “relative dose intensity” (RDI), which is the relationship between the amount of chemotherapy delivered to the patient compared to the standard amount prescribed. Low RDI means that there was a reduction in the chemotherapy the patient received and is generally associated with a poorer outcome. Dose reductions result from the patient’s difficulty in tolerating the drug.
The researchers also looked for “pathologic complete response” (pCR), which is “the lack of all signs of cancer in tissue samples removed during surgery or biopsy after treatment with radiation or chemotherapy” (definition from cancer.gov). This was for women receiving neoadjuvant chemotherapy, which is chemotherapy administered prior to surgery.
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The subjects of this study were women recently diagnosed with stage I-III breast cancer, who either received the “usual care” or a diet and exercise intervention. Those in the intervention group received nutritional counseling with a focus on a plant-based diet. The physical activity included counseling and support for maintaining a home-based exercise program that included strength training (2x/week) and brisk walking (150 min/week of moderate intensity or 75 min/week of vigorous intensity).
What the research confirmed first was that the subjects in the intervention group were able to increase their exercise and diet quality, which showed that it was feasible to make lifestyle improvements even in the midst of chemotherapy.
However, in this study, the RDI for both groups (“usual care” and diet & exercise intervention) ended up being similar, but also quite high, which meant that women in both groups completed most of their treatment. The researchers noted that the study should be re-run with patients who were at greater risk of not being able to complete all their chemo to see how much of an effect improved diet and exercise would have, especially since exercise has been shown in other studies to have a positive effect on patient outcomes.
But a striking difference was seen for women receiving neoadjuvant (prior to surgery) chemotherapy in that the rates of pCR (disappearance of cancer in the tissues) were 53% for women in the intervention group versus 28% for women receiving usual care. That suggests that the intervention enabled the chemotherapy to be more effective.
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The researchers stated the following in summarizing their study: “Given that pCR is an accepted predictor of recurrence and mortality, our findings could provide oncologists with a supportive care intervention that affects the ability to potentially improve survival outcomes” (Sanft et al., 2023, J Clin Oncol). And this is very good news indeed.
The take-home message here is not surprising, and it’s good advice for life in general: no matter what your current lifestyle, prioritizing a healthier diet (emphasis on whole foods, plant-based, less processing, etc.) and engaging in regular cardiovascular and strength training exercise will improve your quality of life. It is always worth the effort.
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REFERENCE:
Sanft et al. (2023) Randomized Trial of Exercise and Nutrition on Chemotherapy Completion and Pathologic Complete Response in Women With Breast Cancer: The Lifestyle, Exercise, and Nutrition Early After Diagnosis Study. J Clin Oncol, 41: 5285–5295. https://doi.org/10.1200%2FJCO.23.00871. [This paper is Open Access and can also be found in PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10691793/]
Frantic Shanti 