Physical activity and breast cancer.

There are many reasons why exercise is encouraged for the breast cancer patient. Physical activity can improve or maintain your physical abilities. It can improve your balance and lower your risk of falls and broken bones. It can keep your muscles healthy and prevent wasting of muscles if there is inactivity due to cancer treatments.

Exercise can lower your risk of heart disease as well as the risk of osteoporosis. It can also increase blood flow and lower your risk of blood clots. Exercise can decrease nausea, lessen symptoms of fatigue, improve your mental outlook such as self-esteem, and reduce anxiety and depression. Physical activity will help you control your weight and can overall improve the quality of life for breast cancer patients.

Hormone receptor positive breast cancer patients are often treated with anti-estrogen therapy such as Tamoxifen or an aromatase inhibitor such as Arimidex. Tamoxifen is very well tolerated but sometimes can have side effects – the most common being hot flashes and weight gain, which physical activity has been found to reduce. Aromatase inhibitors block the production of estrogen in postmenopausal women and have very common side effects such as hot flashes and bone loss or osteoporosis. Regular physical activity can help reduce some of this bone loss.

It is very important to encourage physical activity for women with breast cancer. Exercise can significantly improve her quality of life during and after cancer treatment!

  • Multiple studies have demonstrated an increased risk of breast cancer with alcohol use.
  • When compared to teetotalers, women who drink the equivalent of a half of a glass of wine per day were 6% more likely to develop breast cancer. Women who drank 1-2 glasses a day have an increased risk of 21% chance of developing breast cancer. Women with heavy alcohol use of 2 or more drinks a day were 37% more likely to be diagnosed with breast cancer.
  • In women, breast cancer comprises approximately 60% of all alcohol-related cancers.
  • Research shows that drinking alcoholic beverages consistently increases a women’s risk of breast cancer, especially hormone receptor positive breast cancer. This makes sense because alcohol can increase levels of estrogen in the body, which is related to hormone receptor positive breast cancer.
  • If you want to do everything you can to lower your breast cancer risk, you can stop drinking alcohol completely. If you plan to continue drinking, try to have two or fewer alcoholic beverages per week.
  • Drinking is social for most of us. If you want to have a drink, consider some of the drink options that don’t include alcohol – the makers of nonalcoholic beverages have improved the taste of their products and they are now widely available.

The link between breast cancer and gut health.

Do you know that ER+ breast cancer is one of the most common breast cancers diagnosed (about 70-80%)? ER+ breast cancer means the cancer cells respond to and get growth signals from estrogen. Some very interesting research has looked at all the microorganisms in our gut and their relationship to the estrogen in our body. One of the key indicators of having a healthy gut is to have diverse and abundant microbiome (DNA of gut flora).

Recent studies suggest that gut microbes play a crucial role in regulating circulating estrogen levels. The estrobolome, a subset of microbiome, controls estrogen through two mechanisms: (1) increasing gut permeability (aka. leaky gut) for estrogen to slip out into the blood stream and (2) secreting an enzyme, called β-glucuronidase, that breaks down estrogen into their active forms to bring estrogen back to the body instead of being eliminating in the feces. As a result, your body becomes more estrogen dominant and therefore, the hormone sensitive tissue like the breasts can be affected.

This is still a new concept in research but has an exciting application for us. Taking care of our microbiome is one of the ways that may have a major impact on reducing the risk of breast cancer and recurrence, and overall wellbeing may be improved by reducing inflammation and obesity.

Having a diverse and balanced microbiome is critical in gut health and the immune system. Simply speaking, promoting a healthy balanced microbiome may help you regulate estrogen naturally. Here are a few tips you can try:

1. Eat plenty of vegetables, composed of ALL colors, plus introduce fermented vegetables to boost your gut flora.

2. Avoid trans-fat and corn syrup, which will increase inflammation in the gut and also liver, which are the major detox systems in your body.

3. Reduce sugar consumption — bad bugs tend to like “sweet treats.”

4. Reduce stress which can significantly compromise a diversity of gut microbes.

5. Walking in nature: did you know spending time in nature can actually diversify a healthy microbiome without taking probiotics?

6. Go green: try to minimize plastics, which can contain a lot of toxic chemicals, such as bisphenol-A(BPA). Good bacteria can’t thrive in the chemical environment.

7. Be aware of some medications which can disturb a healthy microbiome such as antibiotics, acid reducers and steroids.

8. Try to have a good bowel movement daily to make sure you are excreting an excess of estrogen.

9. Lastly, get adequate sleep at night. Research shows that the disrupted or shifted circadian rhythm can compromise your gut flora.

Reference: Maturitas 103 (2017) 45–53; JNCI J Natl Cancer Inst (2016) 108(8)
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