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Enhancing Cancer Survivorship Through Wellness Strategies

 

How can wellness strategies enhance cancer survivorship? Expert Dr. Amy Comander from Massachusetts General Hospital discusses research on lifestyle interventions, the role of nutrition and gut microbiome, and other impactful lifestyle interventions.

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Related Resources:

Survivorship Care: Screening and Lifestyle Strategies to Reduce the Risk of Secondary Cancers

Survivorship Care: Screening and Lifestyle Strategies to Reduce the Risk of Secondary Cancers

What Are the Benefits of Early Integration of Lifestyle Medicine?

What Are the Benefits of Early Integration of Lifestyle Medicine?

Equity in Cancer Care: Accessing Lifestyle Medicine for All

Equity in Cancer Care: Accessing Lifestyle Medicine for All

Transcript:

Lisa Hatfield:

Ensuring overall well-being during cancer treatment involves more than just addressing the illness itself. Wellness strategies are key but do they really optimize the health of cancer survivors? I’m getting to the bottom of it with a respected oncologist in this Patient Empowerment Network RESTORE program. 

Dr. Comander, what are some of the most effective wellness strategies you recommend for patients to incorporate during cancer treatment to support their overall well-being?

Dr. Amy Comander:

I’m really excited that over the past few years, we’re seeing more and more research demonstrating the important role of lifestyle interventions in terms of improving our patient’s outcome after a diagnosis of cancer. So I’m a breast oncologist, and of course there’s so much data in the field of breast oncology. But now we’re seeing so much data emerging with regard to individuals with prostate cancer or gynecologic cancers or hematologic malignancies, such as multiple myeloma.

So this is really an exciting time to be paying close attention to this field. So when you say, what are some of the most effective strategies? I have to pick my favorite exercise. This field of exercise oncology is really exciting, demonstrating that individuals who are able to engage in physical activity after their cancer diagnosis have improved quality of life, reduce cancer-related fatigue, and in many cases, improve outcome. And a lot of this data has certainly come from the field of breast oncology, but again, we are seeing it more and more in other types of cancers as well.

In terms of other wellness strategies, we’ve talked a lot about the important role of nutrition and thinking about some of those key concepts of what we consider an overall healthy diet, a predominance of fruits and vegetables, whole grains, limiting red meat, avoiding processed foods, and avoiding sugar-sweetened beverages and alcohol. So that’s kind of all part of a healthy diet that we think about. But more and more research is also demonstrating that diet can actually potentially influence outcome as well. And there’s a lot of research trying to understand the mechanisms of this.

And I think if your listeners are wondering, what’s an area where I can read more about this? I feel like the gut microbiome, learning more about that is really interesting. We know, for example, in the field of multiple myeloma research, or in the field of looking at immunotherapy drugs, a healthy, diverse gut microbiome, meaning those bacteria in your GI tract have favorable characteristics, and they’re very diverse and healthy, that is a reflection of the diet. Lots of healthy fruits and vegetables, fiber in the diet helps result in a healthy, diverse gut microbiome, which in emerging studies is showing that that is associated with an improved microbiome responsiveness to certain drugs, particularly immunotherapy.

So this is an exciting time. The field is evolving, but I’m excited to learn more as we continue to see these studies emerge.

Lisa Hatfield:

Thank you. And, Dr. Comander, how do you see lifestyle medicine contributing to optimizing the health of cancer survivors, particularly in reducing late effects and improving overall well-being?

Dr. Amy Comander:

I’m a strong advocate that these tools from lifestyle medicine should be a part of every patient’s cancer treatment. And these are pretty basic things when we think about, again, physical activity, encouraging exercise, following a healthy diet pattern, getting adequate sleep, social connection. Actually, let’s talk about social connection. I feel like that’s one when I first started getting to this field, I’m kind of like, yeah, social connection, that’s important.

But I will tell you, as I’ve been doing this more and more and working with groups of patients, focusing on providing education about diet and exercise and stress management and sleep and all of these important things that we’ve been talking about, I’ve noticed that the support from other individuals who truly get it, if you bring a group of patients together who are all going through treatment for multiple myeloma, or prostate cancer, or breast cancer, or whatever it may be, that support piece, talking to another person who’s facing the same challenge, who might want to meet you at the YMCA and go to that exercise class, or might be willing to text you, “Hey, how are you doing with those salads you’re trying to have for lunch each day?”

That accountability and support is such an important component of health. And I think we really learned during the pandemic how much social connection and support is so integral to our health. So I think in the field of oncology, the work this organization does, and so many others, that building up community, social connection, social support is really something we should invest more in to help improve the health and well-being of our patients with cancer.

Lisa Hatfield:

Absolutely agree. Thank you. You heard it here from Dr. Amy Comander. Thanks for joining this RESTORE Program. I’m your host, Lisa Hatfield.

How Does Cancer Treatment Impact Nutrition?

 

What are the impacts of cancer treatment on nutrition? Expert Dr. Amy Comander from Massachusetts General Hospital discusses the impact of chemotherapy and nutrition advice for overcoming the impacts of cancer treatment.

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Related Resources:

How Do Wellness Practices Impact Cancer Care Outcomes?

What Is Whole Person Care Exactly?

How Can Wellness Interventions Aid Patients During and After Treatment? 

Transcript:

Lisa Hatfield:

As a patient living with cancer, I’m always thinking about how my treatments might impact my nutrition or vice versa in some cases. Do I need to increase or decrease anything? Should I change my dietary patterns? I’m getting to the bottom of it with a respected oncologist in this Patient Empowerment Network RESTORE Program. 

Dr. Comander, can you give us a general overview of cancer treatment and its impact on nutrition?

Dr. Amy Comander:

Cancer treatment certainly has an impact on nutrition. And as I think about that, it kind of really depends where the patient is along his or her treatment journey. When we think about nutrition, certainly we know if an individual is going through active chemotherapy, often the taste buds change and things that used to be delicious don’t taste as good, and things that maybe a person didn’t like to eat all the time is the only thing he or she can tolerate, like a bagel. Nothing wrong with a bagel, but some of my patients tell me, “That’s all I can eat.”

But in general, when we think about a healthy approach to nutrition, I really counsel my patients on the benefits of a whole foods plant-predominant diet. Note I use the term plant-predominant. That just means it is so beneficial to consume a wide variety of fruits and vegetables and whole grains. Of course, it’s okay to incorporate a protein and maybe that’s a plant-based protein or maybe that’s fish or chicken, okay? But just thinking about the concept of half of the plate being full of fruits and vegetables is so important. And you might say, why is that so important?

Fruits and vegetables, the beautiful colors of various fruits and vegetables really reflect all those beneficial nutrients in the food that are also good for our gut microbiome, which is a term a lot of us hear now in the news, this term gut microbiome. And what does that really mean? Really refers to those microorganisms in our GI tract, gastrointestinal tract. And what’s really interesting is emerging research in some cancers is demonstrating that a healthy gut microbiome is really associated with how well certain treatments for cancer work.

So again, eating fruits and vegetables makes our gut microbiome healthy. And so this is so important for our health. Whole grains as well. Limiting red meat, limiting processed foods, limiting sugar-sweetened beverages. These are all the tips and tricks that I talk about with my patients. And if you want to really look this up and read about it and have a good understanding, again, the American Institute of Cancer Research and World Cancer Research Fund, on their website, they kind of have bullet points illustrating each of these points in terms of how we can approach a healthy diet after a cancer diagnosis.

Lisa Hatfield:

Okay, thank you so much for that information. A little shout out to a multiple myeloma doctor that I watch a lot, because that’s the type of cancer I have, her name is Dr. Urvi Shah, and she has done some research on that and recommends getting 30 different plant-based foods per week, not servings, but just the variety helps your gut microbiome. She’s done some research on that that I won’t go into here but, and it’s not that hard because we get to count all different kinds of lettuce in my salad, if I have romaine, spinach, and iceberg, there’s three right there. So thank you for those comments.

Dr. Amy Comander:

Yes, it’s a great tip to think about how can I get 30 different types of fruits and vegetables into my diet in a given week? And actually it’s kind of a fun challenge. So I love incorporating different types of lettuces into my salad. By the way, herbs count. So parsley, cilantro, things like that, those are plants. So it’s a fun game and it’s really a great way to make your gut microbiome happy and healthy.

Lisa Hatfield:

Okay, thank you. Dr. Comander, what are some key nutritional guidelines for cancer patients during and after treatment?

Dr. Amy Comander:

It’s so important to think about guidelines for nutrition because we know out there on the internet, TikTok, Instagram, Facebook, there’s all kinds of people giving nutrition information. And for a cancer patient, it is very confusing and very overwhelming. That’s why I like to stick to the basics. What do research organizations such as the American Cancer Society, American Society of Clinical Oncology, AICR, American Institute of Cancer Research, what are we recommending?

And again, it’s thinking about a healthy diet pattern which includes an emphasis on whole foods, with fruits and vegetables and whole grains, limiting red meats, avoiding processed meats, limiting sugar-sweetened beverages, avoiding processed foods. If you go to the grocery store and you pick up something and it has 35 ingredients and you don’t understand what most of them are, you probably shouldn’t be eating it, okay?

So these are all some of the general themes that we think about when it comes to nutrition. I know it can be very scary and overwhelming, but just if you, again, think of your plate and if half of it is comprised of fruits and vegetables, a quarter is some type of whole grain, when I say whole grain, think about brown rice, whole wheat pasta, and some grains out there like quinoa and farro that maybe you’ve never tried but are really delicious and good for us.

And then a quarter of that plate, some type of protein source, whether that’s a plant-based protein or perhaps fish or chicken or something like that. But that’s really a great approach to thinking about nutrition. Another point I really need to emphasize is limiting alcohol. So, many people don’t really think much of having a glass of wine or two with their dinner each night, but unfortunately we know that for an individual with a diagnosis of cancer, especially if you’re on new medications or going through chemotherapy, in the best case scenario, alcohol really should be avoided or limited really to special occasions. 

Lisa Hatfield:

You heard it here from Dr. Amy Comander. Thanks for joining this RESTORE Program. I’m your host, Lisa Hatfield.