Miki Scheidel contributed to this post.
This post was first published as an invited post on the Centre for Health Innovation blog. It has been slightly edited here.
We expect that you’ve already heard that you should eat better, exercise more, get enough sleep, manage your weight, stop smoking, and other similar advice from your doctor and others. Did you know that being active in your wellness by building these practices and lifestyle choices can improve your outcomes with conventional cancer treatments such as chemotherapy, surgery, and immunotherapy?
Your ability to recover from surgery, chemotherapy, or radiotherapy is typically better if you have better nutrition, more muscle mass, less excess body weight, and no tobacco use.
Not only are these goals “good for you” in an abstract sense—they may make your life better in ways that you will notice during and after cancer treatment. Shorter hospital stays after surgery. Less sleep disruption. Less fatigue. Less pain. And all without the side effects and the high price tags that many medications have.
Your survival after a cancer diagnosis is also affected by these choices and practices. A better diet, more exercise, better sleep, and better stress management are all linked to longer survival. Even your response to conventional treatments can depend in part on your health status. The composition of your microbiome—your personal collection of microbes living on and in your body—may influence how well you respond to immunotherapy, for example.1Aghamajidi A, Maleki Vareki S. The effect of the gut microbiota on systemic and anti-tumor immunity and response to systemic therapy against cancer. Cancers (Basel). 2022 Jul 22;14(15):3563; Hu Y, Li J et al. CAR-T cell therapy-related cytokine release syndrome and therapeutic response is modulated by the gut microbiome in hematologic malignancies. Nature Communications. 2022 Sep 9;13(1):5313; Wang F, He MM et al. Regorafenib plus toripalimab in patients with metastatic colorectal cancer: a phase Ib/II clinical trial and gut microbiome analysis. Cell Reports. Medicine. 2021 Aug 27;2(9):100383; Baruch EN, Youngster I et al. Fecal microbiota transplant promotes response in immunotherapy-refractory melanoma patients. Science. 2021 Feb 5;371(6529):602-609; Hopkins AM, Kichenadasse G, Karapetis CS, Rowland A, Sorich MJ. Concomitant antibiotic use and survival in urothelial carcinoma treated with atezolizumab. European Urology. 2020 Oct;78(4):540-543. What you eat has a direct and rapid effect on the composition of your microbiome. Exercise, smoking, obesity, and stress are also linked to the health of your microbiome.
You can be active in your wellness after a cancer diagnosis, starting with the 7 Lifestyle Practices. These are known to improve outcomes including survival, risk of recurrence, or symptoms and side effects from cancer or its treatment. Many directly influence your body terrain—your internal environment of hormones, inflammation, blood sugar, oxidation, microbes, and more—which is tied to cancer growth and spread.
At the center of these practices is Exploring What Matters Now. When diagnosed with cancer, your insights related to this exploration may be your best guide to the treatments you wish to take, your priorities in life, and how you want to live. Once you have some clarity with what matters now for you (although your answers may shift over time), you can start looking at the other six practices. As Co-Founder of CancerChoices Michael Lerner advises, “Do what you are drawn to. No practice is healing unless it feels healing.”
Each practice includes a description, the evidence supporting it, and what experts recommend. We provide tips and links to trusted resources such as apps and groups and websites for making changes to support you as you begin and maintain changes. For some practices, such as Sleeping Well and Managing Stress, we describe therapies that can help you achieve these practices.
If you’re not ready for change now, we’ll be there later without any judgment whenever you are ready to begin or if you stumble a bit after getting started. You’re in the driver’s seat. We’re ready to navigate for you. At your time and pace.
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References
Ms. Hepp is a researcher and communicator who has been writing and editing educational content on varied health topics for more than 20 years. She serves as lead researcher and writer for CancerChoices and also served as the first program manager. Her graduate work in research and cognitive psychology, her master’s degree in instructional design, and her certificate in web design have all guided her in writing and presenting information for a wide variety of audiences and uses. Nancy’s service as faculty development coordinator in the Department of Family Medicine at Wright State University also provided experience in medical research, plus insights into medical education and medical care from the professional’s perspective.
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