Movement is Medicine - It's never too late to start if you have (or had) Breast Cancer!

The Importance of Physical Activity in Breast Cancer Patients

The World Health Organization (WHO) recommends 150 minutes (about 2.5 hours) of moderate to vigorous-intensity physical activity per week for adults, which has been shown to reduce the risk of developing cardiovascular disease, diabetes and depression, can improve bone health, and reduce all-cause mortality [1, 2]. Additionally, regular physical activity has also been demonstrated to support breast cancer patients before diagnosis, during treatment and in survivorship.

IMPACT OF PHYSICAL ACTIVITY BEFORE DIAGNOSIS

Research has shown that women who were physical activity before being diagnosed with breast cancer had decreased mortality from breast cancer and all-causes compared to women who were not physically active before diagnosis [4, 6]. One of these studies also found that women who were sedentary (not physically active) before diagnosis but started exercising after diagnosis had a 45% lower risk of death from breast cancer compared to women who were not physically-active before or after diagnosis [6]. This impact was achieved just by engaging in brisk walking 2-3 hours per week!

EXERCISE DURING CANCER TREATMENT IS SAFE AND EFFECTIVE

One study looked at how exercise impacts the health of patients with stage II+ breast cancer. They found that engaging in exercise was safe for these patients, and was associated with improvements in quality of life, fitness level, fatigue, strength, mental health, and weight [3]. Another study conducted on breast cancer patients undergoing chemotherapy found that more intense exercise regimens (50-60 minutes 3 times per week) were slightly better than moderate-intensity exercise regimens (25-30 minutes 3 times per week) in improving pain, hot flashes, and strength, however both regimens were effective in managing side effects from chemotherapy [5].

PHYSICAL ACTIVITY AFTER TREATMENT IS STILL BENEFICIAL

Research on breast cancer survivors has also shown benefit. One study found that breast cancer survivors who practiced 150 minutes of moderate-intensity exercise per week had a 27% decrease in all-cause mortality (ie. dying from any cause) and a 25% decrease in breast cancer mortality, compared to women who had lower levels of physical activity [2].

MOVEMENT IS MEDICINE

So, what does this mean? It’s never too late to increase your levels of physical activity! No matter where you are on your health journey, physical activity appears to benefit health by reducing risk of dying from cancer and other causes and improving side effects during treatments. As always, talk to your doctor to make sure you are engaging in physical activity that is safe for you!

WHAT CAN I DO TO INCREASE MY PHYSICAL ACTIVITY LEVELS?

There are a number of ways to increase physical activity and movement in your daily schedule! An easy way to remember the difference between moderate-intensity and vigorous intensity exercising is talking and singing - at a moderate level of intensity, you can talk but would find it difficult to sing; at vigorous-intensity, it would be difficult to talk. Here’s a few ideas:

• Take the stairs instead of the elevator

• Walk or bicycle to work, or walk the kids to school

• Go for walks before or after work, or during the day

• Take up a sport or hobby that involves movement, like dancing, tennis, swimming

• Raking the leaves, shovelling snow, gardening

• Yoga, tai chi and Qigong

• Household chores like vacuuming, mopping

• Our favourite at Saskatoon Naturopathic Medicine: 15 minute at-home dance session - just turn on your favourite song and dance!

References:

[1] https://www.who.int/dietphysicalactivity/physical-activity-recommendations-18-64years.pdf

[2] Beasley, J. M., Kwan, M. L., Chen, W. Y., Weltzien, E. K., Kroenke, C. H., Lu, W., Nechuta, S. J., Cadmus-Bertram, L., Patterson, R. E., Sternfeld, B., Shu, X.-O., Pierce, J. P., & Caan, B. J. (2012). Meeting the physical activity guidelines and survival after breast cancer: Findings from the after breast cancer pooling project. Breast Cancer Research and Treatment, 131(2), 637–643. https://doi.org/10.1007/s10549-011-1770-1

[3] Singh, B., Spence, R. R., Steele, M. L., Sandler, C. X., Peake, J. M., & Hayes, S. C. (2018). A Systematic Review and Meta-Analysis of the Safety, Feasibility, and Effect of Exercise in Women With Stage II+ Breast Cancer. Archives of Physical Medicine and Rehabilitation, 99(12), 2621–2636. https://doi.org/10.1016/j.apmr.2018.03.026

[4] Lahart, I. M., Metsios, G. S., Nevill, A. M., & Carmichael, A. R. (2015). Physical activity, risk of death and recurrence in breast cancer survivors: A systematic review and meta-analysis of epidemiological studies. Acta Oncologica (Stockholm, Sweden), 54(5), 635–654. https://doi.org/10.3109/0284186X.2014.998275

[5] Courneya, K. S., McKenzie, D. C., Mackey, J. R., Gelmon, K., Friedenreich, C. M., Yasui, Y., Reid, R. D., Cook, D., Jespersen, D., Proulx, C., Dolan, L. B., Forbes, C. C., Wooding, E., Trinh, L., & Segal, R. J. (2013). Effects of exercise dose and type during breast cancer chemotherapy: Multicenter randomized trial. Journal of the National Cancer Institute, 105(23), 1821–1832. https://doi.org/10.1093/jnci/djt297

[6] ​​Irwin, M. L., Smith, A. W., McTiernan, A., Ballard-Barbash, R., Cronin, K., Gilliland, F. D., Baumgartner, R. N., Baumgartner, K. B., & Bernstein, L. (2008). Influence of pre- and postdiagnosis physical activity on mortality in breast cancer survivors: The health, eating, activity, and lifestyle study. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology, 26(24), 3958–3964. https://doi.org/10.1200/JCO.2007.15.9822

REDUCE YOUR CANCER RISK!

CANCER PREVENTION

Prevention is the action of stopping something from happening. We often focus on how to support a person who has already been diagnosed with a health condition, however a big focus on health should be ways in which we can prevent the condition from occurring in the first place. Although cancers can develop for many reasons outside our control, there are many factors which we can change (called modifiable factors), which may alter our risk for developing cancer and other chronic diseases. By addressing these modifiable factors, we can focus on prevention.

As you can see from the table above, there are a number of influencing factors that we have the ability to change. In this article, we will briefly touch on some of these modifiable factors and how they impact our health with respect to cancer prevention, and how naturopathic medicine can help!

Diet

Although the information isn’t very clear regarding the impact our diet has on the risk of developing cancer, there are a few associations that have been found between certain dietary factors and cancer risk, according to the World Cancer Research Fund/American Institute for Cancer Research [1-4]:

• Eating whole grains and high fiber foods (such as fruit, vegetables and legumes) is associated with a protective effect against developing colorectal cancer

• Diets high in “fast foods” or processed foods (which are typically higher in trans/saturated fats, salt and sugar) are associated with increased risk of developing obesity, which is associated with increased risk of cancer

• Higher intakes of red and processed meat are associated with an increased risk in developing colorectal cancer

• High intake of sugar, including in beverages such as soda pop, can contribute to overweight/obesity, which is a risk factor for developing many cancers

Eating a diet high in fruits, vegetables, legumes and whole grains, healthy fats and lean proteins, and limited intake of processed foods and sugar is a great step toward cancer prevention, as well as prevention of other health conditions like obesity. At Saskatoon Naturopathic Medicine, we work with patients to develop an individualized diet plan addressing these risk factors and recommend healthier alternatives.

Physical Activity

Being physically active is associated with a reduced risk of developing colorectal, breast and uterine cancer, and also helps prevent excess weight gain and obesity.

The World Health Organization (WHO) recommends that adults should be physically active most days of the week, for at least 150 minutes of moderate-intensity physical activity per week. Some examples of moderate-intensity exercise include shovelling snow, jogging, swimming, bicycling, and dancing. By incorporating more physical activity into our week, we are also reducing the amount of time we spend sitting (called sedentary activity), which on its own is a risk factor for developing other conditions like obesity [5].

Toxic Exposures and Lifestyle Factors

Toxic exposures refers to exposures of substances that have the potential to cause harm in high amounts. Exposures can occur through our occupation, the environment (ie. pollution, contaminated water, etc), our diet, and even the hygiene and cosmetic products we use every day (ie. deodorants, perfumes, etc). For example, there are chemicals known as endocrine disrupting chemicals (EDCs) which can interfere with our own hormonal (endocrine) system, and can result in an increased risk of developing hormone-associated cancers such as breast cancer. EDCs can be found in plastics, shampoos and other cosmetics, pesticides and others [6].

Two other important toxic exposures to discuss are cigarette smoking and alcohol intake, both of which are strongly associated with increased risk of developing cancer. At Saskatoon Naturopathic Medicine, we assess what exposures to toxic substances you may have been or are currently exposed to, and offer recommendations and tools to help reduce exposures and support the body’s own ability to naturally detoxify.

For more information about reducing your exposures to environmental risk factors, check out this webpage by the Canadian Cancer Society: https://cancer.ca/en/cancer-information/reduce-your-risk/know-your-environment.

Immune Health and Stress

In addition to decreasing the risk of infection, our immune system plays an important role in the development of cancer. A type of white blood cell, called a natural killer (NK) cell, is one of the main immune cells responsible for recognizing cancer cells and preventing them from growing and moving to other areas in the body [7]. Some factors that play a role in how well our immune system functions are adequate sleep, a healthy diet, physical activity levels, sources of inflammation, nutrient deficiencies, and stress levels. It is important to look at any reasons why our immune system may not be functioning optimally, and address these factors to support our health.

The impact of stress on cancer development is still unclear, however there are indirect associations with stress on risk of developing cancer. As mentioned above, stress can impact how well our immune system functions, and can also impact our sleep quality. There are ways in which we can reduce the impact stress has on our health, including meditation, yoga or other restorative exercises, acupuncture, journaling and counselling. Naturopathic Doctors are trained in acupuncture, and are knowledgeable in many stress supports including lifestyle modifications and nutrients/botanicals to manage the body’s stress responses.

There are many ways in which we can make healthier changes to help in the prevention of chronic diseases such as cancer and others like cardiovascular disease and obesity. At Saskatoon Naturopathic Medicine, our Naturopathic Doctors are well-trained in assessing the overall health of patients and identifying where support may be needed. Prevention of disease is not commonly discussed, however it is one of the guiding principles of naturopathic medicine [8] and vital to our overall health.

References:

[1] https://www.wcrf.org/dietandcancer/eat-wholegrains-vegetables-fruit-and-beans/

[2] https://www.wcrf.org/dietandcancer/limit-fast-foods/

[3] https://www.wcrf.org/dietandcancer/limit-red-and-processed-meat/

[4] https://www.wcrf.org/dietandcancer/limit-sugar-sweetened-drinks/

[5] https://www.wcrf.org/dietandcancer/be-physically-active/

[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7731339/

[7] https://molecular-cancer.biomedcentral.com/articles/10.1186/s12943-020-01238-x

[8] https://aanmc.org/6-principles/

Mistletoe and Cancer Care - It does more than spark a kiss!

Mistletoe and Cancer Care - It does more than spark a kiss!

A plant commonly associated with the holidays, Viscum album, also known as mistletoe, is a natural therapy used often in integrative cancer care. Mistletoe is a semi-parasitic plant that grows on a variety of trees from which it obtains its nutrients. It contains a variety of compounds, the most commonly studied of which are lectins, that have been shown to stimulate the immune system and have anti-cancer effects. Cell studies on mistletoe extracts have demonstrated inhibition of cancer cell growth [3] and increase in immune function parameters, including natural killer cells, which are white blood cells responsible for the destruction of tumor cells [4, 5].

Mistletoe is primarily administered as a subcutaneous injection, and commonly used alongside chemotherapy, radiation therapy and/or other conventional treatments in countries such as Switzerland, Germany, and Austria to improve quality of life and manage side effects associated with treatments in patients with cancer [2]. 

Numerous studies have been conducted on the therapeutic use of mistletoe. One of the best methodologically-designed studies was conducted on mistletoe in advanced pancreatic cancer patients, which suggested that patients in the mistletoe treatment group had longer overall survival times compared to those in the control group [6]. The majority of research on mistletoe suggests it supports quality of life in cancer patients and decreases severity and frequency of treatment-related side effects [8, 9]. Mistletoe is generally well-tolerated and safe to use alongside various common chemotherapeutic agents [7].

To learn more about mistletoe therapy, contact us and/or book an appointment with Dr. Dana Kolenich ND!

[1] Pelzer F, Tröger W. Complementary treatment with mistletoe extracts during chemotherapy: safety, neutropenia, fever, and quality of life assessed in a randomized study. J Altern Complement Med. 2018; 24(9-10):954-961. https://pubmed.ncbi.nlm.nih.gov/30247950/

[2] Melzer J, Iten F, Hostanska K et al. Efficacy and safety of mistletoe preparations (Viscum album) for patients with cancer diseases. A systematic review. Forsch Komplementmed. 2009; 16(4):217-226. https://pubmed.ncbi.nlm.nih.gov/19729932/

[3] Eggenschwiler J, von Balthazar L, Stritt B, et al. Mistletoe lectin is not the only cytotoxic component in fermented preparations of Viscum album from white fir (Abies pectinata). BMC Complement Altern Med. 2007; 7:14. https://pubmed.ncbi.nlm.nih.gov/17493268/

[4] Büssing A, Rosenberger A, Stumpf C et al. Development of lymphocyte subsets in tumor patients after subcutaneous administration of mistletoe extracts. Forsch Komplementmed. 1999; 6(4):196-204. https://pubmed.ncbi.nlm.nih.gov/10529579/

[5] Beuth J, Ko HL, Gabius HJ, et al. Behaviour of lymphocyte subsets and expression of activation markers in response to immunotherapy with galactoside-specific lectin from mistletoe in breast cancer patients. Clin Investig. 1992; 70(8):658-61. https://pubmed.ncbi.nlm.nih.gov/1392440/

[6] Viscum album [L.] extract in patients with locally advanced or metastatic pancreatic cancer: a randomised clinical trial on overall survival. Eur J Cancer. 2013; 49(18):3788-97. https://pubmed.ncbi.nlm.nih.gov/23890767/

[7] Weissenstein U, Kunz M, Urech K et al. Interaction of standardized mistletoe (Viscum album) extracts with chemotherapeutic drugs regarding cytostatic and cytotoxic effects in vitro. BMC Complement Altern Med. 2014; 14:6. https://pubmed.ncbi.nlm.nih.gov/24397864/

[8] Beuth J, Schneider B, Schierholz JM. Impact of complementary treatment of breast cancer patients with standardized mistletoe extract during aftercare: a controlled multicenter comparative epidemiological cohort study. Anticancer Res. 2008; 28(1B):523-7. https://pubmed.ncbi.nlm.nih.gov/18383896/ 
[9] Tröger W, Galun D, Reif M, et al. Quality of life of patients with advanced pancreatic cancer during treatment with mistletoe: a randomized controlled trial. Dtsch Arztebl Int. 2014; 111(29-30):493-502. https://pubmed.ncbi.nlm.nih.gov/25142075/

The Role of Naturopathic Medicine in Integrative Cancer Care

Many people diagnosed with cancer seek out the use of naturopathic therapies. It is important to ensure patients implement naturopathic supports under the direction of a knowledgeable naturopathic doctors. Cancer is a multifaceted disease and each individual’s health journey with cancer is unique. From prevention to active surveillance to receiving conventional care, regardless of where a patient is on their cancer journey, naturopathic medicine can provide support through:

1. Addressing fundamental basics of health: Naturopathic doctors have extensive knowledge about lifestyle, diet, sleep, stress, environmental factors and other fundamental aspects of health. NDs can provide information on optimal dietary and lifestyle choices for pre- and post-surgery, chemotherapy and radiation, as well as during survivorship and for promoting prevention. In addition to diet, naturopathic medicine can support quality sleep,  reduce stress levels, support mental health, and optimize overall health. 

2. Conventional treatment support: Naturopathic medicine can support conventional treatments through implementing evidence-based therapies that can limit or reduce side effects and that work synergistically with conventional care. Naturopathic doctors are trained in interpreting lab reports and understanding safety and interactions between naturopathic and conventional medicines.

3. Education and advocacy: NDs provide education to patients and family members with the goal of empowering patients throughout their journey with cancer. We understand the importance of communications and referrals, and we work alongside a patient’s conventional care team to provide patient-centered comprehensive care. 

A diagnosis of cancer can be overwhelming and take a significant toll on a person’s overall health. Naturopathic doctors  strive to learn about their patients and their experiences in order to provide them with purely individualized care, education and empower them and their loved ones to optimize their health throughout their cancer journey.