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New recommendations from ASCO surrounding diet & exercise during active chemotherapy

August 02, 2022

young woman doing abs exercise on a yoga mat

Recently An American Society of Clinical Oncology Journal (ASCO) released new guidance around recommendations for exercise and diet during active chemotherapy treatment. These updates go against the standard chemotherapy recommendations for diet and exercise. In the past telling patients to eat comfort foods such as mashed potatoes and milkshakes was the norm. As long as they were eating, the doctor was happy. When it came to exercise, doctors didn’t put much emphasis on it. Netflix and Chemo was considered standard advice. 

It’s understandable why many doctors took this approach for so long. Cancer treatment is very taxing which can make it hard to have the energy to exercise and to keep food down. That being said, the new ASCO guidelines place a emphasis on diet and exercise. These guidelines are based on 52 systematic reviews (42 for exercise, nine for diet, and one for weight management) and an additional 23 randomized controlled trials. All of which identified systematic reviews and randomized controlled trials evaluating the impact of aerobic and resistance exercise, specific diets and foods, and intentional weight loss and avoidance of weight gain in adults during cancer treatment, on quality of life, treatment toxicity, and cancer control.

If you are struggling to eat well and exercise during breast cancer treatment, know that you are not alone. A 2017 study from Memorial Sloan Kettering researchers found that 75% of people with cancer reported reducing their physical activity following their diagnosis. That lower activity level often persisted for a year or more.

To give you some extra motivation, let’s take a closer look at the new ASCO guidelines on diet and exercise as well as other studies that illustrate just how important a healthy lifestyle during treatment is. 

New ASCO Guidelines on Diet and Exercise

The reviews and trials used to form these new guidelines most commonly studied breast, prostate, lung, and colorectal cancer and found that exercise during cancer treatment led to improvements in cardiorespiratory fitness, strength, fatigue, and other patient-reported outcomes. 

Based on these new findings, what does ASCO recommend patients do in regards to diet and exercise during active chemotherapy?

When it comes to diet, there was a belief in the past that neutropenic diets (specifically diets that exclude raw fruits and vegetables) increased risk of infection during cancer treatment, but this was found to no longer be true and that a diet full of fruits and vegetables was much more beneficial when it came to treatment outcome. 

ASCO believes that oncology providers should recommend regular aerobic and resistance exercise during active treatment. They found that exercise during active treatment improved patient quality of life and patient reported outcomes.

The Breast Cancer Diet Shopping List

Again—neutropenic diets excluding raw fruits and vegetables are no longer something doctors are advised to tell patients to avoid during active treatment and should be encouraged into survivorship. It’s better for cancer patients to avoid processed foods and fill up on nutrient dense options. A 2018 study from the American Cancer Society found that a 10% increase in the percentage of ultra processed foods in the diet was associated with an 11% increase in breast cancer risk.

While there is no one recommended dietary plan for patients with breast cancer, it’s generally considered best to eat a well rounded diet full of whole, nutrient-dense foods. Make sure to add the following food categories to your shopping list—which we are purposely keeping vague so you can choose the foods in each category that most appeal to you.

If you need help finding a diet that works for you during breast cancer treatment, there are oncology dietitians who specialize in creating meal plans for cancer patients.

You can learn more about nutrition and breast cancer here

The Breast Cancer Exercise Routine

Breast cancer treatment can be very taxing physically, so we know that the last thing we want patients to hear is that they need to hit the gym. Luckily, you don’t need to have an intense fitness routine to reap the benefits of regular exercise during treatment. There is moderate scientific evidence that found that physical activity following a breast cancer diagnosis lowers risk of breast cancer death. Also there is strong scientific evidence that physical activity after a breast cancer diagnosis can improve fatigue as well as reduce anxiety and reduce depressive symptoms. 

A new study from Memorial Sloan Kettering exercise scientist Lee Jones shows that women with early-stage breast cancer can reduce their risk of long-term heart problems with exercise. Cardiovascular disease is the leading cause of side effects and early death in these patients.

According to a 2017 study from the journal of Neuropsychiatric Disease and Treatment, regular aerobic exercise improves cancer-related fatigue. While the thought of exercise may be daunting when feeling fatigued, it can help improve your energy levels and mood.

The good news is, you can start slow. The American Cancer Society suggests building up your activity if you’ve been diagnosed with cancer by making small efforts and building on them until you can manage 150 minutes of moderate exercise or 75 minutes of vigorous-intensity activities on a weekly basis. 

If you need help developing an exercise routine, Livestrong at the YMCA has developed a 12-week program led by an exercise specialist trained to work with cancer patients that is low or no cost to those dealing with cancer. 

Symptoms a Good Diet and Exercise Can Improve

If you’re experiencing side effects from breast cancer treatment, you may be pleasantly surprised to find out the small diet or exercise (or both) changes can help with the following symptoms. 

Keep track of any symptoms you’re experiencing so you can bring as much information as possible with you to your next doctor’s appointment and report if any have been alleviated by your new good habits.

Download the Outcomes4Me app for free to use our detailed symptoms tracker!