Taking control of your health

Tuesday 1 April, 2014

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On this page: Maintain a healthy body weightEat more fruit and vegetables | Frequently asked questions about food | Quit smoking | Be physically active | Protect your skin from the sunLimit or avoid alcohol 


Cancer survivors may benefit from maintaining or adopting a healthier lifestyle after their cancer treatment.

Research suggests that a healthy lifestyle (in combination with conventional treatment) can stop or slow the development of many cancers. Research also shows that some people who have had cancer may be at an increased risk of other health problems, such as heart disease or diabetes.

While more research needs to be done in this area, the lifestyle changes recommended for cancer prevention may also help reduce the risk of the cancer coming back or a new cancer developing. Such lifestyle changes can also help prevent other health problems, such as heart problems and arthritis. Make sure you see your GP for regular lifestyle health checks. For more information, visit www.cutyourcancerrisk.org.au.

Maintain a healthy body weight

A healthy body weight is important for reducing the risk of cancer recurrence and improving survival. The health risk associated with your body weight can be estimated using different techniques including the Body Mass Index and waist circumference (see below).

If you have lost a lot of weight during treatment, you may need to regain some weight to return to a healthy weight.

Waist circumference and health risk

Having fat around the abdomen or waist, regardless of your body size, means you are more likely to develop certain obesity-related health conditions. Fat that is mainly around the hips and buttocks doesn’t appear to have the same risk. Men and post-menopausal women are more likely to gain fat around the waist.

Waist circumference can be used to indicate health risk. Place a measuring tape around your waist at the narrowest point between the lower rib and the top of the hips at the end of a normal breath.

Men
  • 94 cm or more = increased risk
  • 102 cm or more = substantially increased risk
Women
  • 80 cm or more = increased risk
  • 88 cm or more = substantially increased risk
Dietitians can help

Dietitians can help you with any nutrition concerns and are available in all public hospitals and some private hospitals and community health centres. Ask at your local centre or ask your GP for a referral.

To find an Accredited Practising Dietitian in your area or with experience in particular problems, call Dietitians Association of Australia on 1800 812 942. Dietitians in private practice are also listed in the Yellow Pages. Ask about Medicare rebates.

Strategies to improve your diet
  • Make fruit and vegetables, wholegrain breads, cereals, pasta and rice, and other lowfat, low-sugar, high-fibre foods the basis of your diet.
  • Choose lean cuts of meat and trim as much fat as possible before cooking.
  • Remove the skin from chicken.
  • Limit your intake of red meat to less than 500g a week and limit processed meats, such as ham, bacon and sausages.
  • Grill, steam, poach and bake rather than fry.
  • Use a non-stick frypan or a spray of oil when pan-frying.
  • Try low fat, low-sugar milk, yoghurt and cheese.
  • Use minimal butter or margarine, or go without.
  • Limit take away foods that are high in fat and salt.
  • Avoid snacks that are high in fat, sugar and salt such as chips, biscuits and chocolate.
  • Avoid sugary drinks and sweetened beverages, such as milkshakes, and caffeine, sports and soft drinks.
  • Reduce portion sizes.
  • Eat slowly and only eat when you’re hungry. Stop eating when you’re full.
  • Drink plenty of water.
  • Adapt your recipes to include more vegetables, e.g. add grated carrot and zucchini, celery, capsicum and peas to pasta sauces.
  • Fill half your dinner plate with vegetables.
"Before he goes to work, my husband makes me a salad for lunch. Then I know that there is something healthy to eat, even if I'm too tired to prepare it."Denise

Eat more fruit and vegetables

Fruit and vegetables are low in fat and calories and help maintain a healthy body weight. They are high in nutrients such as fibre, vitamins and minerals.

The Australian Dietary Guidelines recommend two serves of fruit and 5–6 serves of vegetables each day (www.eatforhealth.gov.au). Aim to eat a variety of different coloured fruits and vegetables. Fruit and vegetables are best consumed fresh and whole (i.e. not in a juice or supplement form) and a combination of both cooked and raw vegetables is recommended.

An illustration of what one serve of various food groups comprises

Frequently asked questions about food

Should I take dietary supplements?

People who have survived cancer often consider taking dietary supplements such as vitamins and herbal tablets to optimise their health. However, these products are not usually necessary for people who eat a healthy, well-balanced diet and there is no evidence that they improve survival after cancer.

Some people who have had treatment for cancer of the oesophagus, stomach, bowel, head or neck may have ongoing problems with food and eating, and may need to see a dietitian. However, in general dietary supplements should never replace whole foods like fruit and vegetables, which are the best source of vitamins and minerals.

When considering any dietary supplements or other complementary therapies, research the products and consider the following factors to make an informed choice:

  • Talk to your doctor, pharmacist or dietitian before starting any dietary supplements or complementary therapies, to ensure the product is safe for you to use based on your medical history and current medications. Even products labelled as natural can have serious side effects and interact with your other medications.
  • Check the product is listed or registered on the Australian Register of Therapeutic Goods (an AUST L or AUST R number is on the label), although this does not guarantee that the product is safe or effective.
  • Consider the cost of the product, especially if its benefits are unclear or you are already experiencing financial difficulties.

Sometimes, cancer survivors can feel pressure from friends and family to use dietary supplements or other complementary therapies.

For more information about dietary supplements or other complementary therapies, call Cancer Council 13 11 20 to request a free copy of Understanding Complementary Therapies or visit www.iheard.com.au.

Should I stop eating meat?

Eating a balanced diet that is high in plant foods, such as fruits, vegetables and wholegrain cereal foods is important, but there is no need to give up meat. Lean red meat is an important contributor to dietary iron, zinc, vitamin B12 and protein. Cancer Council recommends people eat moderate amounts of unprocessed lean red meat (65–100g of cooked red meat, 3–4 times a week).

There is no conclusive evidence that being (or becoming) a vegetarian has a positive impact on survival after cancer treatment.

However, eating too much red meat, especially processed meats such as sausages, bacon and frankfurts, is associated with an increased risk of bowel cancer and possibly prostate cancer. 

Should I eat only organic foods?

The term ‘organic’ is used to describe foods grown without pesticides or herbicides. These foods are generally more expensive. There is no current evidence that organic fruit and vegetables are more effective in reducing cancer risk than conventionally grown fruit and vegetables. However, organic fruit and vegetables may be higher in vitamin C.

All types of fruits and vegetables are good for your health, whether organic or conventionally grown. It is important to thoroughly wash all fruits and vegetables to remove any dirt or traces of pesticides.

Which is better – raw or cooked vegetables?

Try to eat a combination of both raw (e.g. salad) and cooked vegetables. Boiling vegetables for a long time can reduce the amount of vitamins. Steaming and microwaving are good cooking methods to maintain the nutritional goodness in vegetables.

Should I juice fruit and vegetables?

It is better to eat whole fruit and vegetables, rather than juices. Juices are much higher in kilojoules (calories) and do not contain the dietary fibre (which is protective against bowel cancer) of whole fruit and vegetables.

I saw a news story about a certain type of food that is said to prevent/cause cancer. Should I eat a lot of it/avoid it?

News stories about certain foods or diets can be confusing. They sometimes present evidence relating to studies done in laboratories, rather than on humans. 

Certain types of fruit and vegetables are sometimes called ‘superfoods’. However, this is more of a marketing term than a scientific fact. All fruit and vegetables are healthy and should be eaten regularly.

There is also no single food that has been shown to cause or prevent cancer. Evidence supports eating plenty of fruit and vegetables and moderate serves of red meat and energy-dense foods. For more information, talk to your health care team or call Cancer Council 13 11 20 or visit www.iheard.com.au

Quit smoking

If you are a smoker, Cancer Council strongly recommends that you quit. There is no safe level of tobacco use and research shows that by continuing to smoke, you are more at risk of developing another type of cancer.

There are many benefits to quitting smoking. Research indicates that quitting after a cancer diagnosis can increase your expected survival time.

Many smokers find quitting difficult. Seek support and don’t be discouraged if it takes several attempts before you are able to quit for good. See quitting tips below.

"Being diagnosed with stomach cancer gave me the incentive to give up smoking...I feel so much fitter."Tim 
Quitting smoking
  • Ask your doctor for advice about subsidised medications to help you quit.
  • Call Quitline on 13 QUIT (13 78 48) to talk to an advisor and request a free Quit Pack.
  • Set a date to quit and tell your family and friends so that they can support you.
  • Don’t be tempted to “just have one”.
  • Make your home and car a smoke-free zone.
  • Buy a reward with the money you would spend on cigarettes.
  • Consider previous quit attempts as practice, and learn from what did and did not help.
  • Keep a list of all the reasons you want to quit.
  • Think of yourself as a non-smoker.
  • Avoid tempting situations.
  • Distract yourself if you feel tempted, e.g. going for a walk, having a drink of water etc
  • Get support online – visit www.quitcoach.org.au or www.icanquit.com.au.
 

Be physically active

Being physically active and limiting sedentary behaviour every day is essential for health and wellbeing. Physical activity helps to reduce the risk of some types of cancer coming back and can boost energy levels, increase physical strength, relieve stress, reduce the risk of heart disease, improve sleep, and decrease fatigue, anxiety and depression.

Start physical activity slowly and build up gradually. Doing any physical activity is better than doing none. If you are unsure if you well enough to exercise or are concerned about disrupting your recovery, talk to your doctor about the amount and type of activity suitable for you or ask for a referral to an exercise physiologist. Many people lose physical strength during cancer treatment.

For more information, call Cancer Council 13 11 20 for a free copy of Exercise for People Living with Cancer.

How to be more active
  • Walking is great exercise. Walk with a friend or join a walking group, walk to the corner shop instead of driving.
  • Do some simple stretches while watching television.
  • Take the stairs instead of the lift or escalators.
  • Do vigorous housework and activities around the home such as vacuuming or mowing the lawn.
  • Get off the bus or train one stop earlier or park further away from your destination and walk the rest of the way.
  • Do some gardening.
  • Take your children or grandchildren to the park or kick a ball around the backyard.
  • Join a dance, tai chi or yoga class.
  • If you are being physically active outdoors, remember to be SunSmart and use sun protection.

Protect your skin from the sun

Use a combination of protective measures to protect your skin from the sun when the UV index is 3 or above.

  • SLIP on clothing that covers your shoulders, neck, arms, legs and body. Choose closely woven fabric.
  • SLOP on SPF30 or higher broad-spectrum water-resistant sunscreen 20 minutes before going outdoors and reapply every two hours.
  • SLAP on a broad-brimmed hat that shades your face, neck and ears. Adult hats should have at least an 8–10 cm brim.
  • SLIDE on sunglasses. Choose close-fitting, wrap-around sunglasses that meet the Australian Standard AS 1067.
  • SEEK shade. Make use of available shade such as trees or awnings or take your own shade such as umbrellas or beach tents.
  • Avoid solariums and tanning beds, which give off UV radiation.

Some cancer treatments may make your skin more sensitive to the sun, causing it to burn or be damaged by the sun more quickly or easily than before. Ask your treatment team if this applies to you.

For more information, or to check the SunSmart UV Alert, visit www.sunsmart.com.au.

How much sun is enough?

Some exposure to the sun is healthy. Vitamin D, which is essential to develop and maintain healthy bones and muscle function, is produced in the body when skin is exposed to UV radiation in sunlight. UV levels vary across Australia, according to the location, the season and the time of day. This means the amount of time you need to be in the sun to make enough vitamin D will vary. 

[Insert image 'how much sun is enough' pg 69]

Limit or avoid alcohol

Alcohol is a known risk factor for cancer. Cancer Council recommends that to reduce the risk of cancer, people limit their consumption of alcohol. Even low levels of alcohol consumption can increase cancer risk. Neither the World Health Organisation nor the National Heart Foundation of Australia recommend consuming red wine or any other alcoholic beverage to prevent cardiovascular disease.

A guide to standard drinks

For people who choose to drink alcohol, the National Health and Medical Research Council (NHMRC) recommends no more than two standard drinks a day. One standard drink contains 10 grams of alcohol. However, different drinks have different alcohol volumes.

  • 100 mL (small glass) of red wine = 1 standard drink
  • 100 mL (small glass) of white wine = 0.9 standard drinks
  • 30 mL (one nip or shot) of spirits = 1 standard drink
  • 60 mL (two nips or shots) of port = 0.8 standard drinks
  • 285 mL (one middy, half pint or pot) of normal strength beer = 1.1 standard drinks
  • 375 mL of mid-strength beer = 1 standard drink
  • 425 mL (one schooner) of low-alcohol (light) beer = 0.9 standard drinks.
  • For more information on standard drinks and alcohol, visit www.alcohol.gov.au.
Strategies for reducing your alcohol intake
  • Use water to quench thirst.
  • Alternate alcoholic drinks with non-alcoholic drinks, such as water.
  • Sip alcoholic drinks slowly.
  • Switch to light beer.
  • Order half nips of spirits.
  •  Don’t fill wine glasses to top.
  • Have a spritzer or shandy (wine or beer mixed with soda or mineral water).
  • Wait until your glass is empty before topping it up to keep count of your drinks.
  • Have a few alcohol-free days during the week, especially if you are a regular drinker.
  • Eat while you drink to slow your drinking pace and fill yourself up.
  • Avoid salty snacks, which increase your thirst and make you drink more.
  • Offer to be the designated driver so that you limit your alcohol intake or don’t drink.

Key points

  • Cancer survivors may benefit from maintaining or adopting a healthier lifestyle after their cancer treatment.
  • Many survivors say they want to adopt a healthier lifestyle after cancer treatment.
  • Physical activity and a healthy body weight are important for reducing the risk of cancer recurrence and improving survival.
  • Physical activity is important to manage your weight and helps boost energy levels, decrease fatigue, relieve stress and improve overall wellbeing.
  • Eating a variety of fruit, vegetables, wholegrain breads, cereals, pasta, rice and other foods low in saturated fat, salt and sugar helps to maintain a healthy body weight.
  • If you have lost a lot of weight during treatment, you may need to regain some weight to return to a healthy weight.
  • There is little scientific evidence to suggest that taking high-dose vitamin supplements is beneficial. Talk to your doctor before taking a supplement.
  • Quitting smoking can have a significantly positive impact on your survival. Ask your doctor for help and support. There is no safe level of smoking.
  • Sun protection will reduce your risk of skin cancer.
  • Alcohol is a known risk factor for cancer. Limiting or avoiding alcohol will reduce the risk of cancer and improve your general health and wellbeing.

Reviewed by: A/Prof Jane Turner, Department of Psychiatry, University of Queensland; Polly Baldwin, Cancer Council Nurse, Cancer Council South Australia; Ben Bravery, Cancer Survivor, NSW; Helen Breen, Oncology Social Worker, Shoalhaven Cancer Services, NSW; A/Prof Michael Jefford, Consultant Medical Oncologist, Peter MacCallum Cancer Centre and Clinical Director, Australian Cancer Survivorship Centre; David Larkin, Clinical Cancer Research Nurse, Canberra Region Cancer Centre; Miranda Park, Clinical Nurse Specialist, Cancer Information and Support Service, Cancer Council Victoria; Merran Williams, Nurse, Bloomhill Integrated Cancer Care, QLD; Iwa Yeung, Physiotherapist, Princess Alexandra Hospital, QLD; Danny Youlden, Biostatistician, Viertel Cancer Research Centre, Cancer Council Queensland.

Updated: 01 Apr, 2014