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If you're one of the 1.1 million survivors of colorectal cancer, you're probably concerned about your prognosis and whether your cancer will come back. That's understandable. Colorectal cancer survivors are at higher risk for developing secondary cancers. However, you'll be happy to know that lifestyle changes can help mitigate these risks. In fact, in a long-running trial of patients with early stage CRC, those who adhered to a healthy lifestyle reduced their risk of death from cancer.
Following a healthy lifestyle is a multi-pronged approach that includes paying attention to what you eat and drink, getting enough physical activity, not smoking and maintaining a healthy weight.
As food expert and author Michael Pollan famously said, "Eat food. Not too much. Mostly plants." This is a good recommendation for helping prevent cancer in the first place and lowering your risk of colorectal cancer recurrence after treatment. When Pollan says, "Eat food," he means eating real food – food your grandmother would recognize, not food-like products made in a manufacturing facility.
Plant-based foods, such as fruits, vegetables, beans and whole grains, give you a lot of nutritional bang for your calorie intake. Plant foods are dense in water and fiber. They fill you up so you feel satisfied after eating, and fiber is associated with a reduction in the formation of polyps. In fact, a study published in May found that people who had the highest intake of fiber had a more than 50 percent lower risk for colon cancer mortality and a 28 percent lower risk of dying from any cause compared to those who ate the least amount of fiber. Furthermore, vegetables have antioxidants and cancer-fighting compounds, says Dr. Sreeram Maddipatla, medical oncologist/hematologist for the Liver Center and Pancreas Center at UF Health Cancer Center – Orlando Health.
It's not just what you eat but how much you eat. The American Institute for Cancer Research recommends following the New American Plate, which offers simple visual guidance for cancer prevention eating. Fill your plate two-thirds full with plant-based foods and one-third (or less) with animal protein. It's that easy.
Pay attention to portion sizes, too. Most of us eat more than we need (thus Pollan's "not too much" advice). If you're not sure what a serving size actually is, the AICR's Serving Size Finder describes portion sizes in terms of easily identifiable objects, such as a baseball, a fist or a deck of cards. For example, a single service of rice or pasta (half a cup) is equal to the size of half a baseball.
Limit your consumption of processed meats. "They are a big no," Maddipatla says – red meat is associated with an increased risk of forming polyps and developing colorectal cancer. Chicken and fish are good sources of lean protein, especially if they're organic.
Finally, make sure you get plenty of vitamin D, especially if you've already had CRC, says Dr. Mark Pochapin, professor and director of the division of gastroenterology at NYU Langone Medical Center. Most of us don't get enough vitamin D in our diet, so supplements help. Pochapin says men and women should consume 1,000 international units of vitamin D daily.
Again, studies show that regular exercise benefits people who've already developed colon cancer. A meta-analysis of seven CRC studies found that the most active survivors had the lowest rates of death from the disease.
The AIRC says 30 minutes of activity daily reduces the risk of colorectal cancer in part by helping you maintain a healthy weight and by speeding up digestion, which can potentially reduce the amount of time toxic substances remain in your digestive tract.
Pochapin says simply incorporating more activity – especially walking – into your daily routine is easy to do. "Park your car in the farthest spot and walk. Start with one flight of stairs, and build up to two and three," he says. "You don't have to go to a gym. Every form of exercise is good."
Limit Your Alcohol Consumption, and Don't Smoke
Smoking isn't just associated with lung cancer – it's a significant risk factor for many types of cancer. And the more you drink, the higher your risk for cancer, Pochapin says. "Alcohol is such a toxin to your body, and the increased risk of alcohol and tobacco combined is greater than either alone. No one can justify drinking more than one drink per day. I never recommend alcohol for medicinal purposes. It doesn't justify the damage."
Maintain a Healthy Weight
Eating a cancer-preventive diet and getting regular physical activity will help you maintain a healthy weight and lower the risk of your cancer returning. Try to keep your Body Mass Index, a ratio of weight to height, in the healthy range – between 18 and 25.
Here's a final incentive: Improving your lifestyle has benefits far beyond helping to prevent colorectal cancer from coming back. A healthy lifestyle can help lower your risk for other serious conditions, such as diabetes and heart disease, which is actually the No. 1 cause of death, more than all types of cancers combined.