Educating women to take control of their breast health and ensuring early detection of breast cancer is very critical in combating this disease.
Breast Cancer is the second most common cancer in women and is one of the leading causes of death for women globally. In India, Breast Cancer is the most prevalent cancer in women and constitutes to more than 1 out of every 4 new cancer cases (2020). The incidence of Breast Cancer continues to rise in our country and it’s estimated that nearly 1 in 11 Indian women in the metros will develop breast cancer during their lifetime. Though early detection of Breast Cancer can improve survival, almost 57% of women are detected with advanced disease. Hence the 5-year survival rates for Breast Cancer is only 66% in our country (only 66 out of every 100 women with Breast Cancer live at least 5 years after the cancer is diagnosed). Therefore educating women to take control of their breast health and ensuring early detection of Breast Cancer is very critical to combating this disease.
Breast Cancer risks
There are numerous factors throughout a persons lifetime that can influence Breast Cancer risk. Some of these include certain genetic mutations, ageing, family history of Breast Cancer, previous treatment using radiation therapy, postmenopausal hormonal therapy and starting menstrual periods before 12 years of age or menopause after the age of 55. Certain lifestyle factors can also influence the risk of Breast Cancer such as being physically inactive, increase in weight after menopause, pregnancy after 30 years of age, lack of breastfeeding, tobacco use and drinking alcohol. Though factors such as ageing and family history cannot be modified, opting for a healthier lifestyle can positively impact the chances of one developing Breast Cancer.
Since most patients in India reach the doctor only when the cancer is at an advanced stage, every woman must conduct regular self- breast examinations to detect any changes immediately. Regular health check-ups and clinical examination (breast examination by a doctor) is also important. Depending upon the woman’s age and risk factors, Breast Cancer screening can is essential which can involve a mammogram (X-ray of the breast) or other non invasive methods. Further tests may be recommended based on the results of initial screening.
Role of nutrition in cancer management
The journey of a Breast Cancer patient normally begins with diagnosis and ends with recovery. But the ultimate goal for Breast Cancer survivors is to live a full and healthy life without cancer recurrence or the presence of other comorbidities such as heart disease. It’s well-known that lack of physical activity, obesity and excessive alcohol consumption enhance Breast Cancer risk. Inappropriate nutrition can hence play a significant role in Breast Cancer development.
A healthy eating plan which contains more fruits, whole grains, vegetables, dietary fibre, soy, poultry and fish, and less refined foods, red meat, high-fat dairy products and sweets may improve the overall survival of women diagnosed with Breast Cancer. Specific food components that help combat the inflammation and free radical generation that take place during cancer include, dietary fibre (e.g., oatmeal), healthy fats like omega-3 polyunsaturated fatty acids (e.g., fatty fish, flaxseed, walnuts), vitamins C and E, and phytochemicals contained in fruits and vegetables. Consuming nutritious food, maintaining a healthy body weight and regular physical activity can aid in enhancing Breast Cancer survival.
This however is easier said than done. Surgery, chemotherapy or radiation therapy which are used to treat Breast Cancer often take a heavy toll on the patient. It has been found that chemotherapy itself often leads to weight gain and results in side effects such as loss of appetite, nausea, vomiting, changes in taste/smell, and dry mouth which further aggravates the situation. Since the change in taste perception alters food preferences, it is often difficult for the patient to follow certain types of dietary recommendations. Some strategies to make eating easier include adding natural artificial flavours or condiments, eating smaller/frequent meals, consuming more boiled foods, using a straw for drinking, sipping lemon juice or chewing on mint. Additionally, the constant fatigue or lack of energy faced by the patients due to their therapy also reduces their physical activity by almost half.
Nevertheless, the intake of adequate energy and nutrients during therapy can impact the patient’s life positively. Appropriate nutritional support improves response to therapy, reduces its toxic impact, increases immunity and enhances the overall quality of life. Appropriate nutrition and maintenance of body weight with adequate physical activity during the treatment and recovery phase, not only offers relief from the side effects but also improve the long-term health of patients with Breast Cancer. This in turn also protects them further from other illnesses such as hypertension, hyperlipidaemia, diabetes and heart disease.
Tailoring nutrition for breast cancer patients
As each patient suffering from breast cancer is unique, treatment response will vary from one patient to another. As the disease burden evolves from the initial diagnosis to recovery, the dietary intake of the patient will also need adjustment to cope with the change. In this regard, digital therapeutics can play a key role in helping the onco nutritionist customise the nutritional plan for each patient. Depending upon the patient’s response, the plan can be tweaked to accommodate the patient’s preferences while maintaining the essential nutritional balance. The use of such an algorithm-aided, evidence-based dietary plan also assists the clinician by maintaining a record of the nutritional intake and its impact on the overall health of the patient.
Digital technology has refined processes in several areas of life. Since nutritional support is now considered a key component of a comprehensive cancer management programme, digital therapeutics can help pave the way to better and personalised nutrition in cancer patients.
The author is Head of Department and senior consultant breast surgeon at Moolchand Medicity New Delhi and CARER. Views expressed are personal.
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