Physical Health

Your Overall Nutritional Goals

Cancer patients often ask questions about food choices, physical activity, and dietary supplements. They want to learn how nutrition and physical activity can help them to live longer or feel better. The following guidelines are meant to answer some of your questions.

Originally developed by The American Cancer Society (ACS), then edited for eye cancer patients, this monograph will give you as a cancer survivor and your family the information you need to make informed decisions about your food and physical activity choices.

Nutrition and physical activity needs for cancer patients may differ for a number of reasons, including where you are in your cancer experience.

Once diagnosed with eye cancer, each patient may fall into a separate group. Some are in active treatment (including observation, radiation and surgery), recovery, disease-free living or living with stable disease as well as living with advanced cancer.

During cancer treatment, surgery, radiation therapy, chemotherapy and stress can affect your body’s need for nutrients. These treatments can also affect your eating habits and how your body digests, absorbs, and uses food.

Your main nutritional goals during this time are:

• • Make sure you meet your body’s nutrient and calorie needs to maintain a healthy weight.
  • Choose healthy foods that will support your immune system.
  • Avoid foods and drugs that will harm your immune system.
  • Consult a dietician to monitor your progress.
  • Stress can affect your diet, so decrease stress.
  • Take an age and gender appropriate daily multivitamin.
  • Maintain an active lifestyle.

Diet

Little evidence-based research exists linking any certain diet with cancer-fighting properties. However, from what we know about cancer, we can posit a theory: stronger immune systems are better-equipped to fight cancer. Therefore, eating a diet with immune-boosting foods and foods rich in antioxidants (meaning, a substance that prevents potentially damaging oxidizing agents) should help suppress cancer.

Fill up your diet with:

• • Dark leafy greens such as spinach or kale.
  • Green cruciferous vegetables such as broccoli, brussel sprouts, and cabbage.
  • Foods rich in Vitamin C, such as oranges and red bell peppers.
  • Antioxidant-rich fruits and berries, such as pomegranates, raspberries, and blueberries.

There are other medical conditions that limit the intake of the these foods. Therefore, you should discuss diet changes with your general medical doctor.

Vitamin and Mineral Supplements

You may be thinking about using dietary supplements such as high-dose vitamins and minerals during your cancer treatment or you may already be taking some supplements. You should know that physicians do not agree on their use. Therefore, if you are taking any supplements, discuss this with your physician.

Many dietary supplements contain levels that are higher than the amount found in food, and some may also be higher than what is recommended for good health. Some contain substances that may affect some chemotherapy drugs.

Unless your health care team recommends a supplement for a specific reason, do not take any that contain higher amounts than 100% of the daily value. Your first line of defense should be to strive to get the nutrients you need from nutrient rich foods and beverages.

Exercise

Exercise is safe after-cancer treatment, and it has many benefits. It improves bone health, muscle strength, erectile dysfunction, and other quality-of-life measures. Before starting or restarting your exercise program, talk with your doctor or health care team. Ask them about when you can start to exercise and how you can be physically active during treatment. They will consider your condition and your personal preferences and help you work out a plan.

If you have an eye tumor-related retinal detachment, or are receiving radiation therapy and already have an exercise program, you may need to stop for a period of time. In addition, if you have a eye tumor related retinal detachment, Dr. Finger may suggest you keep your head elevated, particularly while sleeping, in order to keep the retina of your central vision attached to its blood supply as much as possible. Further, most patients with tumor related retinal detachments should try to keep their heads upright during the day.

Dr. Finger may suggest that you wait to see what side effects you have before starting physical activity. Having a caregiver or exercise professional present during exercise sessions can be helpful.

Guidelines on Nutrition and Physical Activity for Cancer Survivors

When you are cleared to continue with exercise and Dr. Finger allows you to return to normal daily activities, it is important to avoid inactivity and stay active. Get to and stay at a healthy weight. If you are overweight or obese, limit how much you eat of high-calorie foods and beverages and increase physical activity to promote weight loss.

In order to maintain a health weight:

• • Aim to exercise at least 150 minutes per week.
  • Include strength training exercises at least 2 days per week.
  • Eat a variety of healthy foods from plant sources. Limit the amount of processed meat and red meat you eat.
  • Eat 21/2 cups or more of vegetables and fruits each day.
  • Choose whole grains rather than refined grain products.
    

Dr. Finger does recommend light exercise to keep yourself active and boost your overall health. Around twenty minutes of low-intensity physical activity every  day constitutes as light exercise. If you want “kill two birds with one stone” and get some stress-reducing meditation (more on this to follow) and some exercise done in one session, try light, meditative yoga.

Here are a few of our own recommendations to get you started:

• • Yoga or Tai Chi
  • A relaxing walk
  • Low-impact cycling
  • Low-impact aerobics
  • Dancing

Remember to speak with your doctor before beginning any sort of strenuous activity.

 

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Mental Health

Lifestyle

A diagnosis of cancer is typically overwhelming. This is a time to turn to family members for support and to simplify your life. The journey from diagnosis, treatment and recovery is complex and can be stressful. When possible, the cancer patient should ask family members to avoid adding additional stress. The cancer patient can set aside quiet time to decompress or meditate.

“In my experience,” says Dr. Finger, “some patients decrease stress with exercise. However, due to surgery and secondary retinal detachment, this is not always possible. Instead, almost all patients can take long, moderately paced walks and practice meditation.”

Dr. Finger suggests that his patients reduce the stress in their lives. This is because the patients acute response to stress or “flight and fight response” is associated with a general discharge from the sympathetic nervous system to prepare for fighting or fleeing.

Chemically, the body produces the hormones epinephrine and cortisol (among others). These in turn, increase blood pressure, blood sugar and suppress the immune system. The latter is particularly important for patients with cancer. It is reasonable to assume that chronic stress can be synonymous with a constantly suppressed immune system. Stress reduction can be accomplished by meditation, self-care, exercise and mindfulness.

Keep in mind that everyone has a different lifestyle, and so everyone may have a different way of implementing stress reduction techniques. Some find it easier to read and learn about strategies, others find it helpful to join group meditation sessions, some find tranquility in a spiritual environment, and some even find smartphone apps as an easy and accessible way to integrate stress-reduction into their lives. Don’t get discouraged if the first method you try doesn’t work for you or doesn’t stick with you, as there are countless options to test for yourself.

Dr. Finger highly recommends you read the book Passage Meditation: A Complete Spiritual Practice by Eknath Easwaran.

Our patients have recommended to us their own methods of stress-reduction as well:

Reading:

• • Why Zebras Don’t Get Ulcers: The Acclaimed Guide to Stress, Stress-Related Diseases, and Coping by Robert Sapolsky, Ph.D.
  • Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness by Jon Kabat-Zinn, Ph.D.

Meditation:

• • Yoga (exercise too!)
  • Sound Healing
  • Guided Meditation
  • Vipassana
  • Chakra Meditation
  • Transcendental Meditation

Apps:

• • The Calm App
  • The Headspace App

Living With Stable Disease

During this phase, setting and achieving goals for weight management, a physically active lifestyle, and a healthy diet will benefit your overall health and quality of life. To help you with these goals, we suggest the following guidelines in 3 areas: weight management, physical activity, and dietary patterns. These guidelines appear below. Following these guidelines may help to reduce the risk of cancer recurrence and of developing another cancer.

Living with Advanced Cancer

If you are living with metastatic disease, a healthy diet and physical activity are still important for helping you maintain a sense of well-being and an improved quality of life. Many people with advanced cancer need to change their diet to meet their nutritional needs. They may also change it to help with symptoms or side effects such as fatigue, bowel changes, and a decreased sense of taste or appetite.

For those with poor appetite, weight loss, or difficulty in gaining weight, some medicines can be prescribed to help to increase appetite.

Nutritional supplements such as high- protein/high-calorie beverages and foods can be helpful to those who cannot eat or drink enough to keep up with their body’s needs.

If you are living with advanced cancer and wonder about physical activity, please ask your medical oncologist for advice.