Breast Cancer Checklist
- Breast cancer diagnosis? Check.
- Surgery to remove tumour and surrounding tissue? Check.
- Six rounds of chemotherapy? Check.
- 33 rounds of radiotherapy? Three down, 30 to go.
- Prevention of cancer recurrence for the rest of my life? Big fat question mark.
More than six months after I was hit with the big, scary 'C' word, I've hit a fairly sizable stumbling block in my breast cancer checklist. That is, now that I'm cancer-free at the age of 30 and nearing the end of my treatment, how do I take steps to make sure the disease never returns?
According to Liz Butler, nutritionist and founder of Body Soul Nutrition, many cancer patients undergo surgery, chemotherapy and radiation treatment and then resume their normal lives exactly as they left off. That means following the same diet, whether healthy or otherwise, doing the same amount of exercise and maintaining the same stress levels - essentially, leaving the body with the same conditions in which cancer originally thrived. In many cases, drastic changes need to be made both nutritionally and emotionally so that the cancer cannot return, says Butler, who I met last month for a consultation.
Aside from filling up on cancer-fighting cruciferous vegetables (the likes of broccoli, cabbage, cauliflower and the dreaded Brussels sprouts), getting more vitamin D and minimising alcohol intake, two of the things Butler recommended were for me to give up sugar and dairy products. While there is little research to suggest links between cancer and dairy, says the London-based nutritionist, it's possible that dairy products may lead to an increased risk of developing hormone-related cancers, including breast cancer. Sugar, on the other hand, is one of the most damaging foods for our health and cancer cells are particularly dependent on sugar for their survival, says Butler. You only need to watch Dr. Robert Lustig's famous lecture, Sugar: The Bitter Truth, to know how bad the white stuff can be for your health.
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So far, so good. But will giving up some of the foods I love really stop my cancer coming back? Let me first clarify a few things about my lifestyle: I am 5'5, a slim UK size 6 to 8, I have always exercised regularly and stuck pretty closely to the recommended five fruit and veg a day. Yes, I love eating chocolate, cake, sweets, tea, coffee, cheese and pizza, but I consume all these foods in moderation alongside my daily intake of vitamin supplements, fruit, veg, protein, fibre, carbs and dairy. I have never smoked and I don't drink much alcohol. I had never had a serious illness before my cancer came along. My stress levels have been fairly high at certain points in the past few years but, other than that, I definitely don't fall into the category of someone at high-risk of getting breast cancer: i.e. an obese, sedentary smoker with a bad diet, over the age of 50. Although I tested negative for the BRCA1 and BRCA2 gene mutation, it is still possible that my breast cancer was caused by another gene fault, rather than my lifestyle, diet and environment.
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Nevertheless, I decided to take Butler's advice and give up sugar for a couple of weeks during my fifth round of chemotherapy, figuring that going cold turkey for a period would help me cut down on the white stuff for good. Apart from the fact that I was rushed to hospital within a week with an infection and abnormally low white blood cells (the doctors said it had nothing to cutting out sugar), I found it fairly easy. Chemotherapy alters your taste buds and cravings, so I didn't really want chocolate and cake in the first week anyway. There were a couple of times when I would have chopped my right arm off just for a dark-chocolate-coated raisin, but most of the time, I was fine.
At the end of the day, though, giving up sugar affected my social life. The diet didn't just include giving up biscuits and cakes, but also white rice, white bread, white pasta and anything containing sugar: salad dressing, ketchup, baked beans, tinned soups, juices, alcohol, fizzy drinks, mint sauce, cereals - look at pretty much any processed-food label and you'll find sugar among the ingredients. This made it hard for me not to be the annoying one at dinner parties and in restaurants, the one who turns down invites or asks the group to go to another place that provides more sugar-free options.
As for giving up dairy, it's such a major lifestyle change. Dairy is in so many of the products I eat regularly: the milk in my tea and coffee, the cheese on my pizza. I can drink rice milk at home until the cows come home (geddit?), but it's not quite so easy to find it in cafes and restaurants. (Soya milk is not an alternative for me, because of the association with oestrogen-sensitive breast cancer). What's more, there could be downsides to giving up dairy, for instance where will I get the calcium to strengthen my bones?
If I sound confused, it's because I am. Largely because the doctors disagree with the nutritionists. All my oncologists say I should follow a healthy, balanced diet - that's fairly obvious - but none of them have recommend giving up sugar or dairy. On the contrary, my oncologist told me I don't need to follow any particular diet. So while there's no hard and fast proof that giving up the nasties will prevent my cancer metastising or recurring, should I really stop myself enjoying the foods I love? And if I do follow a sugar-and-dairy-free diet, who's to say my cancer won't return and kill me in 10, 20 or 30 years time anyway?
On the one hand, I want to keep myself alive for as long as possible. On the other hand, I want to enjoy my life, and that includes eating the foods that give me the most pleasure. After all, there's no point living if I have to survive on a rabbit's diet of lettuce leaves and sprouts. That said, Butler's advice is sound and she says it's fine to eat a little of what you like, when you like. Moderation is key.
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Fortunately, I've found my happy medium. I have started the new year by cutting my sugar, refined carbs and dairy intake by about 90%, and my caffeine intake by about a half. I've replaced the milk in my tea with oat milk and I'm eating more veg, nuts and organic foods. But if I'm out in a coffee shop and they only have regular milk, or if I want a few squares of Green & Black's of an evening, I'm fine with that. If I starve myself of the foods I love, I'll just want them more. With my 90% rule, I can have my cake and eat it, and it won't just be another broken New Year's Resolution.
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