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Oncology:
Healthy Eating & Exercise Offer Benefits
During & After Breast Cancer Treatment

HealthReach, Fall 2012 | Page 10

Neelima Denduluri, MD
Medical oncologist Neelima Denduluri, MD was recently appointed to the Clinical Practice Guideline Committee of the American Society of Clinical Oncology.

Everyone needs to put a priority on nutrition and exercise, but it’s especially important during and after breast cancer treatment. Most women are surprised to learn that they need to be careful about gaining weight during breast cancer treatment, specifically chemotherapy, says Neelima Denduluri, MD, medical oncologist.

“People think you automatically lose weight with chemotherapy, but with breast cancer, most women gain weight at the time of their diagnosis and during treatment,” Dr. Denduluri says. This can occur for many reasons. Their physical activity level may decrease due to fatigue or they may reach for comfort foods. For some women, breast cancer treatment may cause premature menopause, which can lead to weight gain.

It is not recommended that patients try to lose weight while undergoing chemotherapy treatment for breast cancer. But, it’s important to pay attention to weight gain during and after treatment, Dr. Denduluri explains, because obesity is a risk factor for both developing breast cancer and for breast cancer recurrence. Long-term goals should be focused on achieving and maintaining ideal body weight.

Meeting with a nutritionist can help patients develop healthy eating habits while undergoing breast cancer treatment and beyond. Registered Dietitian Lindsey Proctor works exclusively with outpatient oncology patients at Virginia Hospital Center. During an initial consultation, Proctor reviews the patient’s medical and weight history, assesses past and current dietary patterns, and asks about any gastrointestinal problems the patient may be experiencing.

This forms the basis for each person’s unique nutritional recommendations.

For a healthy diet, Proctor emphasizes portion control and advocates incorporating more fruits and vegetables because many contain vitamins and minerals that may reduce the risk of cancer and recurrence. She often refers patients to the guidelines of the American Institute for Cancer Research, which recommend that two-thirds of your plate should be foods from plants (vegetables, fruits, whole grains and beans) and a third or less from animal protein (dairy, cheese, yogurt, meat, fish).

“Our nutrition consults are tailored to the individual. If a patient has not been eating any fruits or vegetables, for example, it’s not realistic to expect her to suddenly start eating five to six servings a day. To get her started, I might recommend having fruit at breakfast and then again for a snack, for example. Small changes can lead to lifestyle habits,” Proctor says.

Since chemotherapy suppresses the immune system, food safety is important. Fruits and vegetables should be washed before eating. Exercise caution when eating from salad bars, and pay particular attention at picnics and barbecues, where food often sits out at room temperature for extended periods of time. Rare meats, raw eggs and unpasteurized dairy products also should be avoided, along with meat that is highly charred, as the charred pieces contain carcinogenic compounds.

Staying hydrated during chemotherapy and radiation treatment is extremely important, Proctor notes, because these treatments put patients at risk of dehydration. She also wants to make sure they are getting the right amount of fiber, which is essential to the body’s ability to eliminate excess estrogen.

Dr. Denduluri encourages her patients to try to do some kind of physical activity for 30 minutes a day during treatment, even if it’s walking for 10 minutes, three times a day. Regular exercise can help counteract the effects of chemotherapy, and can reduce recurrence rates. Yoga and Pilates are good ways to keep muscles joints limber, especially for those who are getting certain types of antiestrogen therapy, which can cause joint pain.

“Even moderate exercise can have significant benefits,” says Dr. Denduluri. Women who exercise over two hours per week are less likely for their cancer to recur. Do whatever you can do that works with your schedule.”

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Meet Dr. Denduluri at LADIES FOR LIFE on October 6, 2012
Medical Oncology | Breast Health
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