What type of treatment do you absolutely need once you finish breast cancer treatment? How much is too much? What’s too little? And what about diet and supplements?
Three doctors recently discussed helping patients stay healthy after breast cancer. Their discussion, available through Medscape, helps answer some of these questions.
Antonio C. Wolff, MD, FACP, Associate Professor of Oncology, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, Maryland
Jennifer A. Ligibel, MD, Instructor in Medicine, Harvard Medical School, Boston, Massachusetts; Staff Physician, Dana-Farber Cancer Institute, Boston, Massachusetts
Anne F. Schott, MD, Associate Professor of Medicine, University of Michigan, Ann Arbor, Michigan; Staff Physician, University of Michigan Health System, Ann Arbor, Michigan.
My take-away points on all this:
• Most women with a diagnosis of breast cancer will survive their disease and go on to live full lives.
• Follow-up visits every 3 to 4 months for the first two years after completion of treatment is standard. This can be with an oncologist, radiation oncologist, surgeon, or a primary care physician. Usually it is a combination of the above.
• A mammogram at least yearly is recommended.
• The American Society of Clinical Oncologist guidelines recommend against “any surveillance blood testing or imaging studies in an otherwise-asymptomatic patient with a normal clinical exam.” Translation: If you do not have symptoms or problems, the recommendation is that there is no need for additional tests. Doctors often do testing to reassure women, although the reassurance, apparently, is not all that substantive.
That includes x-rays, PET scans and CT scans.
• Even though studies have not been conclusive, there’s enough evidence to support the benefits of low-fat diet and exercise in limiting risk of recurrence. A low-fat diet is especially important for hormone negative breast cancer.
• Vitamin D is beneficial, even though research so far is not clear on its benefits to reduce risk of recurrence and on the dosage necessary. It has been shown to reduce bone loss.
• Carbohydrate-restricted diets like Atkins are not good for breast cancer survivors, especially those with ER-negative tumors.