Search the Health Library
Get the facts on diseases, conditions, tests and procedures.
I Want To...
Find a Doctor
Find a doctor at The Johns Hopkins Hospital, Johns Hopkins Bayview Medical Center or Johns Hopkins Community Physicians.
I Want To...
Find Research Faculty
Enter the last name, specialty or keyword for your search below.
Reducing Risk of Recurrence
Ten lifestyle changes that may help
All breast cancer survivors live with the concern about a recurrence or a new cancer. This fear is usually the biggest worry of all. Many women feel that their body has betrayed them and therefore it takes time to trust it again.
Learning how to cope with fears of recurrence is important. Though your body has gone through many changes as a result of a cancer diagnosis and treatment, most women become healthy, strong and optimistic once again.
Moving Beyond the Fear of Recurrence
Young breast cancer survivors discuss their fear of a cancer recurrence now that that they have completed treatment
Being a Survivor
Life after Breast Cancer: Conversations on Survival A group of breast cancer survivors talk about what it means to be a survivor. Life after cancer, transitioning to the next steps after treatment, and finding a "new normal"are all discussed.
Lifestyle Changes After Breast Cancer
Lifestyle Changes after Breast Cancer Treatment: Conversations on Survival. A group of breast cancer survivors openly discuss what lifestyle changes were continued or changed after treatment. The importance of living in the moment, maintaining a healthy lifestyle, and knowing what is really important in life are all discussed.
1) Take care of yourself emotionally
- Put your needs first sometimes
- Attend a support group or find a breast cancer survivor you can talk with
- Stay informed about new breast cancer research
- Consider psychotherapy and/or antidepressants if warranted; if you’re taking tamoxifen, check with your oncologist to ensure the prescribed antidepressant does not interfere with your endocrine treatment
- Communicate with your doctor about fears or concerns
- Volunteer or become a breast cancer advocate
2) Take care of yourself physically
- Exercise regularly
- Maintain a healthy weight
- Reduce stress
- Eat healthy
- Limit alcohol consumption
- Keep up with all scheduled screenings
- Quit smoking
- Report any physical changes to either your oncologist or primary care provider
- Seek treatment for lymphedema if you experience signs
3) Eat healthy
Research has shown that a diet high in fat and calories increases circulating estrogen in the blood. Consuming a low fat and low calorie diet after breast cancer can improve your overall health and wellness. Here are some dietary suggestions:
- Eat a diet rich in fruits and vegetables (at least five servings a day)
- Choose organic foods whenever possible
- Wash produce thoroughly to minimize pesticide exposure
- Limit red meat intake
- Consume 2-3 servings of fish weekly. Fish high in omega-3 fatty acids, such as salmon or sardines, are especially beneficial (try to consume freshwater wild salmon whenever possible)
- Increase fiber intake
- Avoid trans fat
4) Reduce stress
As a breast cancer survivor, your life has probably been filled with stress for some time now. The good news is that life will eventually calm down for you and your family. That does not mean the stress with coping with being a breast cancer survivor in combination with life’s everyday stress will not be a challenge. Finding ways to limit or cope with stress has been shown to improve overall survival. Just as every woman’s body is different, so is her ability to cope with stress. It is important that you find practical ways to cope with stress that work for you and your lifestyle.
Some helpful techniques for relieving stress include:
- Support groups
- Mental health counseling
- Exploring your creative abilities (such as painting, drawing or ceramics)
- Massage therapy
- Energy healing (such as Reiki)
- Meditation and deep breathing exercises
- Guided imagery
- Take a cancer vacation to celebrate how far you have come
- Discover new connections (such as religious/spiritual groups, reconnecting with friends, or new hobbies)
- Be patient in finding your “new normal”
- Reflect on the meaning of cancer and the experiences it has brought into your life—both good and bad
- Find strength in your “wounds”
If stress or depression seems to be impacting your overall quality of life, speak to your doctor.
5) Limit alcohol
Research has shown a link between moderate and heavy drinking and breast cancer. High alcohol intake has also been shown to increase circulating estrogen levels in the body. Breast cancer survivors should limit their alcohol intake to a maximum of one drink a day to reduce the chance of a recurrence.
6) Exercise regularly
Exercising regularly improves fatigue symptoms, reduces stress, and impacts long-term overall health. The ten-year survival rate is higher in patients who exercise regularly than in patients who do not. We recommend that you engage in moderate exercise at least 3-5 hours per week.
7) Continue with regular health screenings
In addition to mammograms, you should stay up to date on flu shots and other vaccinations; screening colonoscopies; pap smears; bone density scans (if you’re over age 50 or no longer menstruating after chemotherapy); annual physicals by your primary care provider; dental cleanings; cholesterol, diabetes and blood pressure screening to monitor your risk for cardiovascular disease; and any other screenings your doctor recommends.
8) Maintain a healthy weight
Women who are overweight are more likely to have their breast cancer come back. Maintaining a healthy weight is something you can do to reduce your chance of a recurrence as well as optimize your overall health.
9) Have your vitamin D levels checked
The Nurses Health Study found a relationship between low levels of vitamin D and breast cancer incidence. It is not known yet if taking vitamin D supplements after breast cancer will reduce your chances of recurrences in the future. However, next time you have blood work performed you may want to ask your medical provider to check your vitamin D levels for general health reasons. Taking a supplement and/or spending 20 minutes outside in the sunshine every day will help increase your vitamin D3 levels. For women experiencing bone, joint or muscle pain on aromatase inhibitors, studies are being done to find out if vitamin D supplements at higher doses would be helpful. You should always speak with your doctor before starting higher doses of any vitamins or nutritional supplements, since most are not regulated by the U.S. Food and Drug Administration.
10) Take endocrine therapies as prescribed
It’s very important to take your endocrine therapy drug exactly as prescribed. Research has shown that many women do not—usually because of forgetfulness, cost or undesirable side effects. When not taken as intended, many endocrine therapy drugs are less effective and may create other health problems. If cost or side effects are a concern, speak to your oncologist. Many pharmaceutical companies offer financial assistance programs and there are a variety of ways to manage symptoms.