Surviving breast cancer: Does lifestyle matter?

When Allison "Missy" Wislocki paddles with fellow breast cancer survivors on a local dragon boat racing team, she feels like she's setting a good example for others.

"That's one of our goals is to show men and women after a cancer diagnosis that it is possible to lead a good, healthy, active lifestyle," said Wislocki, a member of the Derby City Dragons, a mostly female team that practices on the Ohio River.

The women also may be helping to extend their lives — though the jury is still out on that.

A recent report says there is "growing evidence that lifestyle choices may help to reduce the risk of having another diagnosis of breast cancer or dying from the disease," but more research is needed.

The report was released last month by World Cancer Research Fund International in partnership with the American Institute for Cancer Research.

The report, from the Fund's Continuous Update Project, is a systematic, global analysis of available scientific research on breast cancer survivors and included 85 studies. An independent panel of experts evaluated and interpreted the evidence after it was collated and added to a database. More than 164,400 women were in the studies.

The report says there are indications of links between better survival after breast cancer diagnosis and having a healthy body weight, being physically active, eating fiber-rich foods and foods with soy, and having a lower intake of fat, especially saturated fat. However, the evidence, at this point, is limited, so the panel did not issue prevention recommendations specifically for breast cancer survivors.

The panel "was unable to draw firm conclusions on the effect of diet, nutrition (including body composition), or physical activity in women with a diagnosis of breast cancer, specifically in relation to the reduction of mortality (from breast cancer or any other cause) or of a second primary breast cancer," the report states.

But World Cancer Research Fund International and the American Institute for Cancer Research suggest that people continue to follow their general cancer prevention tips, which include being as lean as possible without being underweight; doing regular physical activity, such as brisk walking; eating more of a variety of vegetables, fruits, whole grains and legumes; and limiting red-meat consumption.

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"Although it is difficult to make specific recommendations, the research suggests that women who have a healthy weight and are physically active, both before and after they are diagnosed, have a better chance of surviving a diagnosis of breast cancer and of not getting a second primary breast cancer," said Dr. Anne McTiernan, a panel member who's also a researcher at the Fred Hutchinson Cancer Research Center in Seattle, in a news release. "We need to know more about the effects of other factors on the associations between lifestyle and survival, including specific types of tumors, the stage at which a tumor is found, previous cancer treatment, and socio-economic factors."

Dr. Beth Riley, a medical oncologist with U of L Physicians, counsels breast cancer patients to lead a healthy lifestyle.

There may never be "hard-core evidence" that it positively impacts survival because "lifestyle's a difficult thing to prove," said Riley, director of the breast multidisciplinary clinics at the James Graham Brown Cancer Center. "But the more suggestive the evidence is, the more we just start to incorporate that" into practice.

"Most of us who practice oncology, and specifically, breast cancer oncology, counsel patients extensively" on diet and lifestyle, including limiting alcohol consumption and not smoking, Riley said.

When it comes to diet, you don't have to be vegetarian, but "we think the most abundant portion on your plate should be vegetable-based," Riley said. "... I don't expect them to categorically eliminate one food group from their diet, especially, if they love steak, but something like that should be the exception and not the rule."

Riley also thinks it's important to exercise and watch your weight.

Physical activity can be challenging for some breast cancer survivors, but Riley encourages her patients to do what they can handle.

Eventually, you'll "build back your endurance and work toward a more regular exercise regimen," she said.

Wislocki, an eight-year breast cancer survivor, said being physically active through paddling and other exercise, such as working out at Results by Design Fitness, helps to give her a greater sense of control.

"Cancer is a huge mystery, and we don't have all the whys and what fors, or we wouldn't have cancer anymore, so as much as we can control it, then we want to," said Wislocki, who works at Gilda's Club Louisville.

The Dragons, which have a Kickstarter campaign to raise money to buy their own boat, have been paddling together for two years, using a 20-seater loaner boat with a head, tail and drum. "People are really interested in seeing breast cancer survivors get out there and not just talk about it, not just walk about it, but do something powerful," Wislocki said. "... We have all gotten so much stronger for it."

But they've also had setbacks, such as the January death of team member Jana Rankin, who would come to practice even while going through chemotherapy. "She is our inspiration," Wislocki said. "Her name is on a plaque and will go on our new boat."

Susie Stewart teaches Pilates to breast cancer survivors as part of the Pink Ribbon Program at Floyd Memorial Physical Therapy Charlestown Road in New Albany. Participants in her Wednesday evening classes meet once a week to exercise with stretch bands and other equipment. Stewart also encourages them to do additional fitness, such as walking, outside of class.

"If we want to be healthy and live a long, healthy life, we've got to take responsibility, personally, to do the best that we can do, so that if our body gets challenged, it can fight back and it's gonna be prepared for that," Stewart said.

Reporter Darla Carter can be reached at (502) 582-7068 and on Twitter @PrimeDarla.