A cancer diagnosis can be a turning point for many people, many of whom decide to make lifestyle changes which can help them cope with the physical and emotional toll that cancer has on the body, mind and spirit. A diagnosis helps them focus on their health in ways they may not have given much though to in the past. Living well encompasses making lifestyle changes that improve the health of the body and mind.
This section will cover topics like nutrition, physical activity, and mental wellness relevant to those who have been diagnosed with melanoma. In the survivorship section, safe sun practices to prevent the recurrence of melanoma in survivors and managing the fear of recurrence will be addressed.
Nutrition
Eating right can be hard for anyone, but it can get even tougher during and after cancer treatment —in particular, chemotherapy. Treatment may change your sense of taste. Nausea can be a problem. You may not feel like eating and lose weight when you don’t want to. Or you might have gained weight that you can’t seem to lose. All of these things can be very frustrating.
If treatment causes weight changes, eating or taste problems, do the best you can and keep in mind that these problems usually get better over time. You may find it helps to eat small meals every 2 to 3 hours until you feel better. An option you may want to explore is finding a dietitian or nutritionist, an expert in nutrition who can give you ideas on how to deal with side effects of these treatments [1].
Small, simple changes in eating habits go a long way; for example, having a small plate of veggies as a snack or having one less drink tonight. Minimizing the amount of food preparation: simplifying meals, buying things like prepared salad kits and entrees from the grocery store will save time and effort when your energy levels are low.
A study by Tong et. Al found that a Mediterrean diet, polyunsaturated fatty acids, and lycopene have strong supportive evidence of reducing melanoma risk [2]:
- Lycopene is a carotene usually found in red fruits and vegetables, the most well-known being the tomato, but also including red carrots, papayas, and watermelons [3]. Lycopene is known for its photoprotective properties, oral supplementation can increase human basal dermal defense against UV damage and counteract photoaging, and is thought to be the most effective carotene at reducing oxidative stress
- The Mediterranean diet, which is known for its high concentrations of fish and vegetables, is shown to have chemopreventive effects against melanoma [4]
- Other studies supporting the Mediterranean diet have demonstrated a higher percentage of subcutaneous tissue polyunsaturated fatty acids and linoleic acid in patients with melanoma versus control subjects. Thus, diets supporting the use of vegetable oil and fish consumption have been recommended [5]
Although evidence in animals is abundant, there is a need for more human randomized control trials (RCTs) to explore the link between nutrition and the prevention and treatment of a melanoma. And while the primary goal of the study by Tong et. Al was to examine the relationship between diet and melanoma prevention, no current recommendations can be made. They do say, however, it seems likely ‘that diet can also serve as an effective adjuvant therapy (decreasing chances of recurrence) for the treatment of melanoma and non-melanoma skin cancer’ [6].
Consult with your dietitian or nutritionist about this, who as part of your core team, can make recommendations to support optimal digestion and nutrition, and help manage side-effects. For example, using ginger products and eating bland foods can help you manage nausea. They may recommend an appetite stimulant, high protein nutritional drinks, or specific high protein foods to help you meet your needs. If you have low blood counts, you’ll need to take precaution to reduce bacterial exposure from food. Your dietitian will help you navigate which foods to avoid and help find substitutes [7].
Nutrition and melanoma webinar – Melanoma research foundation
Nutrition and physical activity during and after cancer treatment: FAQ – American cancer society
[8] Information taken from the Canadian Cancer Society
Physical activity
While it may be challenging, being active as possible during cancer treatment and recovery can reduce stress or anxiety, improve your mood and self-esteem, boost your energy, stimulate your appetite, help you sleep and help you regain your strength during recovery. Exercise can also help you reduce side effects like nausea, fatigue and constipation [9].
An analysis of the findings from the Canadian Community Health Survey (CCHS) suggest that half of ‘Canadians are not participating in the recommended amount of physical activity and are missing out on a variety of health benefits such as decreased risk of some cancers, cardiovascular disease, stroke, diabetes, osteoporosis, obesity, and improved bone and mental health’[…] [10]
‘[…} While individuals with cancer were less likely to be active than those who have never had cancer, survivors had similar physical activity levels to the population levels. Activity levels in all three groups are much lower than recommended [11].’
How much physical activity you can do during cancer treatment often depends on your overall health and physical condition, how you cope with treatment and what side-effects you may have. Some people —for example, someone who has had breast surgery—may be given particular exercises to follow as part of their recovery [12].
General exercise guidelines during treatment
Each person’s exercise program is unique and should be based on what is safe and works for them. Your goal should be to maintain endurance, strength and flexibility and keep you able to do the things you want to do. There may be times when you don’t feel able to exercise. However, the goal is to be as active as you comfortably can be. These tips may help:
- Start slowly: try walking and slowly increasing how often and how long you walk.
- Exercise when you have the most energy or feel the best
- Gentle activity is better than nothing; sometimes just a few minutes of gentle stretching can make you feel better
- If you don’t have the energy to exercise for a long period of time, break it up into shorter sessions throughout the day
- Include physical activity that uses large muscle groups such as your thighs, abdomen, chest and back
- Vary activities to include strength, flexibility and aerobic activities
- Try something new like yoga, tai chi or dancing
- Make exercise enjoyable by exercising with a friend or listening to music
- Try to remain active within your daily routine
- If you’re able, do housework such as vacuuming, washing floors and dusting. This is exercise too! Try doing a little every day instead of all at once
- Mow the grass, wash the car or weed the garden
- Walk instead of driving or park your car in a parking space a distance from your destination and walk to it
- Use the stairs instead of the elevator
- Get some fresh air or try meditation exercises to help reduce fatigue
- Drink plenty of fluids before, during and after exercise. Stop and rest when you’re tired
Safety precautions
- Before you begin any exercise routine, consult with your clinician or oncologist
- Don’t exercise if you have anemia or if mineral levels in your blood, such as sodium or potassium, are not normal
- Avoid public places, such as gyms, if you have low white blood cell counts or a weakened immune system
- Avoid uneven surfaces or any weight-bearing exercises that could cause falls or injury
- If you have osteoporosis, arthritis, nerve damage or cancer that has spread to the bone, do not use heavy weights or exercise that puts too much stress on the bones
- Avoid swimming pools if you are receiving radiation therapy as chlorine can irritate skin in the treatment area
[13] Information taken from the Canadian Cancer Society
[1] “Lifestyle Changes after Having Melanoma Skin Cancer.” American Cancer Society. American Cancer Society, 20 Mar. 2015. Web. 14 July 2015.
[2] Tong, Lana X., BA, and Lorraine C. Young, MD. “Nutrition: The Future of Melanoma Prevention?” American Academy of Dermatology (2014): 151-159. Wiley Online Library. Web. 14 July 2015.
[3] ibid.
[4] ibid.
[5] ibid.
[6] ibid.
[7] “What Is Nutrition Therapy?” Nutrition Therapy for Melanoma. Cancer Treatment Centers of America, 2015. Web. 15 July 2015.
[8] “Physical Activity during Cancer Treatment.” Canadian Cancer Society. Canadian Cancer Society, 2015. Web. 15 July 2015.
[9] ibid.
[10] Neil, S. E., C. C. Gotay, and K. L. Campbell. “Physical Activity Levels of Cancer Survivors in Canada: Findings from the Canadian Community Health Survey.” Journal of Cancer Survivorship Research and Practice (2013): n. pag. Springer Link. Web. 15 July 2015.
[11] ibid.
[12] “Physical Activity during Cancer Treatment.” Canadian Cancer Society. Canadian Cancer Society, 2015. Web. 15 July 2015.
[13] ibid.