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Survivorship Guide for Bone Marrow/Stem Cell Transplant
Caring for Your Body
As cancer survival rates improve and more of us live into old age, it is increasingly important to protect ourselves against developing new cancers and other chronic conditions. Although we can’t change our health or treatment history, there is a lot we can do to improve our overall health and reduce our future risk of disease and chronic conditions. Research has shown, for example, that what we eat can actually influence how certain genes are expressed and thus affect our cancer risk. Our level of activity can affect our weight and hormone levels, which impacts the risk of developing certain conditions. Even small changes in our day-to-day activities can lead to improvements in our overall health and well-being.
One of the main recommendations for reducing our risk for cancer is to maintain a healthy weight. Body fat, particularly fat around the waist, is associated with the development of various cancers, including post-menopausal breast cancer, colorectal cancer, endometrial, kidney, and pancreatic cancers. The most effective way to maintain a healthy weight is through an integrated approach that combines healthy eating with regular exercise. In addition to reducing our future cancer risk, a healthy diet and regular physical activity can reduce the risk of chronic conditions, such as heart disease, stroke, diabetes, and osteoporosis (weakening of the bones). A healthy diet and regular exercise are also associated with improved overall vigor and mood, reduced stress levels, and a more resilient body.
The key recommendations of the American Institute for Cancer Research (AICR) are to:
Depending on how well you know yourself and your relationship to food, you might want to make a big change in your eating habits all at once, or introduce change slowly, picking one or two items from the list below. Getting all the nutrients you need requires choosing a variety of foods. If you suffer from GVHD or have other conditions that make it difficult for you to digest properly, maintain a healthy mineral balance, or consume a well-balanced diet, it is recommended that you consult with a dietitian. Think creatively about your food choices, introduce more healthy foods into your diet, and enjoy new tastes and flavors.
Eat Plant-Based Foods
Choose Whole Grains Over Refined Grains
Reduce Your Consumption of Red Meat and Processed Meats
Replace Unhealthy Fats with Healthier Fats
Healthier Fats – Monounsaturated and Polyunsaturated Fats
Polyunsaturated fats include omega-3 fatty acids. Consumption of foods rich in omega-3 fatty acids is associated with lower rates of heart disease. Good sources of omega-3 fatty acids include cold water fish (salmon, sardines, halibut, and others), algae, chia seeds, flax seeds, walnuts, and canola oil.
Unhealthy Fats – Saturated and Trans Fat
One type of fat that is particularly bad for our health is trans fat. Trans fat both raises overall cholesterol and lowers our level of the good cholesterol (HDL) that protects against heart disease. Trans fat can also trigger inflammation, an overactivity of the immune system that has been implicated in heart disease, stroke, diabetes, and other chronic conditions. Some trans fat occurs naturally in meat and dairy. But most is created in the manufacturing process when liquid oils are processed and turned into solid fats like shortening and margarine. Many types of fast foods, processed foods, cookies, donuts, and muffins contain trans fat. Read labels to avoid products with trans fat and high levels of saturated fats.
Drink Plenty of Water and Reduce Sugary Drinks
Although modest amounts of alcohol may have a protective effect on heart health, cancer risk increases with the amount of alcohol consumed. If you do choose to drink alcohol, women should limit their consumption to one drink or less a day, and men to two drinks or less a day.  
Cut Down on Salty Foods
Get Your Nourishment from Food Rather than from Supplements
Think creatively about ways to increase your activity level. This could involve signing up for a gym or an exercise class but could also simply entail a commitment to walk or bicycle more often, use the stairs instead of the elevator, or regularly park a few blocks from your intended destination. In addition to helping us maintain a healthy body weight, exercise can help to improve our mood and reduce depression and anxiety.
Regular exercise can help increase strength, maintain muscle mass, and promote flexibility. Research also shows that people who exercise regularly have a lower risk of developing breast and colon cancer, as well as diabetes. Activities that include weight-bearing exercises can also help to improve bone density and reduce the risk of osteoporosis, which is a thinning of the bones. Bones are living tissues, and like muscles, gain strength and density when they are put to work.
The key to exercising is to plan it into your schedule and find as many ways as possible to incorporate it into your everyday life. If you would like more company, weave exercise into your social activities. Keep in touch with a good friend by scheduling a weekly time to walk and talk. Instead of driving to a restaurant, invite friends to walk there with you. If you crave time to read, take your newspaper or book and read it on the exercise bike instead of on the couch. If you are a homebody, consider purchasing a few exercise videos to do at home. If you belong to a gym, arrange to have one of the trainers work with you to design a workout that will help you build strength, stamina, and flexibility.
The Centers for Disease Control recommends at least 30 minutes of exercise five times a week. If you find it difficult to exercise for a 30-minute time block, you can still derive benefit by doing 10 minutes of exercise three times a day. Studies show that quality of life and fitness levels can improve with even a small increase in activity.
Ideally, an exercise program should include activities that improve flexibility, cardiovascular health, strength, and bone density. Many activities provide overlapping benefits. Weight-bearing exercises that strengthen bones, such as weight lifting, jogging, brisk walking, racquet sports, and stair climbing, are also good for cardiovascular fitness and stamina. Even activities, such as yoga and T’ai Chi, which are often associated with improving flexibility, have poses that put weight on the bones and can improve bone density, strength, and stamina, if done regularly.
Start slowly and increase your level of activity over time. Overdoing it can be taxing and harmful to your body. Remember to consult your physician before beginning a new exercise program.
If you have osteoporosis or other underlying medical conditions, consult with your doctor or a physical therapist about any limitations. If your condition stops you from meeting the guidelines of 30 minutes, five days a week, come up with a physical activity plan that meets your abilities. In general, getting some exercise is better for you than getting no exercise.
Exercise can energize and can be helpful in combating fatigue. Even on days when you feel reluctant to exercise, pushing yourself to engage in some moderate activity can often feel refreshing and invigorating.
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