There is a one in eight chance of a woman in the United States developing breast cancer in the course of her lifetime. Given the prevalence of this disease, being aware of the lifestyle factors involved in treatment response can greatly improve post-diagnosis survivorship and quality of life. To learn more about the importance of lifestyle for breast cancer patients, I am joined by Amy Comander, MD, who has specialized in breast oncology for over a decade. In this conversation, we focus largely on engaging the pillar of exercise toward breast cancer treatment and recovery processes.
“Where we do have good data in the oncology space is the important role of physical activity. So that’s often something I ask all of my patients at that first visit, ‘What do you do for exercise?’”
Amy recommends about 150 minutes of moderate aerobic activity, which can include light movement like walking to the mailbox, each week. Understandably, this may be difficult for individuals who are undergoing physically taxing cancer treatments. When counseling her patients, Amy considers their individual conditions and tailors their recovery plans to their needs.
“Those individuals who can remain physically active during treatment tolerate chemotherapy better… which then ultimately results in a better outcome. So physical activity during the treatment and beyond is so important.”
In fact, exercise’s role in cancer recovery has been found to be so critical that a new field, Exercise Oncology, is now emerging. Exercise Oncology is dedicated to studying metabolic and immune changes in cancer patients based on their physical activity.
“Our muscles release these myokines which potentially affect so many pathways… they may augment the immune system. There are so many fascinating mechanisms that are being uncovered.”
Listen to the full episode to learn more about this groundbreaking “new frontier” of cancer research.
Here are the details of our conversation:
[00:01:53] Amy’s work in breast oncology and survivorship
[00:02:50] Lifestyle medicine in oncology care
[00:03:53] Amy’s unique specialization and career journey
[00:06:05] Creating data-driven, credible resources for patients
[00:07:38] Using a diagnosis as a starting place for lifestyle change
[00:09:41] Nutrition data and exercise data
[00:10:35] Physical activity guidelines and their role in cancer recovery
[00:12:44] Personal and biological benefits of exercise
[00:15:04] Metabolic and immune mechanisms
[00:16:06] Connecting the immune system, cancer, and exercise
[00:17:08] ASCO’s guidelines on diet, weight, and exercise during cancer treatments
[00:18:52] Specificity in patient counseling
[00:19:58] Amy’s program, Paving the Path to Wellness
[00:23:41] Data on lifestyle interventions
[00:27:11] Optimizing exercise outcomes
[00:28:49] Debunking soy intake and cancer risk
[00:29:53] Sleep and stress in cancer outcomes
[00:31:24] Mental health and stress management for cancer patients
[00:33:03] Conveying the importance of exercise to patients
[00:34:39] Social connection’s impact on health
Dr. Amy Comander is a breast oncologist at the Massachusetts General Hospital Cancer Center. She is Director of Breast Oncology and Cancer Survivorship at the Mass General Cancer Center in Waltham and at Newton Wellesley Hospital, and Medical Director of the Mass General Cancer Center in Waltham. Dr. Comander is Director of Lifestyle Medicine at the Mass General Cancer Center, which is the first cancer center to have a dedicated lifestyle medicine program. As an Instructor in Medicine at Harvard Medical School, she enjoys teaching medical students and residents about oncology, as well as lifestyle medicine.
Given her strong interest in cancer survivorship and lifestyle medicine, Dr. Comander is dedicated to improving the quality of life, well-being, and outcome of individuals with cancer through important lifestyle interventions, including exercise, diet, and mind/body interventions. She promotes healthy lifestyles for both her active treatment patients as well as those in the survivorship phase of care. She practices what she preaches, having run marathons, including ten consecutive Boston Marathons so far, with the goal to improve the lives of those with a diagnosis of cancer.
In collaboration with Dr. Beth Frates, she has launched “PAVING the Path to Wellness,” a 12-week lifestyle medicine-based survivorship program for women with breast cancer. Along with Dr. Frates and Dr. Michelle Tollefson, she has published the “PAVING the Path to Wellness” workbook. Dr. Comander is currently proud to serve as the first oncologist on the Board of Directors of the American College of Lifestyle Medicine. She is also on the Board of the Ellie Fund, a non-profit that provides services and support to women diagnosed with breast cancer in Massachusetts. She is a medical advisor to the non-profit organization, SurvivingBreastCancer.org. She has served as a medical advisor to Oneinforty, a non-profit organization dedicated to educating people of Ashkenazi Jewish heritage about the one-in-forty chance of having inherited a BRCA mutation. She is married to Jason, a physician-scientist at Mass Eye and Ear, and is the mom of two teenagers.
Learn more about Amy’s PAVING the Path to Wellness Program here
Find more tips for lifestyle change in the PAVING the Path to Wellness Workbook