Patient Support and Counselling

Healthy Lifestyle Recommendations:

Your patient is encouraged to lead a healthy lifestyle. Here are some evidence informed recommendations about modifiable lifestyle factors for your information:

Body Weight

Body mass index (BMI): 18.5-25 kg/m2
Waist circumference: less than 80 cm for women / less than 94 cm for men.

Physical Activity

Spread out exercise throughout the day and week, such as 30 minutes five days a week.
Focus on moderate-intensity physical activity (brisk walking, jogging) and resistance exercise.

Nutrition

Avoid processed drinks and foods.
Eat a variety of vegetables, fruits, whole grains, and legumes.
Limit consumption of red meats (such as beef, pork, and lamb), and avoid processed meats.
Limit consumption of salty foods and foods processed with salt.

Dietary Supplements/ Bone Health

Vitamin D: 1000 - 2000 IU per day.
Calcium: 1200 mg per day (from all sources).
Treatment and follow up as per Canadian Osteoporosis Guidelines.

Alcohol

Limit alcohol consumption (<3 drinks/week).

Smoking

Practice smoking cessation as per the guidelines

Immunizations

Annual non-live influenza vaccination unless contraindicated.
Other vaccinations as appropriate.

Other cancer screening

Age-appropriate screening for cervical, colorectal and other cancers.

Other:

Genetic counselling:

Patients should be encouraged to report any changes in their family history of cancer. All women from high-risk families should be offered a referral for genetic counselling.

Family Planning:

Pregnancy while on endocrine therapy is contraindicated. The absence of regular menses does not equate to menopause in all cases. Non-hormonal contraception is generally recommended (i.e. condoms, IUD) while the patient is on breast cancer treatment (radiotherapy, chemotherapy and endocrine therapy). There is an increased risk of sub-fertility / infertility and premature menopause in women who have had previous chemotherapy. Referral to a fertility specialist may be considered.