Wellness for Cancer Initiative
The intention of these trends is to increase our collective health literacy about preventable cancers. Health education for 40+ year old women is globally trending and is a primary strategy for health promotion.
Theme: Making healthy lifestyle choices, the best time to prevent cancer is Now.
Making healthy lifestyle choices is very important for women in their 40s and beyond. This is especially true because this is when cancer prevention becomes more important. In addition, women usually make most of the decisions for their families, so it is important to inform them about how to stay healthy. Post-menopause is the age when women are most likely to develop breast cancer, the number one risk of death in women behind heart disease.
Obesity-related cancers: meningioma, multiple myeloma, adenocarcinoma of the esophagus cancers of the thyroid, postmenopausal breast, gallbladder, stomach, liver, pancreas, kidney, ovaries, uterus, colon, and rectum.
What determines health? 1
- Medical Care 10%
- Genes/Heredity 16%
- Environment 21% – Environment includes surrounding yourself with others who make good lifestyle choices as well.
- Lifestyle 53% -Lifestyle includes choices made about all aspects of living.
The Big FIVE unhealthy habits include: Smoking, Alcohol Abuse, Unhealthy Eating, Sedentary Behavior, and Ineffective Stress Management.2
Wellness has the broad capacity to include all aspects of physical, psychological, and social wellbeing including health- health promotion- and disease prevention.3
FOCUS: Post-Menopausal Breast Cancer Risks are Modifiable
Up to 80% of postmenopausal breast cancers are associated with increased estrogen levels.
Most women are unaware endogenous estrogen exposure can lead to an increased risk of breast cancer, the early onset of menstruation (<12 years) or late menopause (>55 years), using hormone replacement therapy, and having a body mass index (BMI) greater than 30.4 Up to 80% of postmenopausal breast cancers are fueled by endogenous estrogens.5
It takes years for cancer to develop but lower estrogen levels have been observed to reduce the risk of both new diagnosis and recurrent Breast Cancer (BC).
While there are numerous mechanisms and pathways that trigger the opportunity for cancer to grow, our trends highlight endogenous estrogens and their association with overall BC risk, particularly for postmenopausal women.
Reducing these estrogens by diet and exercise maintaining a BMI <30 has served as a primary means to decrease overall risk.
Where does the estrogen come from since the ovaries no longer produce it?
It is adipose tissue that contributes to most of the circulating estrogen in postmenopausal women which is associated with increased risk of BC.
Menopausal weight gain means more adipose tissue and more estrogen. Overweight postmenopausal women increase their BC risk by 20-40%; and have a 20-60% BC greater risk than leaner postmenopausal women.4 That extra belly fat acquired during menopause becomes the body’s main source of estrogen in later years further increasing the risk of BC.
Fortunately, being overweight is a reversible condition.
Reducing these estrogens through healthy lifestyle behaviors serves as a primary means to decrease this risk of postmenopausal BC.
Lifestyle Interventions to promote health
TREND 1: Dietary options can lower postmenopausal breast cancer risk up to 40%.
The Mediterranean diet is one of the more researched diets and has been observed to decrease endogenous estrogens in postmenopausal women7 Cancer-oriented diets are often plant-centered — vegetables are viewed more as the entrée than a side dish. El Camino Hospital’s Cancer Healthy plate recommends ½ vegetables and fruit, ¼ lean protein and ¼ whole grains.8
Healthy Breast Cancer Diet Guidelines9 (UCSF Cancer Center)
- Eat 8 to 10 colorful fruit and vegetable servings daily
- Consume 30 to 45 grams of fiber daily
- Avoid processed and refined grains/fours/sugar
- Lean protein with every meal, plant protein daily
- Limit fatty and processed meats and dairy
- Include healthy fats like cold-water fish, chia seeds, flaxseeds, walnuts, soybeans, avocados, olive oil
- Consume 1-2 Tablespoons chia or ground flax daily
- Herbs and spices daily
- Limit alcohol consumption
- Drink 1-4 cups of green tea daily
- Drink plenty of fluids
- Daily activity to achieve and/or maintain healthy weight
A Swedish study reported 1-2 daily servings a day of cruciferous vegetables reduced the risk of postmenopausal BC by as much as 20-40%.10 A vegetable-fruit-soy diet reported lowered BC risk by 30% in Singaporean Chinese postmenopausal women, increasing to 43% when diet was followed 5 or more years.11
Studies associate flaxseed with production of less active forms of estrogen.
A high fiber diet is associated with reduced hormones linked to BC, increased estrogen in stool, and reduced obesity.4 An NIH/AARP Dietary fiber study concluded a reduced risk of 13% when comparing postmenopausal women in the high quintile of fiber intake to the lowest quintile.12
Dietary Lifestyle in Action Changing dietary lifestyle behaviors may start with a cooking class. Evidence supports cooking classes have favorable results on BMI and increased consumption of grains, seeds, legumes, berries, and vegetables.13 Psychologically speaking, women may view attending the class as a more approachable action step than immediately trying to adhere to a controlled diet.
TREND 2: Physical Activity is trending…It’s not too late to influence BC risks
Studies associate Physical Activity (PA) with a reduction in BC risk through hormonal and nonhormonal pathways.14 Postmenopausal women who exercised the equivalent to running 3 hours weekly and those active in doing moderate household work to the equivalent of 24 hours weekly reduced BC risk by 40%4.
Evidence also suggests that prolonged time spent sitting may lead to higher levels of estrogen in postmenopausal women.14 And women who engaged in low activity levels at menopause transition and who later increased their activity levels were at a reduced BC risk compared to those that remained sedentary.15
Body weight is especially important in postmenopausal BC prevention, physical activity helps to reduce total body weight and abdominal fat.
In a large study with 20 years of follow up, higher levels of both recent and long-term moderate/vigorous physical activity, including brisk walking, were associated with lower BC risk among postmenopausal women.15 This finding of lower risk associated with recent activity suggests that it is not too late to modify physical activity levels to influence BC risk.15
Physical Activity in Action (Marketing): Evidence suggests the general public has limited knowledge that cancer can be prevented by the same options as reducing heart disease.
Physically active women tend to be more responsive to existing PA health messages compared to women who do not exercise. Health promotion needs to envision new ways to communicate with women who are not interested in physical activity. Messaging could be tailored by the stage of change/readiness (pre-contemplation, contemplation, planning, action, maintenance), self-efficacy, and social support needs.
Some studies report that using forceful or fear-based language appears to be ineffective and may negatively affect motivations and outcomes. Recent messaging “Do what you can” appears to have broader acceptance.
A social marketing approach could be more effective – where techniques are used to influence people’s behavior for social good or to improve individual health outcomes. An appealing message would focus more on the immediate social and mental benefits of increasing energy, having fun, spending time with others. These messages in contrast to longer term benefits like reduced risks of breast cancer.
Physical Activity in Community Design: According to the CDC, creating or modifying environments to make it easier for people to walk and bike to everyday destinations (e.g., library, grocery store) helps increase PA and can make communities a better place to live.
Making a healthy community is good for everyone
Global evidence is accumulating: the sum is greater than the parts
While individual lifestyle factors have been associated with postmenopausal BC prevention (e.g, diet, physical activity, smoking, alcohol, and body fatness), studies are accumulating evidence on the benefits of clustering factors to reduce cancer risks. Behavioral risk factors are often correlated as individuals follow common lifestyle patterns influenced by intrapersonal, social, and cultural characteristics.16 Globally, studies have created versions of a Healthy Lifestyle Index (HLIS) to assess the effect of these combined factors on the risk of BC.
One of the first HLIS studies was conducted in Mexico and observed an 80% lowered risk of postmenopausal BC comparing the highest to the lowest quintiles of the index.17
A 2014 European Prospective Investigation into Cancer (EPIC) study was undertaken with 242,918 postmenopausal women and created a BC-specific HLIS. Results showed a lowered risk of BC in women with healthier lifestyles, a 3% reduced risk of BC per point increase in HLIS. 16
An HLIS study conducted on Indigenous Maori women in New Zealand reported that among postmenopausal Māori those in the top HLIS tertile had a significantly lower odds of breast cancer.18
Integrated Lifestyle in Action: Lifestyle behavioral improvement is a holistic concept. People are not isolated — they are part of bigger systems involving family, workplace, and community. Their lifestyle behaviors tend to cluster around perceptions, feelings, beliefs, self-confidence, and self-efficacy. The Travis Iceberg model3 depicts this point beautifully. What contributes to the state of health (what is observable above the surface), is built on what lies below the surface.
Remembering always that our clients are naturally creative, resourceful, and whole. Our role is not to fix or to treat, it is to meet people where they are.
Health coaches can support how to eat healthy and add more PA into one’s day, effectively manage stress, develop supportive relationships, and identify community resources to sustain change.
- Jordan, M. “How to be a Health Coach: An Integrative Wellness Approach,” 2013.
- Prochaska, J.O. and Prochaska, J.M., Changing to thrive: the stages of change to overcome the top threats to your health and happiness,” 2016.
- Travis, John W., 3rd Edition: “The Wellness Workbook: How to Achieve Enduring Health and Vitality,” 2004.
- Wiggs, Alleigh, “The Effects of Diet and Exercise on Endogenous Estrogens and Subsequent Breast Cancer risk.” Frontiers of Endocrinology, 2021.
- Majumder et al. “Post-menopausal Breast Cancer: from Estrogen to Androgen Receptor.” Oncotarget, 2017.
- Cohen, Lorenzo PHD and Jeffries Alison, Med, “Anticancer Living: Transform Your Life and Health with the Mix of Six” 2018.
- Carruba G, Granata OM, et al. “Traditional Mediterranean diet decreases endogenous estrogens in healthy postmenopausal women.” Nutr Cancer. 2006.
- Ledsmo, Natalie MS, RD, CSO “Women’s Health Matters: Nutrition and Breast Cancer, UCSF Medical Center.
- Terry P, et al. “Brassica vegetables and breast cancer risk.” Jama. 2001.
- ButlerLM, WUAH, “A vegetable-fruit-soy dietary pattern protects against breast cancer among post-menopausal Singapore Chinese women.” AM J Clin Nutr 2010.
- Park, Yikyung, “Dietary fiber intake and risk of breast cancer in postmenopausal women: the National Institutes of Health-AARP Diet and Health Study.” AM J Clin Nutr 2009.
- Berrino F, et al. “Reducing Bioavailable Sex Hormones Through a Comprehensive Change Diet: The Diet and Androgens (DIANA) Randomized Trial. Cancer Epidemiol Biomarkers Prev. 2001.
- Slojewska, Kinga, “The effect of Physical Activity on Sex hormone levels in women. Implications for Breast Cancer risk.” Via Medica, 2021.
- Eliassen, A. Heather, SCD et al “Physical Activity and Risk of Breast Cancer among postmenopausal women.” AMA, 2010.
- MeKenizie, et al “Health Lifestyle and risk of Breast Cancer among post-menopausal women in the European Prospective Investigation into Cancer and Nutrition Study.” Intl Jrnl of Cancer, 2014.
- Sánchez-Zamorano LM, et al.: “Healthy lifestyle on the risk of breast cancer.” Cancer Epidemiol Biomarkers Prev. 2011.
- McKenzie, F.,et al. “Healthy lifestyle and risk of breast cancer for indigenous and non-indigenous women in New Zealand: a case control study.” BMC Cancer 2014.
TREND 1: The most exciting innovation in early detection—The Galleri test has arrived!
One of the MOST exciting developments in early cancer detection is the Galleri test.
While medical guidelines recommend screening for breast, prostate, colorectal, cervical and lung cancers, over 70% of all cancer deaths are caused by other cancer types that are not commonly screened for.
The Galleri blood test can detect the presence of over 50 different cancers with a 99.5% specificity with one simple blood draw. This means that if the test result is positive for a cancer signal, it has less than a 1% chance that the test is wrong.
- The test is also able to identify the site of the cancer’s origin in the body with an 89% accuracy.
- Of the 12 cancers responsible for two-thirds of all cancer deaths per year in the US, the Galleri test can detect these with a 76% sensitivity.
- The Galleri test is intended to be complementary to and not a replacement for recommended cancer screenings.
It is estimated that if the Galleri test were added to routine cancer screenings, the number of cancers detected in adults in the US through screening could increase from 200,000/year to over 600,000/year, a three-fold increase in cancer detection. Today, many cancers are found too late, leading to poor outcomes,” says Dr. Liu., Mayo Clinic Oncologist “The ability to detect cancer early is critical to successful treatment.
TREND 2: Wellness brands evolve to become more inclusive without ostracizing, stereotyping or collectively grouping individuals by offering the “cancer” service.
Statistics show that 1 in 2 individuals will be diagnosed with cancer. The ability to address and adapt services and programs for individuals requires sensitivity and finesse.
If the medical industry can personalize medical treatments for cancer, surely the wellness industry can adapt any of its services for cancer and many other conditions.
As the wellness industry emphasizes greater personalization, it does not seem sensible or practical to have one menu for healthy clients and another menu for clients with a disease or chronic illness. When we label, we limit thoughts and beliefs about what we think a person is capable of receiving. People diagnosed with cancer are not all the same. What happens when a person has more than one condition? Or with a person living with metastatic (incurable) cancer—does this mean he can only receive “the cancer massage” for the rest of his life?
Individuals living with cancer or touched by cancer are not a demographic. They are just as unique as any other human—each with their own set of wellness preferences. Cancer is only a part of someone’s whole life; it does not define them as a person or their wellness choices. This is an important distinction that the wellness industry is learning and adopting.
During a recent conference hosted by Professional Beauty Group, several cancer thrivers’ voices were shared alongside wellness thought leaders who had experienced or were touched closely by a family member with cancer. Together, they shaped the conversation surrounding their experiences and their hopes for the evolving wellness industry.
- Marina Efraimoglou, owner of Euphoria Retreat and cancer thriver, mentioned that people are “almost” identified by their situation—a breakup, divorce, cancer or chronic situation—but it is our job to help them see that they are so much more than their disease.
- Corrina Yap, director of wellness at Rosewood Hong Kong and cancer thriver, expressed that as an industry, we are still learning, but we cannot “other” individuals (making them separate from) by offering them the disease-oriented service.
- Neil Jacobs (CEO Six Senses) and John and Karina Stewart (owners of Kamalaya) each shared personal experiences with cancer and why it is so important to recognize the whole individual by providing the same menu of services for guests and adapting them for each guest’s unique and personal situation.
- Lauri Medina, MD, (oncology surgeon) and Lauren Huffmaster (cancer survivor and executive director of Adventure Therapy Foundation) discussed the need to be more sensitive. A woman aged 30 with two kids is coming in for a service just as any other woman aged 30 with two kids. This woman may even have metastatic cancer, which means she will likely die of cancer, but she cannot allow cancer to define her or her family’s journey. Being normal and living a life that is normal for them is the most empowering way we, as an industry, can be supportive.
- The Bra Sisters (UK) spoke about how women, during cancer treatment and beyond, want lingerie that is more feminine and less medical-looking. They were inspired to start their business based on their personal experience shopping for lingerie and having to go to the back of the store to shop in a sub-set of bras made for people with cancer.
TREND 3: Access to living well and healing evidence and practices from leading doctors and wellness practitioners has never been so readily available.
This past year, while the whole world was experiencing trauma, healing and living well summits surfaced in a variety of ways. Healing as a topic itself applies to everyone, and with the rise in digital summits, there was greater accessibility of quality content from leaders in the fields of healing and wellness.
A multitude of collaborations surfaced—whether cancer-only forums or summits sponsored by cancer organizations and charities OR healing-focused summits with cancer as a common thread.
We provide three inspiring examples where cancer was a thread within a larger context of healing summits.
Hay House HEAL Summit hosted a seven-day summit with each day covering a healing topic related to the body, heart, emotions, mind, energy, spirit, and the sharing of miraculous healing stories. Thought leaders addressed cancer as part of a topic.
- Deepak Chopra spoke about cultivating a healing mindset with respect to cancer or any illness. Dr. Chopra emphasized that an individual may have a diagnosis, but they are not their prognosis.
- Kelly Turner, PhD, a best-selling author, researcher, and consultant in the field of integrative oncology, addressed common threads that she has studied on healing mindsets and cancer.
- Veronique Desaulniers, DC, The Breast Cancer Conqueror®, spoke about seven lifestyle changes to beat cancer.
- Siegel, MD, a world-renowned expert in cancer treatment and holistic medicine, addressed healing emotions and how childhood trauma can lead to illness if unaddressed.
- Joe Dispenza, DC, New York Timesbest-selling author, researcher, and international lecturer, discussed his latest findings from the fields of neuroscience, epigenetics and quantum physics to explore the science behind spontaneous remissions. He addressed how this knowledge can help people heal who are experiencing illnesses, chronic conditions, and even terminal diseases—so they can live a more fulfilled and happy life and evolve their level of conscious awareness.
The Embodiment Conference hosted 1,000 speakers over 10 subjects, which ran simultaneously and reached an audience of 500,000.
- Doctors, practitioners, and the general public came together in these sessions and discussions.
- Simultaneous topic channels included Meditation & Breath, Yoga, Coaching & Therapy, Dance & Creativity, Ecology & Research, Intimacy & Relationship, Leadership & Business, Martial & Healing Arts, Movement & Anatomy, and Trauma & Social Change.
- Cancer and many other chronic illnesses were addressed as part of the greater topic.
Love & Resilience: The Contemplative Care Summit
New York Zen Center’s Contemplative Care Programs have transformed the lives of individuals around the world by supporting the integration of spiritual practice and caregiving.
Over the past decade of engagement in healthcare environments, New York Zen Center witnessed an acute need for an approach to care that extends beyond the patient and their loved ones to include the clinicians themselves.
Too often, and as seen during COVID, clinicians experience burnout, a sense of isolation, and loss of meaning in their work and lives. Now, more than ever, there is a critical need for deeper connections with patients, team members and loved ones in this time of the pandemic.
- Thirty-two presenters focused on themes such as Loving Relationships, Livelihood & Work, Illness & Aging, Death & Dying, and Ritual & Imagination.
- Sensei Koshin Paley Ellison and Sensei Chodo Robert Campbell discussed the transformative and practical aspects of contemplative caregiving.
TREND 4: Yoga and oncology continue to be a priority in clinical research.
Yoga has increasingly become recognized as a complementary approach to reducing the onset and severity of cancer-related symptoms and/or symptom management.
- Individuals are likely to approach yoga as a complementary therapy option based on recommendations from their healthcare team.
- Individuals use yoga to enhance recovery and wellness.
- The underlying reasons for the use of yoga among cancer patients and survivors include relaxing; coping with cancer-related distress, pain and fatigue; taking an active and positive role in their cancer recovery; managing other non-cancer conditions (cardiovascular, disease, arthritis); and increasing energy, physical activity, immunity, sleep and mental cognitive abilities.
Clinical research has demonstrated the acceptability and feasibility of yoga among cancer patients during cancer treatment and after transitioning outside a medical setting.
- 89% of US National Cancer Institute’s (NCI) accredited comprehensive cancer centers provide information on yoga, and 69% offer on-site yoga.
- This rise in information and access to yoga, breathwork and meditation is becoming more present in cancer centers around the globe.
Source: Yoga Alliance on the Evidence of Yoga and Cancer
TREND 5: Unleashing the power of the immune system as a smart way to prevent, control and eliminate cancer continues to make strides.
Compounding the fear of cancer is the fact that cancer’s treatment is often considered worse than the disease itself. But due to decades of research, cancer immunotherapy (also known as immune-oncology) includes medical treatments designed to harness the power of one’s own immune system to prevent, control and fight cancer.
Immunotherapy enhances the ability of the individual’s immune system to recognize, target and eliminate cancer cells, wherever they are in the body, making it a potential universal answer to cancer.
- The immune system is precise, so it is possible for it to target cancer cells exclusively while sparing healthy cells.
- The immune system can adapt continuously and dynamically, just like cancer does. If a tumor manages to escape detection, the immune system can re-evaluate and launch a new attack.
- The immune system’s “memory” allows it to remember what cancer cells look like, so it can target and eliminate cancer if it returns. This “immunomemory” may result in longer-lasting and potentially permanent protection against cancer recurrence.
Harnessing the power of the immune system treats the patient, not the tumor. And many believe that it may be reasonable to start using the other “C” word—CURE—to describe the future of cancer.
Building upon the progress made the past three years, The Wellness For Cancer Global Wellness Institute Initiative predicts that wellness will continue to become more accessible and tailored to all guests, including individuals at risk of or touched by cancer. Leading this integrative lens are wellness hotel and destination brands and preeminent skin-care brands that are integrating cancer awareness as a strategic customer service initiative that is embedded within their overall business and operational strategies, including customer touch points (e.g., spa and wellness service and programs, food and beverage), product/service development, and community outreach.
TREND 1: Spa and Wellness Industry becomes serious about being Cancer Aware by establishing minimum education standards
As the spa and wellness industry continues to have more open conversations about being cancer aware, global training standards will emerge as currently the entry level of therapist training varies significantly. Cancer treatments affect all systems of the body, and the ability to tailor a massage or beauty treatment rest on the foundational knowledge of a therapist and not on a one set protocol that purports to be appropriate for every body.
TREND 2: Beauty not only moves to being clean but also into being Cancer Aware
With shifting statistics of 1 in 2 individuals being diagnosed with cancer during their lifetime and the consumer push toward being clean to avoid cancer-causing ingredients, skin-care brands recognize the need to study and communicate which of their products can safely be used by clients whose skin has been impacted by cancer treatments and whose skin health is comprised of various skin types all at the same time.
While testing of skin-care ingredients and the impact on people in cancer treatment is poor and virtually nonexistent, brands will test their products with clients to ensure to the best they can that clients won’t have skin reactions to their products at a time where there is little tolerance by the client for additional adverse skin reactions.
TREND 3: Wellness Brands apply principles of healthy living to people touched by cancer
Leading wellness brands will adapt principles of breathwork, meditation, focused attention exercises, yoga asana, exercise and plant-based diets to people touched by cancer to support healthy living, resiliency, and the way in which the mind and body functions to express themselves. Additionally, brain health exercises that can be applied to all aging individuals have been shown to improve cognitive function in cancer survivors with respect to attention, brain speed and memory, resulting in less anxiety, depression and fatigue.
TREND 4: Sleep programs will address circadian rhythms from cancer prevention through cancer treatment and into survivorship.
While the wellness industry is deploying a spectrum of sleep programs, the importance of circadian rhythms can be extended from cancer prevention, through cancer treatment and into survivorship. With disrupted circadian rhythms linked to cancer biology of several cancers (e.g., breast, prostate and colorectal cancers), insomnia affecting up to 80 percent of individuals with cancer, and sleep disturbances reported to last up to 10 years post cancer treatment, the importance of helping guests explore ways to improve their sleep is vital.
TREND 5: Menopause programs assist women with lifestyle changes for cancer prevention, through cancer treatment and to prevent the risk of recurrence
Newly launched menopause programs help individuals manage symptoms, such as hot flashes, mood disturbances, sleep, skin health and psychological issues associated with the process of menopause.
These programs can also address the nutritional and physical aspects of functional aging, which include the increased risk of breast cancer after menopause. While menopause itself doesn’t increase breast cancer risk, an aging body does.
The culprit—estrogen—with 80 percent of breast cancers in post-menopausal women fueled by estrogen. While certain types of estrogen decrease during menopause, the body continues to produce it in later years with most of it coming from adipose fat cells and adrenal glands. The weight gain during menopause is a risk factor for post-menopausal cancer since more fat cells mean more estrogen. And this type of fat also increases inflammation in the body, which is also linked to a higher risk of breast cancer.
Additionally, menopause programs can be adapted to the many young women who are thrown into medically induced menopause from their cancer treatments.
The Global Wellness Institute serves as an umbrella organization for numerous Initiatives, that are independently chaired and run. The resources, editorial, research and opinions presented by the Initiatives do not necessarily reflect the opinions of the Global Wellness Institute.