Lifestyle changes to maintain your quality of life while living with NET

How individuals with NET can benefit from a healthy lifestyle

Living with NET can be an unpredictable journey with a number of challenges for those affected. However, there are things you can do to help your body fight against cancer, recover from treatment, get or stay healthy and simply be more prepared for the challenges to come.

Lifestyle behaviors such as physical activity and a healthy diet play an important role at every stage throughout the cancer journey and can influence treatment efficacy and treatment-related toxicity, as well as risk of cancer recurrence, prognosis and overall survival.^1,2

Moreover, maintaining healthy habits can also lower the risk of other illnesses, such as heart disease, diabetes, and stroke.³ It also helps individuals feel better, reduces fatigue, and enhances overall quality of life.²

Changing your lifestyle for the better

There are several lifestyle changes that can help improve your health and make you feel better:

Stay active

When coping with NET and the related treatments, you may find yourself less active than usual or you may be limiting your physical activity on purpose to try to conserve energy or prevent further symptoms. However, an inactive lifestyle can lead to increased fatigue and loss of muscle strength.³ Incorporating regular, moderate physical activity into your daily life is recommended by cancer societies.² It can boost your energy levels, improve your strength and help keep your body working as efficiently as possible.³ Physical activity following a cancer diagnosis is also associated with improved survival.²

You could start with light activities such as taking the stairs instead of the escalator, going for a walk or doing some light strengthening exercises, and then gradually increase your activity level over time once you feel confident with the exercises you are doing and want to do more. Excessive training may cause additional fatigue, so avoid overexerting yourself too quickly, know your limits, and get enough rest.³

If you feel uncertain about the type or amount of activity that is right for you, ask your doctor. Additionally, some people may need to take special precautions when exercising. Therefore, talking to your healthcare team is advisable before starting a new routine.

Eat a healthy diet

There are a number of reasons why focusing on diet and healthy eating is important, especially for people with NETs.

Eating well can:³

• Help you cope better with treatment.

• Help wounds and damaged tissues heal after treatment, including surgery, chemotherapy and radiotherapy.

• Improve your body’s immune system, which protects you from infections.

• Help you maintain a healthy weight and provide valuable energy to carry out your everyday tasks, which is important even if you are not undergoing treatment.

For patients whose symptoms are well controlled and who are well on no other prescribed diet, they should simply follow a healthy and well-balanced diet high in fruit, vegetables and whole grains, but low in salt, saturated fat and added sugar. A healthy diet also includes lean proteins, low-fat dairy and a small amount of oils and spreads.³ Also, it is important to drink enough water and stay hydrated.

On the other hand, some NETs, such as gastroenteropancreatic neuroendocrine tumors (GEP-NETs), may require a special diet because many oils, fruits and vegetables may trigger carcinoid symptoms. If you want to learn more about NET specific diet tips, take a look at the eBook ‘Nutritional guide for people living with NETs’ which is available for download free of charge.

Get rest and avoid stress

When dealing with NET and its challenges, it is important to take time to relax, get enough rest and take a break from your responsibilities.

Learning and practicing relaxation techniques such as mindfulness, meditation or yoga may help manage stress and build strength.³ In addition, following a healthy sleep pattern with at least 6-8 hours of sleep every night can boost your immune system and improve your sense of well-being. You can also reduce stress by doing things you enjoy, such as spending time with family and friends or taking time for your hobbies.³

Overall, it is important to listen to your body and take a break when you need it.

Quit smoking

If you smoke, there is no better time than now to stop.

Tobacco smoke is incredibly harmful to your health, causes long-term negative effects on the body and increases your risk of developing secondary conditions such as heart disease, stroke, or other cancers. Smoking can even worsen certain effects of treatment.³

Quitting can reverse many of these effects on your body, lessen the side effects of some treatments and promote faster healing after surgery.³

Giving up smoking is not easy, but there are several smoking cessation programs to help you succeed, including support groups, individual or psychological counseling or other methods. Ask your doctor for recommendations, advice and guidance throughout the process.³

Secondhand smoke can be just as harmful. If your family and friends still smoke, ask them to quit with you or at least ask them to avoid smoking around you.

Limit your alcoholic drinks

Regular alcohol consumption is associated with numerous health risks, including unhealthy weight gain, elevated blood pressure, as well as impaired concentration, judgment, mood, and memory. It also raises the likelihood of having a stroke, developing dementia, and increases the risk of certain cancers.^3,4

In patients with NETs, drinking alcohol can trigger and intensify symptoms of carcinoid syndrome, a common complication of neuroendocrine cancer characterized by flushing, heart rate issues, wheezing and severe gastrointestinal problems.⁵ It is therefore recommended for people with NETs to avoid drinking alcohol or at least limit on the amount of alcohol you drink to 2 drinks per day for men and 1 drink per day for women, according to the American Cancer Society.^5,6 In the UK, the National Health Service (NHS) guidelines recommend individuals should not regularly consume more than 14 units of alcohol per week (that is the equivalent to 6 pints of beer or 10 small glasses of wine), and if an individual drinks regularly, they should spread their weekly alcohol intake over at least three days, and include several alcohol-free days each week.⁷

Avoid other illnesses

People with NET or other cancers may be more susceptible to infections because the cancer itself and cancer treatments, like chemotherapy or radiation therapy, and malnutrition can weaken a person’s immune system, making it difficult for them to fight infections.⁸

Therefore it is essential for patients with NET to try to avoid catching seasonal colds or other secondary illnesses because they may be more vulnerable to complications and suffer a more severe course of illness because of their weakened immune system.

In some circumstances, patients with cancer may also need to be vaccinated against specific pathogens such as the flu or SARS-CoV-2 (COVID) to lower their risk of getting seriously ill if they are exposed to those viruses in the future. However, it is a good idea to talk to your NET care team before you get any vaccines. They can tell you which vaccines are safe and recommended for people with your type of NET, whether you need the vaccine, and when the best time is for you to receive it.⁹

Apart from vaccines, it is also important for patients with NET to keep up-to-date on other recommended health screenings or preventive actions like regular check-ups as well as breast and skin cancer screenings.

Help with changing health behaviors

In many cases, permanent lifestyle changes is a significant challenge. People need a supportive environment to change their behavior and maintain that change. Family and friends who offer support or follow positive behaviors, such as regular exercise, eating a healthy diet or not smoking, may help to increase motivation and make attempts more successful and long-lasting. Other things that patients have mentioned to support a positive change in health behaviors is seeing the benefits of the behavior change.²

Whatever your motivation for changing your lifestyle, it is important to stay committed, ask your loved ones and your healthcare team for support and don’t give up.

Track your health and lifestyle factors with ‘My NET Diary’

If you are looking for a tool to help you record your behaviors and habits and make lifestyle changes easier, then ‘MyNET Diary’ is just right for you.

With ‘My NET Diary’ we offer a printable diary especially designed for people affected by NET to help them keep track of their symptoms, medications, nutrition, mood, physical activity, and other relevant health information.

Download the printable ‘My NET Diary’ for free today.

References

1. Ligibel J. Lifestyle factors in cancer survivorship. J Clin Oncol Off J Am Soc Clin Oncol 2012;30:3697–3704.

2. Tuinman MA., et al. Lifestyle changes after cancer treatment in patients and their partners: a qualitative study. Support Care Cancer Off J Multinatl Assoc Support Care Cancer 2024;32:248.

3. Lifestyle and well-being after treatment. Macmillan Cancer Support. Available at: https://www.macmillan.org.uk/cancer-information-and-support/after-treatment/lifestyle-and-wellbeing-after-treatment. Accessed June 13, 2024.

4. Alcohol’s Effects on the Body. National Institute on Alcohol Abuse and Alcoholism (NIAAA). Available at: https://www.niaaa.nih.gov/alcohols-effects-health/alcohols-effects-body. Accessed June 14, 2024.

5. What to avoid with carcinoid syndrome. Neuroendocrine Cancer Awareness Network. Available at: https://netcancerawareness.org/what-to-avoid-with-carcinoid-syndrome/. Accessed September 25, 2024.

6. Alcohol Use and Cancer. American Cancer Society. 2020. Available at: https://www.cancer.org/cancer/risk-prevention/diet-physical-activity/alcohol-use-and-cancer.html. Accessed August 19, 2024.

7. Alcohol units. National Health Service (NHS). 2022. Available at: https://www.nhs.uk/live-well/alcohol-advice/calculating-alcohol-units/. Accessed June 14, 2024.

8. Why Are People with Cancer More Likely to Get Infections? American Cancer Society. Available at: https://www.cancer.org/cancer/managing-cancer/side-effects/infections/why-people-with-cancer-are-at-risk.html. Accessed June 17, 2024.

9. Vaccinations and Flu Shots. American Cancer Society. Available at: https://www.cancer.org/cancer/managing-cancer/side-effects/infections/vaccination-during-cancer-treatment.html. Accessed June 17, 2024.