General measures
- Nicotine restriction (refraining from tobacco use).
- Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day).
- Aim for normal weight! Determination of BMI (Body Mass Index, body mass index) or body composition by means of electrical impedance analysis and, if necessary, participation in a medically supervised weight loss program or program for the underweight.
- BMI ≥ 25 → participation in a medically supervised weight loss program.
- Falling below the BMI lower limit (from the age of 19: 19; from the age of 25: 20; from the age of 35: 21; from the age of 45: 22; from the age of 55: 23; from the age of 65: 24) → Participation in a medically supervised program for the underweight.
- Review of permanent medication due topossible effect on the existing disease.
- Avoidance of psychosocial stress:
- Stress
- Avoidance of environmental stress:
- UV radiation
- Exposure to ionizing radiation
- Benzo(a)pyrene – found in exhaust fumes, smoke and tar.
- Occupational contact with carcinogens such as arsenic, talc, asbestos, tar/bitumen, chromium (VI) compounds.
- Etc.
Supportive therapies [see below S-3 guideline]
- [see below nutritional medicine and sports medicine
- Education about the side effect “osteoporosis” as long-term side effects of tumor therapy.
Vaccinations
The following vaccinations are advised:
- Flu vaccination
- Pneumococcal vaccination: immunocompromised individuals should be vaccinated sequentially with the 13-valent conjugate vaccine PCV13 and six to 12 months later with the 23-valent polysaccharide vaccine PPSV23 against pneumococcus.
Regular checkups
- Regular follow-up examinations for early detection of recurrence (recurrence of the disease).
Nutritional medicine
- Nutritional counseling based on nutritional analysis
- Nutritional recommendations according to a mixed diet, taking into account the general knowledge of nutrition in a tumor disease. This means:
- Consume only limited energy-rich foods.
- Moderate total fat intake
- Little red meat (pork, beef, lamb, veal) and sausages.
- Once or twice a week fresh sea fish, ie fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerel.
- High-fiber diet (whole grains, vegetables).
- Daily total of 5 servings of fresh vegetables and fruits (≥ 400 g; 3 servings of vegetables and 2 servings of fruit).
- Reduce consumption of smoked and cured foods, because they contain nitrate or nitrite as a component of curing salt. Their preparation produces compounds (nitrosamines), which are risk factors for various tumor diseases.
- Refrain from polluted foods such as offal and wild mushrooms.
- Do not eat moldy food
- Observe the following special dietary recommendations:
- Calcium-rich (1,000 mg calcium / day) diet: fish, fresh vegetables, dairy and whole grains and nuts are beneficial for bone formation.
- Vitamin D-rich diet (supplementation with 800-1,000 IU of vitamin D3 required, as no adequate intake of vitamin D from food is possible!).
- Avoidance of phosphate-containing drinks and foods (eg cola drinks, various sausages and meat products).
- Note that for optimal bone metabolism must be fed less acid-forming foods and instead more base-donating foods.
- Diet rich in:
- Trace elements (zinc)
- Omega-3 fatty acids: alpha-linolenic acid – green leafy vegetables, e.g. spinach, lentils, walnuts, as well as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) – at least once or twice a week fresh sea fish, i.e. fatty sea fish such as salmon, herring, mackerel.
- Probiotic foods (if necessary, dietary supplements with probiotic cultures).
- Selection of appropriate food based on the nutritional analysis
- See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
- For detailed information on nutritional medicine, please contact us.
Sports Medicine
- Endurance training (cardio training) and strength training (muscle training).
- Sufficient physical activity means ≥ 150 min/week of moderate physical activity or ≥ 75 min/week of intense physical activity.
- Moderate physical activity: Playing badminton, golfing, leisurely cycling, skiing, swimming, dancing, playing tennis (doubles), playing volleyball, brisk walking/hiking without luggage, mowing the lawn, climbing stairs, carrying light loads, and doing moderately heavy household, gardening, and repair work.
- Intense physical activities: Playing basketball, playing soccer, running, jogging, playing tennis (single game), brisk cycling, hiking with luggage, mountain climbing, heavy gardening, as well as carrying heavy loads.
- In general, endurance training on a bicycle ergometer can be recommended, which is performed according to the principle of interval training. This means that load phases of 1 to 3 minutes duration alternate with rest phases of also 1 to 3 minutes duration. The training should be performed at about 80% of the maximum heart rate for a total of 30 minutes.
- Sufficient physical activity means ≥ 150 min/week of moderate physical activity or ≥ 75 min/week of intense physical activity.
- Preparation of a fitness or training plan with suitable sports disciplines based on a medical check (health check or athlete check).
- Regular exercise after cancer diagnosis reduces all-cause mortality by more than 30% in patients with both breast and colon cancer (breast and colon cancer) and gynecological tumors, gliomas (collective term for some brain tumors of the central nervous system), hematological entities (blood cancers), as well as kidney, lung, prostate and stomach cancers; patients with breast and colon cancer showed a decrease of relative 37% and 38%, but men with prostate cancer (-30%) also benefited.
- For detailed information on sports medicine, please contact us.
Psychotherapy
- Psychotherapy if necessary
- Tai chi as a physical-mind exercise system; studies show good efficacy against cancer-induced fatigue in various solid tumors.
- Detailed information on psychosomatics (including stress management) is available from us.
Complementary treatment methods
Sources of information on the Internet
| American Botanical Council | http://cms.herbalgram.org |
| American Institute for Cancer Research | http://www.aicr.org |
| CAM-Cancer, Complementary and Alternative Medicine for Cancer | http://www.cam-cancer.org |
| Cochrane Complementary Medicine | https://cam.cochrane.org |
| European Scientific Cooperative on Phytotherapy | http://escop.com |
| Competence network complementary medicine in oncology – KOKON | https://www.kokoninfo.de or https://www.kompetenznetz-kokon.de |
| MD Anderson Integrative Medicine Center | https://www.mdanderson.org |
| Memorial Sloan Kettering Cancer Center, Nutrition and Herbal Remedies. | https://www.mskcc.org |
| National Center for Complementary and Integrative Health | https://nccih.nih.gov |
| Onkopedia Guidelines Complementary Medicine | https://www.onkopedia.com |
| PRIO Prevention and Integrative Oncology (AG der DKG) Information. | http://www.prio-dkg.de |
