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Dr. Katrina Cox, ND
How to create a plan to reduce the chances of cancer recurrence
. https://theopportunityincancer.com/book/

How to create a plan to reduce the chances of cancer recurrence

Cancer can be considered one of the most harrowing modern health journeys. It is estimated that almost fifty percent of those in North America will be diagnosed with cancer in their lifetime. As treatment options progress, over sixty percent of those diagnosed with cancer will survive beyond five years. While that is incredibly positive, it doesn’t mean that survivors are always living with great quality of life and they are commonly plagued by the question, “How do I stop it from coming back?”.

Although there are never any guarantees in mitigating cancer’s return, the foundational lifestyle actions of eating well, quitting smoking, reducing alcohol, and getting enough exercise and sleep are accepted in medicine as significant. Yet, research has also demonstrated that recurrence can be even more profoundly impacted by addressing two other, often overlooked factors: mood, specifically depression and anxiety, and nutrient status.

Megan is an amazing survivor and example of how addressing lifestyle choices, as well as mood and nutrient status, can dramatically reduce the risk of recurrence. When I met Megan, she was a first-time mom who started her journey with cancer at an early stage in life. In her 40s, she was diagnosed with breast cancer. She went through treatment and although everything went well, she struggled once she was in remission. Her energy was low, her hair wouldn’t grow back, and she didn’t feel like herself. Although these physical symptoms were challenging, the thing she found most difficult was her mood and mindset. Megan was always known as a happy and joyous person, but after cancer she wasn’t. Many people would comment that she should be overjoyed she had kicked cancer’s butt.  However, she didn’t feel like that was true. She was worried about every little thing, and she lost the joy in everyday life. Her partner was the one who suggested she needed to find some help because she just didn’t seem interested in life.

Megan went to her family doctor, they interviewed her about her life choices, got her to fill in some questionnaires about mood changes and reassured her she was doing everything right. She was told to go home and enjoy her family, because as far as they could find, everything was fine. Megan became one of the statistics – 30 percent of cancer survivors suffer from life debilitating depression and anxiety (1). Many of these cases of depression and anxiety amongst survivors, and even their family members are not detectable on the typical questionnaires and tools we use today. The most important reason for Megan to address her depression and anxiety was that in large long-term studies it has been proven that addressing depression and anxiety reduces the risk of recurrence in cancer – especially breast cancer (1). Megan eventually took the important step to find a support network that was more equipped to listen to her concerns.

While addressing her mood was critical, it was also evident from Megan’s assessment using my specific cancer-recovery questionnaire, The Eight Pillars of RecoveryTM, that many of her symptoms, including her depression and anxiety, were likely related to, or aggravated by nutrient deficiencies such as iron, vitamin D, and vitamin B12. Most survivors will find that no matter how important it is to have a better handle on their mental health, without the appropriate energy to meet this challenge, it can feel like an insurmountable task.

Through assessing and addressing Megan’s vitamin and nutrient levels we discovered that Megan was vitamin d, and iron deficient. She wasn’t alone; according to a recent study more than eighty percent of survivors post-chemotherapy suffer from vitamin D deficiency (3).  In addition, having Vitamin D levels in the top quarter of the range on lab work has been shown to reduce recurrence.  In Megan’s case, bringing her vitamin D and iron levels up, resulted in marked improvement in her fatigue, her hair began to grow back, and she was able to focus on addressing her mental health even more powerfully. We also began to address some of her other areas of concern highlighted via the Eight Pillars of RecoveryTM questionnaire using some of the tools found in my book, The Opportunity in Cancer.

As Megan’s case shows, there are some very simple, yet powerful factors, that can significantly reduce the risk of cancer recurrence, but they aren’t as commonly advised by practitioners as we might think. However, with the right tools and assessments, cancer survivors can begin to reclaim their power and quality of life, so they can begin loving life again, free from the fear the cancer recurrence.


  1. Int J Environ Res Public Health. 2017 Sep; 14(9): 999.Published online 2017 Sep 1. doi: 10.3390/ijerph14090999 PMCID: PMC5615536 PMID: 28862672 Stress and Depressive Symptoms in Cancer Survivors and Their Family Members: Korea Community Health Survey, 2012
  2. Wang, X., Wang, N., Zhong, L. et al. Prognostic value of depression and anxiety on breast cancer recurrence and mortality: a systematic review and meta-analysis of 282,203 patients. Mol Psychiatry 25, 3186–3197 (2020). https://doi.org/10.1038/s41380-020-00865-6
  3. Li M, Chen P, Li J, Chu R, Xie D, Wang H. Review: the impacts of circulating 25-hydroxyvitamin D levels on cancer patient outcomes: a systematic review and meta-analysis. J Clin Endocrinol Metab. 2014 Jul;99(7):2327-36. doi: 10.1210/jc.2013-4320. Epub 2014 Apr 29. PMID: 24780061.
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