What “The Truth About Cancer” got wrong about BRCA mutations and cancer

Expert Guidelines

NCCN guidelines recommend genetic counseling and testing for people without cancer who have the following family history:

• A relative who has tested positive for an inherited mutation in a gene that increases cancer risk.
• One or more first- or second-degree relatives with breast cancer and any of the following:
  • diagnosed at age 45 or younger
  • triple-negative breast cancer
  • two separate breast cancers, with the first diagnosis at age 50 or younger
  • male breast cancer
• One or more first- or second-degree relatives with:
  • colorectal cancer before age 50
  • endometrial cancer before age 50
  • ovarian, fallopian tube, primary peritoneal cancer
  • rare or childhood cancers
• One or more first-degree relatives with:
  • metastatic or high-grade prostate cancer
  • pancreatic cancer
• Two or more relatives on the same side of the family diagnosed with any combination of the following at any age:
  • breast cancer
  • pancreatic cancer
  • prostate cancer
  • melanoma
  • sarcoma
  • adrenal cancer
  • brain tumors
  • leukemia
  • endometrial cancer
  • thyroid cancer
  • kidney cancer
  • diffuse gastric cancer
  • colon cancer

The American Cancer Society (ACS) guidelines on exercise, nutrition and weight for cancer prevention recommend the following: 

Diet and nutrition

• Follow a healthy eating pattern, including:
  • foods that are high in nutrients in amounts that help you get to and stay at a healthy body weight.
  • a variety of vegetables, fiber-rich legumes (beans and peas), and whole fruits in a variety of colors. Consume at least 2½ to 3 cups of vegetables and 1½ to 2 cups of fruit each day, depending on your calorie requirements. 
  • whole grains rather than refined grains. At least half of the grains you eat should be whole grains. 
• A healthy eating pattern that limits or does not include:
  • red and processed meats.
  • sugar-sweetened beverages. 
  • highly processed foods and refined grain products.
• It is best not to drink alcohol. People who choose to drink alcohol should:
  • have no more than 1 drink per day (women) or 2 drinks per day (men).

Exercise

• Exercise regularly.
  • Adults should get at least 150 minutes of moderate-intensity activity (equal to a brisk walk) or 75 minutes of vigorous activity (heart rate is increased, breathing is faster and you are sweating) each week, preferably spread throughout the week.
  • Physical activity has been shown to lower the risk of several types of cancer, including breast, endometrial, prostate and colon. It also reduces the risk of other serious diseases such as diabetes and heart disease.

Weight

• Achieve and keep a healthy weight.
  • Being overweight or obese is a risk factor for many cancers, including breast, colon, endometrial and pancreatic. You can control your weight through regular exercise and healthy eating.

Other experts, including the following, also provide guidelines for exercise, nutrition and health: 

• The Academy of Nutrition and Dietetics
• The United States Office of Disease Prevention and Health Promotion 
• The American Institute for Cancer Research  

Questions To Ask Your Health Care Provider

• Should I have genetic testing for an inherited mutation?
• Can my diet and lifestyle help me prevent cancer?
• What else can I do to lower my risk for cancer?