Women with breast cancer will be told to limit themselves to two glasses of wine a week and to take regular exercise.
They will also be encouraged to lose weight – if necessary – so they are within the ‘normal’ range for their height.
The advice has been issued by the health watchdog Nice to try to boost survival rates by preventing the cancers coming back later.
In addition, patients will be urged to take cheap hormonal pills including tamoxifen and aromatase inhibitors for up to ten years after undergoing surgery.
Currently, women are advised to take them for five years afterwards, but many stop earlier because of debilitating side effects.
Research has found that continuing their use for ten years or longer reduces the risk of breast cancer coming back by up to 34 %.
Breast cancer is the most common cancer in women and there are approximately 55,000 new cases in the UK each year.
Although survival rates have improved dramatically since the 1990s, the illness remains one of the leading causes of death in women, killing 11,500 a year in Britain.
Nice has issued a series of draft recommendations for patients with early-stage breast cancer. Experts will be consulted on them over the coming months.
The draft guidelines include getting doctors to urge their patients to limit their alcohol intake, exercise regularly and lose weight, if overweight or obese. All of these have been linked to improved survival rates. Ideally, women should drink no more than five units of alcohol a week – equivalent to two large glasses of wine.
Currently, there is no suggested limit specific to women with breast cancer, but the Department of Health’s general recommendation to women is that they should drink no more than 14 units a week. The Nice guidelines say breast cancer patients should take regular exercise, even if they feel unwell. This can include walking, gardening and housework.
Ideally they should aim to do 150 minutes of physical activity a week although many women will struggle because chemotherapy can make them feel very weak and tired. Around 25,000 patients a year will be encouraged to take hormonal pills including tamoxifen and aromatase inhibitors for more than five years after treatment and possibly up to ten.
Tamoxifen costs about 8p a day whereas aromatase inhibitors, which include letrozole and anastrazole, are only 5p a day.
But around half of patients who take the pills experience hot flushes, difficulties sleeping and the bone thinning condition osteoporosis. Many will be reluctant to take them for prolonged periods when they are cancer-free.
Professor Mark Baker, director of the centre for guidelines at Nice, said: ‘Although breast cancer survival rates have improved over recent decades, it remains the leading cause of death in women aged 35-49.
‘Since the publication of Nice’s original guideline in 2009 there have been a number of advances in the way early-stage breast cancer is managed and these are reflected in this updated guideline.
‘This will help healthcare professionals to provide consistent, high quality care for people with early breast cancer and ensure equal access to the most appropriate treatments, no matter where people live in England and Wales.’
The draft guidelines also state that women who have a mastectomy should be offered an immediate breast reconstruction, if they want one.
Some women are denied the operation by cost-cutting health trusts which claim it is cosmetic and of low priority.
Baroness Morgan, chief executive at the charity Breast Cancer Now, said: ‘If now funded and implemented across the country, these steps could save and improve thousands more women’s lives.’Daily Mail