Breast cancer in young premenopausal women are usually more aggressive so chemotherapy is usually included in the treatment plan.
In addition to chemotherapy:
Women with oestrogen positive breast cancer are prescribed tamoxifen for several years
Women with Her2 positive breast cancer are prescribed transtuzumab
When you’re diagnosed with triple negative breast cancer, the options for systemic treatment is limited to chemotherapy and if you still have residual disease after your initial round - that is, if you still have cancer cells present in your breast or your lymph nodes, you’ll be given a second cocktail of a different chemo.
Therefore, if you’re a woman with TNBC it’s important to maximise the effectiveness of the chemo you’re receiving because there is no back up tamoxifen or transtuzumab to take afterwards.
In today’s post, I’m going to share with you the things I did during chemotherapy that allowed me to achieve a complete pathological response and how I also breezed through chemo with minimal side-effects.
I also digged deeper into some of the studies looking at how to increase the effectiveness of chemotherapy which you may wish to implement during your treatment.
Chemotherapy directly kills cancer cells in your body, but the downside is that it’s non-targeted meaning it can’t differentiate between cancer cells and normal cells. So you might be killing some cancer cells but it’s also likely harming your normal healthy cells - which is why you’ll experience lots of serious side-effects when you’re in treatment.
When you’re feeling unwell and icky from chemo, the natural tendency is to lay around and do nothing.
So how do you mitigate some of the serious side-effects of chemotherapy?
The answer is to also nourish and protect your normal healthy cells.
If you’re having neo-adjuvant chemotherapy (having chemo before surgery), then the best possible outcome from finishing your chemotherapy is a complete pathological response. This means that your chemotherapy is effective at killing 100% of the tumour in your breast and/or lymph nodes. And the only way you’ll be able to know if you had a complete pathological response is if you had chemotherapy before you had breast surgery. Because you need to see the change in the size of the tumour to validate the effectiveness of your chemotherapy.
Achieving a complete pathological response is a huge win because it will give you the best possible prognosis whichever type of breast cancer you have. And if your type of breast cancer is triple negative, then another bonus is, you won’t be subjected to another round of chemotherapy.
So your goal is to be able to finish ALL the sessions of chemotherapy that have been planned by your oncologist.
However, if you experience some really serious side-effects then your oncologist may warrant stopping treatment early - which you’d want to avoid.
So here are my top 9 tips for maximising the effectiveness of your chemotherapy while minimising side-effects. The tips I’ve mentioned here are simple and doable with a bit of preparation. Full disclaimer, to double-check with your oncologist before adopting any of the things I’ve mentioned here.
Tip #1: Weaken your cancer cells and protect your healthy cells through fasting
At the time of my chemo treatment 7 years ago, I hadn’t heard about the benefits of fasting, however, today it’s gaining popularity.
So how does fasting work to benefit us during chemo?
The benefits of fasting has been shown in animal studies and is two-fold.
Fasting increases the effectiveness of chemo and also reduces its toxicity.
It’s thought that during fasting, healthy cells don’t spend energy on growing but instead they spend their energy in a “protective” state. Cancer cells don’t do this during fasting - a term called differential stress resistance.
How long should you fast for?
In a 2018 study of 34 women with either breast or ovarian cancer, the duration for fasting was 36 hours before chemotherapy and 24 hours after. It was found that the women tolerated the fasting quite well and seemed to improve their quality of life such as fatigue and gastrointestinal symptoms compared to when they didn’t fast during chemo. During the fast they were allowed only water, herbal tea and a small amount of vegetable juice or vegetable broth. You can find more details of the study here.
If you are thinking of doing fasting during chemotherapy, just make sure you inform your oncologist and point them to these studies I’ve mentioned.
Tip #2: Up your level of nutrition through juicing
The quickest and most effective way of getting nutrition into your body is through juicing. I started juicing as soon as I was diagnosed so I had a few weeks of absorbing liquid nutrients before I started chemo.
I juiced a lot of fruits and vegetables. It was mainly carrots and spinach in the beginning and later on I cut down the carrots due to the high sugar content and added more cruciferous vegetables like broccoli and cauliflower.
Tip #3: Increase your circulation
The aim of chemotherapy is to kill any floating cancer cells in your circulation. These cells can act dormant for many months or years and “seed” the spread of cancer to other organs. Therefore it’s important to kill any freely floating cells that may be present in every nook and cranny of your body.
To do this, I think it’s important to open up your blood vessels and maintain good circulation just before you start your infusion and afterwards as well.
I would do a short workout before my infusion or I would walk to the hospital where I was having my treatment. A quick check for good circulation is to make sure your hands and feet are warm and pink.
I also placed a warm heat pack on my chest where the tumour is. Because the infusion would typically last a good few hours, I covered myself with a warm blanket for the entire duration. This ensured the chemo would freely flow to all parts of my body.
Most of the oncology wards now provide cold-caps for their patients to preserve their hair. The way it works is that it decreases the blood circulation on your head and thus reducing the effectiveness of the chemotherapy at killing the hair follicles. I caution the use of cold-caps just because I think it can potentially compromise your circulation during treatment.
Tip #4: Expel the toxins out
After the chemotherapy has been pumped into your body, it’s important that you’re able to effectively pump it out, so your body can recover and be ready for the next session.
Maintaining really good blood flow and circulation is equally important after your session is over. Now that you’re recovering at home, your liver will be in overdrive trying to detoxify the chemo that’s circulating in your blood.
You might be feeling pretty crook for the first few days after your chemo session and that’s perfectly normal.
For the first few days, sometimes getting out of bed would be a huge challenge.
I would tell myself to get out out of bed and to just walk around in circles in my tiny apartment.
Sometimes my husband would hold my hand because I would be too dizzy to walk around the block and get some fresh air. The key here is to move your body as much as you physically can to maintain good blood flow to your liver.
When I was feeling much better I would exercise vigorously.
Sweating is a fantastic way to detoxify your body.
I also kept up my juicing to assist the liver in detoxification.
Tip #5: Hydrate, hydrate, hydrate!
It’s extremely important to hydrate before, during and after your infusion. I would also supplement with some fibre on the day of treatment and several days after to avoid severe constipation. It’s a real nasty side-effect of chemo and anti-nausea drugs.
Before I left for the hospital I would usually prepare a big jug of water or liquids next to my bedside table so when I got home I could just crash in bed, and it was there ready and waiting for me to hydrate.
In chinese medicine, it’s thought that chemotherapy is “heaty”. And that’s the reason why you experience “heaty” symptoms such as mouth ulcers, constipation and flushing. In order to counteract the “heatiness” we must drink some “cooling” foods or liquids. So other than water next to my bedside table, I also cooked a big pot of barley and drank the cooled water that it had been boiling in. I also drank a pot of chrysanthemum tea if I haven’t opened my bowels the next day.
Because I was so well hydrated and supplemented my liquids with some fibre, I didn’t have any issues with constipation and never needed to take any laxatives.
Tip #6: Bolster your immune system
Even though you’ll be given an injection to increase your white blood cells, your immune system will still take a big hit during chemo.
It’s important to avoid a serious infection whilst on treatment because this can delay your next cycle. Avoid being around sick people and because we all can’t live in a germ-free bubble, it’s important to strengthen your immune system.
Eat foods that stimulate your immune system. Some examples include:
Asian mushrooms like maitake and shiitake. Saute them in some garlic, another immune boosting food. In Japan, these mushrooms are provided in the hospital where patients are undergoing chemotherapy. They contain a molecule called letinan. You can find these in your local oriental grocery store but if there’s none near where you live, then the next best things is to take a mushroom and immune boosting supplement. Some asian mushrooms like reishi can’t be eaten fresh and you must take them in a capsule.
Once you’ve finished chemo, your immune system will be at its weakest and yet, that’s when you need it to be the strongest as it’s the main factor in keeping you cancer-free in the long-term.
Tip #7: Revive and protect your healthy cells
Eating really well during treatment is important to provide your healthy cells with loads of antioxidants that keep it protected. Munch on lots of anticancer fruits like berries and cooked vegetables especially the cruciferous ones like broccoli and cabbage. Keep up the fresh juices, they will nourish and hydrate you at the same time. Lastly, invest in some supplements to further protect your healthy cells from radical damage caused by chemo. However, it’s also important to not have too much antioxidants when chemo is still circulating in your bloodstream - which is usually 24-48 hours after your infusion. You don’t want to cancel out the effects of the chemotherapy by having too much antioxidants - it really is a delicate balance. I talk more about my supplements regime here in this article.
Tip #8: Rally support
I had my infusion every three weeks for a total of 6 infusions. What’s really important to emphasise was how regimented I was during those couple of months on chemo. I can’t take full credit for this as my husband was the one that prepared everything for me and was constantly reminding what I needed to do.
If you have a support person to take care of you during chemo, then it’s a good idea to show them this article, so they can better prepare and assist you during chemo so all you need to focus on is recovering.
I would highly recommend that you also join a support group - online or real life. One of the big benefits of support groups - especially if you join one that has hundreds or even thousands of members, is that someone will answer your questions pretty much straight away.
They can provide you with helpful and practical advice when you’re struggling with the side-effects of the chemotherapy.
Tip #9: Boost your mood
It’s vital to keep your spirits up during the many months it would take for you to complete chemotherapy. Try and see your friends and family during your treatment so you won’t feel so isolated. Watch some funny movies on Netflix to take your mind off the mental and physical stress you’re experiencing. Keep a journal and write your feelings down. The health of your mind is just as important during treatment.
Remember that laughter is the best medicine.
Lastly, don’t forget to celebrate the end of your chemotherapy.
Compared to surgery and radiation, chemotherapy is the hardest treatment out of the three to physically and mentally endure.
Let me know in the comments if you found any of these tips useful - I would love to hear from you.