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When I was first diagnosed with breast cancer, the treatment I was most anxious with is chemotherapy. Looking back now, 8 years after going through six cycles of chemo, it was the most gruelling and physically challenging part of surviving cancer.
A mastectomy and radiotherapy felt like a walk in the park.
When I found out I had cancer, my breast surgeon recommended I do chemotherapy first - aka neo-adjuvant chemotherapy - chemotherapy before surgery.
I was in such a shock in the beginning that I didn’t question whether this was the right thing to do. Luckily for me it was, because here I am 8 years later, alive and well having survived triple negative breast cancer.
Having a receptor negative breast tumour meant that chemotherapy was the only systemic treatment available for me. The microscopic cells that had potentially broken off from the main tumour and floated around in my blood was what I was concerned about. Because I knew it was these cells that can “seed” the spread of cancer to vital organs.
So I regarded having chemo as an all or nothing game. There was no back-up immunotherapy or hormone receptor blockers for me after I finished treatment.
I needed the chemo to work.
So I decided I had to give it all I’ve got.
And boy did it pay dividends!
I had a complete response to chemo.
If you’re having neo-adjuvant chemotherapy (having chemo before surgery), then the best possible outcome from finishing your chemotherapy is what physicians call a complete pathological response. This means that the chemotherapy you received was effective at killing 100% of the tumour in your breast and/or lymph nodes.
The only way you’ll be able to know if you had a complete pathological response is if you had chemotherapy before you have breast surgery.
Having chemotherapy after the tumour has been removed from your body makes it impossible to know whether the chemotherapy was effective at killing any stray cancer cells.
What also surprised me (many years later) was when I heard about women who had the same cancer I had, but didn’t respond to the same chemo regimen that I received. Their tumours didn’t shrink at all and in fact some of their tumours grew in the months that they were in active chemo treatment.
So be wary that if you’re having neo-adjuvant chemotherapy that you’re able to physically feel your tumour shrinking or if it’s no longer palpable that you get scans mid-way through your chemo cycles. If your tumour isn’t shrinking, then more than likely your chemo is not working and you need your oncologist to change treatment strategies ASAP.
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 may experience some side-effects during chemo.
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 experience serious side-effects during chemotherapy then your oncologist may warrant stopping treatment early - decreasing your chances of achieving a complete pathological response.
So when you’re having chemo, your goal is to be able to finish ALL the sessions of chemotherapy that have been planned by your oncologist, and the best way to do this is maximise its effectiveness while minimising side-effects.
One of the main side-effects of chemo I was concerned about was nausea. Generally, I’m a queasy kind of girl and can go green very easily, so naturally I was super worried about vomiting.
However, my oncologist assured me that in this day and age, the anti-nausea drugs are so good, that no cancer patient should be vomiting whilst on chemo, otherwise they need to go back to their doctor and demand to change their anti-nausea medication.
This was so reassuring and I was very pleased to not vomit once during the six cycles of chemo I had.
I found it really disappointing that my oncologist didn’t give me ANY “lifestyle” tips about what to eat or what to do during the months that I was having treatment. I soon realised that most oncologist are not really trained or have any real interest in nutrition or holistic healing.
I think as cancer patients, we need to be more proactive about our recovery. Just because our oncologist hasn’t mentioned anything about what to eat or other lifestyle things, it doesn’t mean that we can’t focus on adopting “extra” healthy initiatives, as long as we’re open with our oncologist about what we’re doing whilst on chemo.
It was only recently that the Australian Society of Oncologist released a statement advising the benefits of exercise during chemotherapy to combat side-effects, even though the evidence has been building up for many years.
For most of us, we’re battling cancer right now so we don’t have the luxury of waiting for the medical community to slowly adopt new and beneficial things.
Because I bounced back relatively well after each round of chemo, getting involved in my own recovery also had huge benefits of increasing my confidence and empowering my mind. It made me feel less helpless in this roller coaster of a cancer journey.
I had something to do and something to focus on every single day.
So in today’s post, I want to share with you my top 9 tips for chemotherapy.
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 8 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 chemotherapy 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
Alot of women will gain weight during chemotherapy, probably a contrast to what most people believe. This could be because of stress and emotional eating or it could be due to the steroids they’re given by their oncologist to dampen down any allergic type side-effects.
In any case, it’s important that you stick to healthy meals when you’re not fasting. A cooked plant based diet is easier to digest and kinder to your gastrointestinal system - which will be severely compromised during chemotherapy. Because the lining of your gut replicates quite quickly, the chemo - which affects rapidly dividing cells -will wreak havoc on your digestive system.
I believe, 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.
Juicing should really be one of the thing that you focus on during chemotherapy. It hydrates you, deliver loads of nutrients and detoxifies your body.
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 as I’ve said before, it can “seed” the spread of cancer to other organs. Therefore it’s vital to kill all rogue 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 chemotherapy infusion, during the infusion and afterwards when you get home.
During the day of infusion, I would do a short workout at home or I would walk to the hospital where I was having my treatment. It was only 15 minutes away so it was great preparation before going into my infusion session.
If you don’t live near the hospital, you can also try to arrive early on the day of your infusion and go for a brisk walk around the grounds of the hospital. Breathing in lots fresh air and getting your blood pumping is a great prep before you go in to the hospital both physically and mentally.
A quick check that you have good circulation is to see that your hands and feet are warm and pink.
I also placed a warm heat pack on my chest where the tumour was located. The infusion would typically last a good few hours, and I always made sure I covered myself with warm blankets for the entire duration, never getting cold even with the air conditioning blowing around me. This ensured the chemo would freely flow to all parts of my body that cancer could be lurking in.
**Bonus Tip: As the chemo is flowing into your veins try to relax, breathe deeply, close your eyes and do some visualisation. I like to visualise a game of pacman, where the chemo drugs are eating all the cancer cells. You can also imagine the tumour melting away and the cancer cells disappearing.
Most of the oncology wards now provide cold-caps for their patients to preserve their hair. Although losing my hair was one of the most traumatic things I had to endure, I don’t think it’s worth doing because my intuition says that it could affect the effectiveness of chemotherapy.
The reason I say this is because of the way it works.
Cold-cap decreases the blood circulation on your head and thus reducing the effectiveness of the chemotherapy at killing the hair follicles. If your hair-follicles could be spared then that means any cancer cells in the vicinity could be spared as well. It only takes one single cell to form a new tumour and that’s why 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.
So don’t forget to hydrate! Drink lots of fluids like your life depends on it so you can pee out all that extra chemo out of your system ASAP.
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 peel myself from my comfy bed and just walk around intermittently in circles in my tiny apartment. I would go back to bed and repeat throughout the day.
Sometimes I would feel too out of it to walk around the block, so my husband would hold my hand and we would walk together. Getting some fresh air actually felt really good.
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. This is another critical component to why I believed I responded so well to the chemo while minimising side-effects.
Sweating is a fantastic way to detoxify your body.
When you feel like you’ve recovered well enough after chemo, you have a short window of opportunity to up the intensity of your exercise regime before another round of chemo will hit you again. So it’s critically important that you make the most of this time to do a full body workout.
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 which most women will suffer due to the chemo drugs and the anti-nausea drugs. My favourite fibre supplement is this one.
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 believed that chemotherapy is “heaty”.
It’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 pearl 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 support a strong immune system.
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.
Asian mushrooms like maitake and shiitake are great immune boosters. Saute them in some garlic, another immune boosting food.
In Japan, these mushrooms are served in hospitals 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 like this one. Some asian mushrooms like reishi can’t be eaten fresh and you must take them in a capsule.
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 as your physical body during treatment.
Remember that laughter will release feel good endorphins. It really is the best medicine when you’re feeling crap.
Lastly, don’t forget to celebrate the end of your chemotherapy. Compared to surgery and radiation, chemotherapy is by far the hardest treatment to physically and mentally endure.
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