Today it’s been two years since I read “consistent with invasive ductal carcinoma” on my biopsy report. The time and space between then and now is unfathomable to me. Like 100 years wrapped into 730 days. I’m both surprised at how quickly I’ve jumped back into “normal” life and at how the memories of having cancer are still woven so carefully into my daily thoughts.
It probably doesn’t help that I work with other survivors on a daily basis so I’m constantly educating and supporting those people. But it’s not just that – my port scar, the faint tan from radiation, the tightness in my chest and shoulder are all physical reminders that keep me living with one foot in regular life and one in cancerland.
The healing doesn’t end when treatment ends. I am seeking out ways to calm my grief and anger over the fact that I went through something so life-altering at 30 years old. I am healing physically and trying to regain a lot of strength. I have residual pain from treatments, and my body physically reacts with anxiety any time I get a scan done. I am learning how to navigate new and old friendships without oversharing or totally withdrawing from the situation.
It might sound like a lot, and it is, but I promise that I do my best not to dwell on the hard parts of survivorship. I’m thankful to have more days to continue experiencing lovely things and connecting with my favorite people. If you want to read a more about my experience in survivorship so far, you can read my essay “Trusting the Redirection” in Wildfire Magazine’s Cancer Culture Issue from February/March 2022. Use code ‘FRIENDSANDFAMILY’ for 15% off.
I also had my annual mammogram and an additional ultrasound yesterday. The results came back clear, besides the ever/never-shrinking hematoma (so dramatic!) that I developed after my MRI biopsy in November. So all is technically well, and I’ll keep celebrating these results and anniversaries for a long, long time I hope.
I honestly thought I’d have more to say when I sat down to write this, but I think I’ll just keep it short and sweet. I wish you all health and happiness and I hope you have a great week!
Aerobic exercise (a.k.a. “cardio”) has many proven benefits for all humans. Cardio relates to cardiac, meaning it’s for the heart! For cancer thrivers, aerobic exercise can have many excellent benefits (including improved survival rates and decreased rates of recurrence!) and should be recommended for all oncology patients. Read on to learn about the benefits and general recommendations for aerobic exercise during cancer treatments.
Benefits of Aerobic Exercise
Increase your sensitivity to treatment = better tumor cell destruction!
Prevent muscle loss and build strength (including your heart muscles)
Reduce treatment-related side effects
Reduce depression and anxiety
Improve your sleep
Reduce your recurrence and mortality risk significantly (up to 50% for some)
Improve your quality of life
Psstttt… if you’re not convinced already, I’m not sure what will get you on board this point!
Types of Aerobic Exercise
Riding your bike
*If running was part of your pre-treatment routine, it may be ok to continue, BUT as some treatments can put you at risk of cardiac dysfunction, it may be best to stick with more gentle cardio until your heart gets stronger. Always check with your doctor or physical therapist!
**Avoid swimming in the ocean or public pools if you are neutropenic, have recently had surgery, or have open wounds/blisters from radiation therapy due to increased risk of infection!
Aerobic Exercise Guidelines
We’ll use the FITT principle for aerobic exercise guidelines:
Frequency: 3-5 days per week
Intensity: RPE 2-3 – keep it light for cardioPROTECTIVE benefits!
Time: 10-60 minute sessions for total of 150 minutes per week
Type: Choose your favorite from those listed above!
What is RPE, you ask? RPE, or Rate of Perceived Exertion, is a measure of how hard you feel you’re working. Use this Modified Borg Scale to guide your intensity during your workouts!
Modified Borg Scale
VERY, VERY HARD
Understand if the chemotherapeutic agents you received can cause cardiotoxicity. If so, be sure to request a baseline cardiac workup. Know that low-intensity exercise may have a cardioprotective effect during treatment!
Monitor your vital signs!
Use your fitness tracker to monitor your heart rate OR here’s a video on how to check your heart rate manually!
Report any significant or unusual shortness of breath to your physician.
Watch for swelling that may be early signs of lymphedema or cardiac dysfunction.
Monitor lab values! Generally, if your lab values fall in the following ranges, you should check with your provider before exercising:
Neutrophils (ANC) <1.5 x 10^9/L
Platelets < 20,000 cells/uL
Hemoglobin < 8g/dL (anemia)
Be cautious if you know you have any of the following:
Bone or lung metastasis
Abnormal sensation or dizziness/imbalance which may increase your fall risk
Now you know some general guidelines for aerobic exercise for cancer patients! By the way, these general guidelines apply to those without cancer as well! Always seek medical advice before starting a new exercise program and remember: All information shared on this page is for educational purposes only. If you are thinking of starting an exercise program, consult with your physical therapist or physician to determine what is right for you!
You’ve probably heard the old saying, “If you don’t use it, you lose it,” right? Well, it’s true! For oncology patients in particular, resistance training is an important way to maintain strength, balance, and quality of life during and beyond cancer treatments.
Benefits of Resistance Training
Maintain functional STRENGTH to continue to do the activities you love
Improve or maintain MUSCLE mass
Improve or maintain BONE health
Improve QUALITY OF LIFE
Reduce MORTALITY risk by 33% [Hardee, et al, 2015]
*Pro tip: Choose a type of exercise you enjoy to make it fun and something you look forward to!
Resistance Training Guidelines
2-3 days per week
Focus on major muscle groups
40-60% of maximal effort
What is RPE, you ask? RPE, or Rate of Perceived Exertion, is a measure of how hard you feel you’re working. Use this Modified Borg Scale to guide your intensity during your workouts!
Modified Borg Scale
VERY, VERY HARD
Special Considerations for the Oncology Population
Take extra precaution AND work with a specialist if you know that you have:
Abnormal sensation or dizziness/imbalance which may increase your fall risk!
Now you know some general guidelines for resistance training for cancer patients! By the way, these general guidelines apply to those without cancer as well! Always seek medical advice before starting a new exercise program and remember: All information shared on this blog is for educational purposes only. If you are thinking of starting an exercise program, consult with your physical therapist or physician to determine what is right for you!
I know I’ve been terrible at keeping y’all up to date on my life lately, but that’s because I’m just busy living right now. When I look back on my life one year ago, I still have a hard time believing any of this actually happened. Cancer treatments consume your life for nearly a year (or more for some), and then you’re just done? When chatting with other survivors, we all seem to comment on how none of it seems real. We were in survival mode for so long, and when the dust finally settled, we had to come to terms with the fact that, yes, indeed, we did have cancer. What a trip!
Every day gets easier, but some days all the feels creep up and you don’t know whether to be sad or angry or go hide in the corner until it passes. I try not to take anything for granted, but I’m just human, too, and I often get sucked back into the usual work, sleep, eat, repeat. With that said, I’ve been making a concerted effort to go for walks by the beach, do yoga, hit up weekly farmer’s markets, and get together with friends when I can. Those things help. A lot. Make time to do things that bring you joy.
On Monday, I had my annual MRI – just a follow up scan to keep a close eye on things. Thankfully, all looks clear. There is a small area of enhancement in the same area where I mentioned I needed a biopsy back in July which already came back benign so here’s hoping I don’t need another biopsy! In my professional opinion, I’m right in the middle of tissue healing from radiation therapy, and there’s a lot of scar tissue forming right now. With that comes a lot of tightness and discomfort in my left chest wall, and I think that friction is creating a small cyst in that region.
Again, the survivorship game is not all sunshine and rainbows. While everything is technically “all good” now, sometimes it isn’t. There are a lot of things that I still need to work through, but I just choose to take it one day at a time.
October is Breast Cancer Awareness Month
This brings me to the main point of this post which is that Breast Cancer Awareness Month is back! I personally choose to refer to BCAM as “Breast Cancer ACTION Month” as I think it’s a great time to donate to breast cancer research, reach out to family/friends you know going through cancer and offer your support, and speak up to lawmakers and organizations with power to make change in medical care for cancer patients.
October is a time of pink ribbons and shameless promotion of products that support breast cancer. Breast cancer thrivers have coined this “pinkwashing” and want to remind you to be mindful of any products you purchase this year. Any major company that claims to put proceeds to support breast cancer better be donating at least 20% of their profits to organizations that fund breast cancer research. And, if you choose to make a donation to breast cancer organizations, choose one or two that fund research primarily or that you know directly supports thrivers with care packages, financial support, or practical support (like providing free wigs, offering transportation or house cleaning, or fertility preservation assistance).
Here are a few of my favorite breast cancer organizations to support:
Metavivor – donates funds to support research for metastatic breast cancer (the incurable one) – FYI MBC Day is October 13, 2021
This October, I’ll be focusing on holding the American Cancer Society accountable for their recent change in recommendations to delay annual mammogram screening for those age 45 and older. This is a recent change in recommendations and adds insult to injury to prior recs that both breast self-exams (BSE’s) and clinical breast examinations are not indicated for early detection of breast cancer. These recommendations are based off a study out of Shanghai in 2018 that indicated that more benign lesions were found on BSE’s than malignant ones, and therefore led to unnecessary procedures like imaging and biopsies. In case you can’t guess who benefits from these recommendations, let me spell it out for you…INSURANCE COMPANIES.
For adolescent and young adult (AYA) cancer thrivers (ages 15-39) who are ineligible for annual mammograms, the only way for us to detect cancer early is through BSE’s. The more frequently we do these screenings, the earlier we can seek care for any abnormal findings, and the better our prognosis if we should be very unlucky to find a malignancy. I found my lump on a BSE and it saved my life. I will advocate for BSE’s until my lungs give out. Should you feel so inclined to support this cause with me, please reach out to the American Cancer Society via phone/chat or social media to let them know how you feel about this!
I’ll also be sharing a bit on social media about how PT can be helpful before, during, and after cancer treatment because October is also National Physical Therapy Month. Follow me on Instagram for more – @bri.d.pt!
Beyond that, October is my favorite month, so I’m going to get some Halloween decorations out and get ready for Spooky Season! Maybe I’ll pull out the old purple wig for Halloween this year, too! Stay well, friends!
It’s officially been a minute (or a few months, but who’s counting?)! I had every intention of continuing to write, but in all honesty, I just needed a break from the cancer updates and info sharing.
Recently, Justin and I have been super busy! We were finally able move into our new home a few weeks ago (thanks, mom & Malia!), and then we immediately left on vacation to Montana and Washington, leaving our cute new place a mess with unpacked boxes and mismatched furniture. We are so grateful to have a new space where we can start fresh after navigating so much uncharted territory in 2020. I’m looking forward to lots of memories made here ❤
While traveling, we were able to visit with all of my family, celebrate the 4th of July in Butte, America (there’s no better place to be on the 4th – don’t knock it til you’ve tried it!), catch a few fish on the Big Hole, reconnect with our best buds from PT school, and even witness one of them get married (Congrats, Riki & Anthony!). I was so elated to be able to hug everyone and see all my favorite kiddos. Hawaii is great y’all, but it’s times like this when you realize living on an isolated island in the Pacific isn’t always all it’s cracked up to be! I cried so hard before we came back home because I know I truly have such special relationships with all of you.
Besides our recent adventures, all is well down here. I’ve been working heavy part-time and I’ve realized that I’m now able to help my oncology patients on a much deeper level. I’ve always tried to empathize as much as I could, but the reality is that, unless you’ve gone through cancer yourself, you probably can’t relate. This isn’t to discourage anyone from working with oncology patients, but rather a reminder that what they’re going through is far more than just physical discomfort.
As far as my health goes, I had an ultrasound on my left breast a few weeks ago due to a suspicious spot I found while doing one of my way-too-frequent self-checks. It turned out to be just scar tissue (as expected), but they also found a small cyst-like area above it, and I’ll go for aspiration next week just to be safe “because of my history.” I wonder if it will ever get easier hearing that, but likely not…
I’ve continued to work with my naturopathic doctor to get to the root cause of my autoimmune thyroid dysfunction. I completed a urine test to determine heavy metals toxicity and the results indicated high levels of mercury and platinum and moderately-high levels of lead. Mercury is linked to many environmental sources, but is primarily associated with high levels of dietary fish. The platinum levels are residual from the platinum-based chemotherapy (Carboplatin) that I received over 12 weeks last year, and lead is also find in many environmental sources including water, pipes and paint. So I will treat it with a chelating agent which will strip the metals from their sneaky hiding places in my body….after I eat one last giant poke bowl!
I also completed a food sensitivity test and will get those results back in a few weeks. Again, I am a huge believer in holistic care. If there are things I can do to optimize my health going forward, then it’s worth a shot to me. I still go to acupuncture about once a month and have continued seeing a mental health professional. It truly takes a village to make it through a cancer diagnosis, and you are all part of that team for me!
I’ll try to be more consistent at posting updates and sharing helpful information, but for now, I’m just going to keep focusing on LIVING and finding joy in each day. Sending you all my love!
Radiation therapy is used as an adjunct treatment for cancer to kill off any remaining cancer cells in the surrounding tissues which are often called “micrometastases.” Radiation therapy is not appropriate for all cancer patients, but for those who do have treatment plans which include radiation, the short and long-term effects can be difficult to tolerate. Today, I want to share more about one long-term effect of radiation therapy called radiation fibrosis.
What is Radiation Fibrosis?
Radiation fibrosis (RF) refers to tissue changes which occur locally after someone goes through radiation therapy. Tissues which are most often affected are the skin, subcutaneous tissues (fat, muscle, bone), organs such as the lungs or heart, or the gastrointestinal/genitourinary tracts depending on the part of the body that is irradiated. Ions from radiation beams cause DNA damage and localized inflammation around the tumor site as well as in the surrounding normal tissues. The degree of damage often depends on each individual’s sensitivity to the radiation itself as well as the dose given and area of tissue treated.
Who is at Risk for Radiation Fibrosis?
Anyone who undergoes radiation therapy as part of their cancer treatments is at risk for RF. Some factors that increase susceptibility of developing RF include:
Those who also have concurrent chemotherapy or surgery
Those with pre-existing connective tissue disorders (scleroderma, lupus, or Marfan’s syndrome)
Those with a genetic mutation in the ataxia-telangiectasia (ATM) gene which assists to repair damaged DNA
How does Radiation Fibrosis Present?
RF onset can be immediate, early delayed (0-3 months after treatment), or late delayed (>3 months after treatment), however most find that symptoms begin to show up 3-4 months after treatment ends. Symptoms usually come on gradually and they are, unfortunately, not reversible.
Some of the symptoms include:
Thickening of the skin
Muscle tightness or atrophy
Limited joint mobility
Mucosal fibrosis (mouth, throat, GI tract, genitourinary tracts)
What Treatments are Available for Radiation Fibrosis?
Physical therapy is proven to increase range of motion lasting up to six months post-treatment (and probably longer if the person continues their exercises)! PT’s can use manual therapy or prescribe specific exercises to mobilize the skin and myofascial tissues, increase range of motion in affected joints, improve strength, and manage lymphedema (if they are a lymphedema specialist – if not, then they should refer you to someone who is a certified lymphedema specialist).
For reproductive/colorectal cancers in particular, seeing a pelvic floor physical therapist may be indicated to ensure independence with toileting (especially bowel movements) or to assist with sexual concerns like pelvic pain or tightness.
Other potentially-beneficial treatments may include hyperbaric oxygen therapy, pentoxyfilline (a drug that helps to improve blood flow to the tissues) with or without the addition of vitamine E (a powerful antioxidant), and botox injections – but the research is still pending on the true benefits of these treatments!
If you or someone you know is going through radiation therapy, let them know about RF & send them to a physical therapist to help with any mobility concerns they may have!
Radiation-induced fibrosis: mechanisms and implications for therapy (Straub, et al. 2015)
Supervised physical therapy in women treated with radiotherapy for breast cancer (Braz da Silva Leal, et al. 2016)
Radiation Fibrosis Syndrome: Neuromuscular and Musculoskeletal Complications in Cancer Survivors (Stubblefield, et al. 2011)
Cancer isn’t pretty. Besides generally feeling unwell, the hair loss, body composition changes, aches and pains, and hormonal fluctuations are not exactly sexy. Having cancer (or loving someone who does) can certainly challenge intimate relationships. It’s important for cancer warriors to know this isn’t unusual and there are plenty of ways to maintain healthy relationships with their partners ❤
Some cancer- or treatment-related challenges that may affect someone’s sexual function, sexuality, or intimacy with their partner can include:
Chemo side effects including fatigue, nausea/vomiting, weight loss/gain, or infertility concerns (etc, etc, etc….)
Post-surgical or post-radiation considerations like:
pain or restrictions from scar tissue or irradiated tissues (especially with cancer of the reproductive organs)
decreased sensation around the nipples after mastectomy
urinary incontinence or erectile dysfunction post-prostatectomy
New medications that reduce desire or arousal
Hormonal changes resulting in low libido, vaginal dryness, or painful sex
Body image concerns including attractiveness to self or partner
Depression, anxiety, or PTSD surrounding a cancer diagnosis and treatment
There are many ways that pelvic floor physical therapists (PFPTs) can help support both men and women during and after cancer in this realm. PFPTs can treat the physical changes that come with cancer including post-surgical rehab or prescribe general strength/aerobic training. We can treat incontinence after surgery or radiation. We can recommend sexual positions or devices to reduce or eliminate pain with sex. And sometimes, we help our patients find new ways to connect with their partners when they’re not ready to be sexually intimate yet.
Often, seeing a licensed counselor or psychologist for individual and/or couples therapy can be very helpful to maintain or restore intimacy. Remember, cancer is not pretty, and there is no shame in asking for help! If you’re having concerns or challenges in your relationship, please reach out to me to see if pelvic floor PT or a referral to a mental health professional might be right for you.
*This blog is part 3 of Pink October’s Pelvic Floor Series, a way to raise awareness of pelvic floor problems during cancer treatment and discuss sex & intimacy after a cancer diagnosis.
On today’s blog, I wanted to bring attention to female pelvic pain and dyspareunia (pain with intercourse) secondary to cancer treatments.
Often, when a woman has gone through adjuvant hormonal treatments, chemotherapy, abdominal/pelvic radiation, or fertility-saving drugs during active treatment, the body goes into a state of menopause or “chemopause” as it’s commonly referred to in the cancer world.
Low estrogen levels during chemopause can cause symptoms like:
Amenorrhea (loss of menstrual cycle)
Vaginal dryness or atrophy
Joint aches and pains
In particular, vaginal dryness or atrophy can have a huge impact on sexual health, emotional health, and relationships post-cancer. If the pelvic floor muscles are compromised by treatment, it can result in pelvic pain (like pain from overactive or tight pelvic floor muscles, pain in the tailbone, lower abdominal pain, or pain around post-surgical scars), bladder/bowel changes, or painful sex.
Thankfully, a pelvic floor physical therapist with specialized training in examination and treatment of the pelvic floor muscles can treat these conditions and are an amazing asset to oncology patients on their road to recovery. Some PT treatments for pelvic pain and dyspareunia may involve:
Pelvic floor muscle strengthening or relaxation exercises with or without biofeedback training (computer or ultrasound-based pelvic floor training technology)
Stretches for tight muscles around the abdomen, pelvis or hips
Manual therapy including general massage, pelvic floor muscle release techniques, or scar tissue mobilization
Education and lifestyle strategies surrounding posture, nutrition, bowel and bladder habits, and lubrication options during intercourse
Education in the use of vaginal dilators to reduce pain that occurs with tampon insertion, gynecological exams, or sex
Encouragement around body image and sexual health (this could include referral to a sex therapist or psychologist when appropriate)
If you’re reading this, and you feel like you could benefit from pelvic floor physical therapy during or after cancer treatment, you can find a qualified pelvic floor PT in your area here or here. Ask your doctor for a referral today!
And a quick reminder for all of us… The path to recovery from cancer involves a whole host of treatments including chemo, hormonal treatments, surgery, and radiation just to name a few. Each of these treatments can come with significant side effects or long-lasting comorbidities. Just because someone is “cured” from cancer doesn’t always mean they are living without long-term effects from treatment. Keep this in mind, and be kind!
*This blog is part 2 of Pink October’s Pelvic Floor Series, a way to raise awareness of pelvic floor problems during cancer treatment and discuss sex & intimacy after a cancer diagnosis.
When the last thing you expect is to be diagnosed with breast cancer at age 30 (or under 40, honestly), your desire to have (or not have) future children becomes very clear suddenly. I may have been the person who was in no rush to have kiddos, but I took it pretty hard knowing I was about to start chemotherapy that would significantly affect my ability to reproduce, possibly even making it impossible to conceive naturally.
In all the rush of my initial diagnosis, I wasn’t able to write about options to preserve fertility during chemotherapy. Honestly, it was some of the most emotional decision-making I had to do at the time, so maybe I put it off because it was all very overwhelming! Ultimately, I made two important decisions in order to help save my fertility, which I’ll share below with a few other important concepts regarding fertility preservation.
Chemotherapy & Its Effect on the Ovaries
First, you may wonder how exactly chemotherapy affects your ovaries. Chemo medications are designed to target and kill rapidly dividing cancer cells. Unfortunately, those meds can’t differentiate between rapidly dividing cancer cells and rapidly dividing normal cells in the skin, digestive tract, and reproductive organs. Just as you’d expect to see some side effects like skin/nail changes or mouth sores, we expect to see some attack on the ovaries as they also have a known cycle of cell turnover (a.k.a. ovulation). Thus, if you’ve never had children, and your cancer is stable enough to delay treatment for a few weeks to a month, your doctor should recommend all of the fertility-preservation options they have available. If they don’t offer, you better ask!
Egg Preservation Prior to Active Treatment
I was referred to a fertility specialist/reproductive endocrinologist who was excellent. I had the option to extract eggs (unfertilized) or embryos (fertilized) which would be frozen by a process called vitrification until I need them at a later date. I chose to freeze eggs as research now shows no major difference in later IVF success rates whether an egg or embryo is used, per my physician.
The whole process is timed with the menstrual cycle, so specific hormones are injected during the follicular phase (when the ovarian follicles that store the eggs begin to grow and mature) beginning on day 2 or 3 of menstruation. The fertility specialists monitor follicle growth and count every few days with a pelvic ultrasound and bloodwork. As the follicles mature, indicating ovulation to be close, a different medication is given to delay ovulation until the mature eggs can be retrieved.
The retrieval process is done under light anesthesia in the fertility office. A needle is directed into each ovary through the back of the vaginal vault. Suction is used to retrieve the mature follicles, and after inspection of all eggs to determine which are viable, the eggs can be fast frozen (“vitrified”) and stored in an egg bank until needed. Voila! Now, I have a back-up option post-cancer if I’m unable to conceive naturally! Thank goodness for modern medicine.
Throughout all of that, the worst side effects I had were some moderate bloating and cramping after the egg retrieval. I was also given a separate hormone during the follicle-stimulating phase that helped to avoid an estrogen spike so my mood remained stable throughout (I’m sure my husband appreciated that I wasn’t a hormonal monster through it all). Despite having to delay chemo about 4 weeks to complete this process (remember, they like to time it with your natural cycle), I have no regrets on completing this first for peace of mind alone.
The Cost of Fertility Preservation
Whoever my future kids are, I hope they know I reallllllyyyy want them, because fertility options are not cheap! Most insurances do not cover egg/embryo preservation if you do not have a diagnosis of “infertility” even if you get cancer that you never wanted which might render you infertile… (I’ll refrain from saying any more). The egg retrieval process alone usually costs somewhere around $10k which doesn’t include the annual storage fee for the eggs (mine is about $700 per year).
Fortunately, there is a great option for cancer thrivers through the Livestrong Foundation. My fertility specialist had me begin paperwork to apply for their grant which covers about 1/3 of the total cost if you qualify (most cancer patients do unless your insurance covers). Ask your fertility doc if this is an option for you!
Options to Preserve Ovarian Function during Chemo
Besides the pre-treatment egg retrieval, my medical oncologist also recommended that I go on a gonadotropin-releasing hormone (GnRH) agonist called Zoladex during chemo. This is a monthly injection that essentially halts ovarian function by blocking GnRH (a hormone released from the hypothalamus in the brain that triggers the release of follicle-stimulating and leutinizing hormones which act directly on the ovaries). The cancer community “lovingly” refers to this state of no periods as “chemopause” because it is essentially a medically-induced menopause complete with joint aches and hot flashes. I have been lucky that my side effects have been mild, and I’m very thankful to give my reproductive system this brief pause while I kick cancer’s ass.
After treatment, once I get the ok from docs, I’ll still be able to try to conceive naturally. The chances of conceiving naturally are lower for those of us who’ve gone through chemo or radiation, but it’s definitely possible! If I need a little help, then I’ve got a few tiny frozen eggs lined up for further fertility treatments down the line.
It’s Okay to Be Concerned about Your Fertility
I’m thankful that my OB/GYN and oncology team were very supportive about fertility preservation prior to starting active treatment. For many women, hearing your plans for a family will likely have to change after cancer is devastating. I didn’t expect to be so emotional about this whole process, to be honest. I’ve always wanted kids some day, but I wasn’t a person who constantly planned my life around it. Even still, early into my diagnosis, I found myself mourning the loss of my potential fertility more than the fact that I could die from cancer. I don’t believe it does anyone any good to stop planning for the future and let cancer have all the control, so be sure to tell your doctors how important saving your reproductive health is to you!
My heart goes out to anyone reading this and going through the same decision-making process. My heart goes out to those of you reading this who are struggling to conceive even without a cancer diagnosis. I’m so thankful to have so many options to consider and know that, in the right time, children will be a part of my journey, too. For those of you just starting out on your cancer and fertility journey, be sure to ask your doctors what the best options are for you!
Hello! I hope everyone had an excellent Labor Day weekend!
I wanted to make good on my promise to write about intermittent fasting as I hope it’s something that will benefit at least a few of you out there! For the past 5-6 years, I’ve included some type of intermittent fasting (IF) in my routine. I can honestly say that I notice a huge difference in my energy levels and metabolism compared to periods when I don’t intentionally include IF in my regimen.
In the past few years, fasting has become rather trendy. However, IF has quite a bit of research behind it, which pulls it out of that “fad diet” category (not to mention many religious groups have practiced fasting over long periods for centuries and it’s working for them). IF changes the body’s metabolic processes on a cellular level and therefore has important effects for both the body and brain – cool!
Here’s how IF works:
Normally, when the body needs energy, it uses glucose first as a rapid energy source. Once the available glucose has been used up, the body begins to break down fat to fuel our metabolism. Protein is the last to be broken down and is usually not utilized unless the body is under extreme conditions (i.e. starvation).
During a period of fasting/caloric restriction, the body is able to use up it’s glucose stores and begins to break down fat for energy. We can use fat from any part of the body that has excess fat stores like subcutaneous fat (a.k.a. “that stubborn belly fat”), visceral fat (fat that builds up around your abdominal organs), and intramuscular fat.
By significantly reducing calorie intake during IF, our body is able to use the spare energy to boost its processes of detoxification in the liver and kidneys. Waste removal from our cells also increases, and our body as a whole is able to operate more efficiently.
Optimized cell functioning and cellular repair (this is called “autophagy” which literally means “self-eating” – eating the bad stuff, anyway)
Decreased insulin resistance = lower risk of type 2 diabetes mellitus
Reduced oxidative stress and inflammation in the body
Increased fat loss while maintaining lean body mass
Improved brain function and neuroprotective effects
Types of intermittent fasting include:
Weekly fasting (5:2)
Limit calorie intake to 500-600 calories for 2 days out of the week.
Daily fasting (16:8)
Eat all of your normal daily calories within an 8-10 hour window and fast (0 calories) for the other 14-16 hours. 16:8 is the most common, but for females and those with difficulty regulating blood sugar, a 14-hour fast can be more ideal.
Only 0-calorie liquids allowed for a 24-hour period. Can be done several days per week, but best to alternate fasting days with healthy eating days.
With all of that being said, IF is appropriate for most people. Be sure to consult your doctor, registered dietitian, or physical therapist before trying intermittent fasting. It is important to eat an adequate amount of calories in a balanced diet for all of your meals. It’s also extremely important to maintain proper hydration (water & electrolytes), especially with longer fasts.
I have continued to do 14:10 fasting during my chemotherapy, most days of the week. There is some research that IF can reduce chemo side effects2 and I continue to feel very strongly about making sure my insulin/blood sugar regulation is under control to prevent this tumor from taking advantage of any opportunity to grow! I am very aware of my overall calorie intake as my body needs plenty of nutrients to stay strong during treatment. This is NOT a time for me (or any cancer thriver) to be in a calorie deficit!
Please feel free to leave questions about IF in the comments section below! Stay tuned for more updates on my personal journey later this week as I complete taxol/carbo #6!