Health

Kathleen,

Congratulations on making the decision not to tackle fitness goals alone. There are a wide variety of fitness tricks and nutritional approaches that might be helpful, however many find that the best approach is often the one that considers (in no particular order):

1) Life/family responsibilities (i.e. your energy demands)
2) How regularly & intensely you trained before chemo
3) Resources ($, access to exercise equipment, facilities, etc)
4) Current energy levels and your energy cycles (i.e. good day vs bad day)

Because those variables can really impact how you approach slimming down, I'll include just a few exercise-based and nutrition-based notes.


Exercise
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* Get a journal and record snapshots of your general activities, nutrition and exercise. Journaling will keep you honest and enable you to, truly listen to your body. Speaking of snapshots, you may also want to take before photos and put them in your journal and wallet. They can be powerful motivators.

* Listen to your body and obey it. This really bears repeating. Pay close attention to not only how your body feels right after a workout but how it feels 1-2 days later as well! The journaling will help a lot, review it weekly.

* In the beginning, start with short, low to moderate intensity workouts, 20-30mins long. Do them only on your higher energy days. Avoid exercising on low energy days at first...consider making gentle stretches the most that you do on low intensity days. Some people find that they can only handle 10-15mins. That's ok. You might even try doing 2 short but vigorous workouts of 10-15mins, gradually increasing the length of workout by a few minutes and decreasing intensity before increasing intensity and length.

* As you progress (after a few weeks or so) you may want to try incorporating 1-2 more intense interval (burst) style workouts per week. They are a great way to help boost the metabolism without introducing some of the inflammatory effects that could potentially accompany lots of long workout sessions.

* If you are more of an enthusiast and are ready for it, very controlled interval training using a modified tabata scheme, could be a useful strategy, minding the caveats above. The Tabata scheme is based on 4 minute exercise cycles composed of 8 continuous, 30-second rounds of exercise, where you work as hard as you can for 20 secs and rest for 10 secs. Initially, 20 secs will probably be way too much. Consider the following scheme for progression:

Initial Stage => Modified Tabatas, w/ 8 rounds of 5-10 secs full-out exercise followed by 20-25secs break.

Progression => Add 2-5 secs of work every 1-2 weeks or as tolerated.

* If you choose to work with a trainer, make sure to find one that's sensitive to not only the inevitable energy swings but also the importance of balancing movement around joints (e.g. pushes and pulls are balanced) as well as moving in all planes.

Nutritionally
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* Especially in the beginning, try to train only when you're both rested and well nourished (eat ideally 1-2hours beforehand). Smoothies/Shakes are great for pre/post workout meals since it can be a bit easier to absorb the nutrients easier.

* Eat every 3.5-4hours (~4-6x per day) and Eat your largest meals earlier in the day and taper your meals as it gets later. Last meal should be the smallest, though still complete.

* Typical meals should include (low GI & fibrous carbs, lean complete proteins, good, higher omega 3 fats). Of course, avoid processed foods in favor of loading up on leafy greens and the like (organic is best)!

* Discuss _any_ supplementation (multivitamin/mineral, probiotics, fish oil, etc) with your doctor first.

* Try to avoid snacking within ~2 hours of bedtime. If you must, try to limit the damage by stocking the fridge and cupboards with fibrous, low GI/GL foods (glycemic index/glycemic load)

I'll close by encouraging you to remember to periodically add to your mental/spiritual toolkit for navigating the almost inevitable bumps along the road to your body transformation, it's often great to add an inspirational quote, story or song to your journal, on your journal review day (for example). Sorry if that was waay more than you were bargaining for, but I hope you'll find the info useful. Enjoy!!!

Turmeric is a spice commonly used in traditional Indian cooking and medicine. It accounts for the deep yellow color of some curries. Curcumin is a chemical found in turmeric that has some activity against cancer cells in a laboratory. Turmeric is mainly used for its anti-inflammatory properties. A search of the National Cancer Institute database on clinical trials did not reveal any human trials on cancer prevention with turmeric. This is still being investigated in the lab, and if successful there, will move on to human trials.

White flour is highly processed as compared to whole grains. White flour and other processed foods should be avoided as part of a healthy diet. White flour and white sugar have a high glycemic index/load. When you eat them their sugar is immediately absorbed and causes a spike in blood sugar followed by a spike in insulin. This can ultimately lead to insulin resistance and the development of diabetes.

Vitamin D is one hot topic these days, and it’s easy to get carried away with the enthusiasm. What we know about vitamin D and cancer prevention is this: we’re not sure. The studies that have been done looking at an association of vitamin D levels and cancer incidence have been mixed with regard to whether or not vitamin D is associated with a lower risk of cancer. I stress the word “association” here. We really don’t know if there is any causal relationship between vitamin D and cancer incidence. People who have normal vitamin D levels or who are taking vitamin D supplements may have other lifestyle factors that contribute to their overall good health. A randomized controlled clinical trial would be the gold standard to establish a causal relationship and we don’t have one yet. I recommend that you have your vitamin D level checked by your primary care physician and I think it is reasonable for most people to take a vitamin D supplement.

There are some situations in which a cancer patient may want to be sure to drink more water than usual. Some of these situations would include having nausea or diarrhea during treatment (these can lead to dehydration), receiving treatment that makes it difficult to swallow, or getting a chemotherapy that is potentially toxic to the kidneys. The question remains, how much water is enough? That can depend on a lot of factors (physical activity, humidity in the environment, amount of perspiration) and can vary from one individual to another. The Institute of Medicine recommends about 13 cups for men and 9 cups for women as a general guideline. Logic would dictate that you certainly need enough to prevent dehydration. Some of the symptoms of dehydration include fatigue, headache, lightheadedness, dry mouth and skin, decreased urination, constipation, and of course thirst.

I was fairly active before my diagnosis -- running, tap dancing, swing dancing, etc -- and found that keeping up with my exercise/activities as much as possible was crucial to both my mental health and my recovery during treatment. I had four chemo infusions of taxotere/cytoxan (one infusion every 3 weeks) and was able to run through two of them (although not during the first week when the bone pain was too intense). After the third infusion, I had to dial it down to walking (I also had to let the dancing go). But once chemo was over and I was able to get rid of the excess water weight from the steroids, I was able to get back to running and even attain my old mileage within a couple of months. I also ran, danced, walked, etc. during 6.5 weeks of radiation which I believe is the number one reason why I didn't have too many issues with fatigue.

As far as motivation goes, running and dancing and doing all the things that made me feel normal and healthy and whole was my way of telling cancer it could suck it. It was also a way to stay in touch with my body and to appreciate what it could do, even under duress, even with a couple of essential parts missing.

Being a vegetarian is not a 100% guaranteed that you will not get cancer. It is a healthier lifestyle, however, there are many variables that can cause cancer and breast cancer. Add to the equation, eating meat in an earlier life, environmental factors, genetics/family history, obesity, smoking, lack of exercise and history of drinking alcohol. All these factors can cause breast caner.

Moreover, know where your fruits and vegetables come from. Many of our fruits and vegetables that we eat have been treated with pesticides, (which in turn places more estrogen in our bodies, which can cause breast cells to grow abnormally).

Be aware of what vegetables that have a high estrogen content in them. Such as sweet potatoes and “true yams” are totally different vegetables from two separate botanical families. Yams are brighter, orange color and are served more frequently in stores and restaurants, have a higher estrogen component in them. Yet women who maybe at risk for breast cancer are not aware of this factor

Furthermore, there are studies that have shown curcumin and black pepper have cancer-fighting properties to help to reduce breast cancer. Other measures that can be taken to reduce breast cancer is to lower or eliminate the consumption of alcohol. Check your Vitamin D levels, it appears that women who have a low Vitamin D level are more at risk for breast cancer.

In addition to, these factors that I have mentioned above, one must get adequate sleep, exercise, and take time for you.

Thanks for the info on whole grain and wheat. Is there anything you should know when looking for "Gluten-free"? I almost picked up a box of gluten free mix to make bread today ($7.00 on sale ouch!) but I wasn't sure if there was anything I should be looking for on the label to be sure it was truly healthy.

Inflammation is heat or fire in the body. This includes a distinction between acute and chronic inflammation. Think about when you've had a cut or wound. Your skin is red, flamed, and perhaps uncomfortable. That's acute inflammation. But in chronic inflammation, the "flare" does not stop. It continues on and on for months and years where the body acts with immune and other processes to heal a "wound" and yet there isn't one. The chronic inflammation then begins to support health conditions such as cancer.

To reduce inflammation, eat organic vegetables, some fruits, spices such as turmeric, and consider specific supplements. Inflammation levels can also be tested. The most common blood test is called c-reactive protein (CRP) high sensitivity available through mainstream blood laboratories. A healthy level is below 1.0 mg/L.

You can learn more about inflammation and cancer, including a more in depth explanation about inflammation and how to reduce it, in an article on the EmbodiWorks integrative cancer care resources website at http://www.embodiworks.org/cancertreatments/bodymindspirit/inflammation/.

Wishing you optimal health and healing.

Up until recently, the “official” answer from NIH and others has been that there is not been any study that conclusively links stress as a direct cause of cancer. The National Cancer Institute fact sheet says,

“Although the results of some studies have indicated a link between various psychological factors and an increased risk of developing cancer, a direct cause-and-effect relationship has not been proven.” Here is a link to that source: http://www.cancer.gov/cancertopics/factsheet/Risk/stress

An article in the New York Times regarding the link between stress and cancer says,

“What has emerged is a tenuous connection between stress, the immune system and cancer, with a surprising new insight that is changing the direction of research: it now appears that cancer cells make proteins that actually tell the immune system to let them alone and even to help them grow. As for whether stress causes cancer, the question is still open.” Here is the link to this source: http://www.nytimes.com/2005/11/29/health/29canc.html?pagewanted=all

An article in PychCentral regarding this matter says,

“Currently, there is no evidence that stress is a direct cause of cancer. But evidence is accumulating that there is some link between stress and developing certain kinds of cancer, as well as how the disease progresses. Hundreds of studies have measured how stress impacts our immune systems and fights disease. At Ohio State University, researcher Dr. Ron Glaser, Ph.D., found that students under pressure had slower-healing wounds and took longer to produce immune system cells that kill invading organisms. Renowned researcher Dr. Dean Ornish, M.D., who has spent 20 years examining the effects of stress on the body, found that stress-reduction techniques could actually help reverse heart disease. And Dr. Barry Spiegel, M.D., a leader in the field of psychosomatic medicine, found that metastatic breast cancer patients lived longer when they participated in support groups.

Other studies have gone as far as to show those women who experienced traumatic life events or losses in previous years had significantly higher rates of breast cancer.

Still, the National Cancer Institute reports, “Although studies have shown that stress factors, such as death of a spouse, social isolation, and medical school examinations, alter the way the immune system functions, they have not provided scientific evidence of a direct cause-and-effect relationship between these immune system changes and the development of cancer.”

Nonetheless, some medical experts say therein lies the link between cancer and stress — if stress decreases the body’s ability to fight disease, it loses the ability to kill cancer cells.” Link to source: http://psychcentral.com/lib/2006/stress-a-cause-of-cancer/

However, a study in 2010 published in Nature was reported by Newsmaxhealth saying,

“Stress is a killer and is implicated in numerous deadly conditions including high blood pressure and heart attacks. Now scientists have biological evidence that common, everyday stress can trigger cancer.

A new study by Yale University School of Medicine and Fudan University in China shows that stress causes signals to be sent to mutant genes that make them turn cancerous.” Source: http://www.newsmaxhealth.com/headline_health/stress_cause_cancer/2010/01/28/312526.html

All the above being said regarding the “evidence” linking stress and cancer; my own experience is that I frequently see patients with cancer seeking help with hypnosis to boost their immune system, overcome side-effects of treatment, control pain, and make changes to a healthier lifestyle. And in the majority of these cases it is most common to see where prolonged and chronic stress (along with lifestyles with poor stress coping skills) have existed prior to the diagnosis of cancer. There are cases also where I have seen individuals experience ‘better healing’ responses by adding the mind-body tools available through hypnosis and lifestyle changes. I think that anyone diagnosed with cancer would benefit from learning many varieties of stress management, including hypnosis to access and use the mind-body connection for positive messages, images, and intentions for healing and stress-resiliency.

Great question! By removing unhealthy foods from the diet – foods such as refined and artificial sugar, processed foods and most animal-based foods – and increasing whole, plant-based foods I gained more energy, felt better and reached a healthy weight. Eating nutrient-dense real food also greatly decreased the stress on my body in terms of digestion and inflammation. And enjoying some good quality dark chocolate once in awhile helped, too.

I would recommend making regular stops to rest and sleep. Also eating whole, fiber-rich foods (as opposed to highly processed foods) will give you slow and steady energy throughout the trip rather than short bursts of energy followed by a crash (of energy, not your car).

I have already described my thinking in this regard in a recent blog that surrounded the publication of an English study that clearly and unequivocally demonstrated the protective value of non-steroidal anti-inflammatory drugs in patient at high risk for colon cancer (http://robertanagourney.wordpress.com/category/colorectal-cancer-2/). To a large degree, cancer can be viewed as a wound that will not heal. Wound healing is a paradigm of inflammation. The more we can do in our lifestyles, diets, and therapies to reduce inflammation, the better.

The sooner you can resume normal activities the better off you are. I don't mean push it, and I don't mean start doing jumping jacks. Start walking and add distance incrementally. And do this every day. One block, two, three, until you're comfortably walking a mile or so.

Equally important is the rehabilitation of your arm. If you haven't had physical therapy many excellent resources are mentioned above. You can run through arm exercises in fifteen minutes or so. I still do so to this day. After full lymph dissection and radiation the natural tendency of the arm and skin is to retract and tighten.

One of the best things I'e found is yoga. Many cancer treatment centers (in Houston through MD Anderson and Memorial Hermann) now offer yoga for cancer survivors. It's excellent and a gentle way to reduce stress.

There are exercises developed by lymphedema experts specifically to decongest the swollen limb. They tend to combine stretching protocols with decongestion protocols utilizing the "muscle pump", that is, causing the major arm and leg muscles to slowly expand and contract and squeezing the skin against a compression garment or bandaging. There are a number of videos available demonstrating these specialized exercises.

Our favorite is the Video "Remedial Exercises For the Upper Extremities" by Klose Norton Training & Consulting is available for $34.95 + $5.00 s&h for NLN members, $39.95 + $5.00 s&h for non-members from:
National Lymphedema Network
1611 Telegraph Avenue, Suite 1111
Oakland, CA 94612-2138

Edema Exercises for Patients with Arm (Leg) Lymphedema by Dr. Vodder School in Austria

Focus on Healing through Movement & Dance by Sherry Lebed Davis which you can order thru the NLN 1-800-541-3259 $28.00 + 5.50 s/h for members, 32.95 + 5.50 s/h for non-members. Or you can order it from the producer, Enhancement Inc.1-800-366-6038 for 29.75 + 3.00 s/h.

Arm Exercises Video by Dr. Vodder School - North America, 2000.

Dr. Judith Casley-Smith, 94 Cambridge Terrace, Malvern SA 5061, Australia, E-mail: casley@enternet.com.au, includes swimming exercises for lymphedema in her book, "Exercises for Patients with Lymphedema of the Arm and a Guide to Self-Massage and Hydrotherapy". She also has one for the legs. You receive it when you order her "Exercise Video" for both arms and legs. Price for overseas including postage & insurance is Economy $60, Air $65. She asks that payment be in a personal check in your own currency on you own band, but please add $15 for conversion.

There are exercise routines described in some of the lymphedema books, but I favor the videos since the demonstrations are more understandable than the dry words and static sketches or photos.

Joe Zuther had an excellent article in his January 6, 2011 blog called "Decongestive and Breathing Exercises for Lymphedema."

Thank you for this great question. Pardon me while I get on my soap box. :)

When we are diagnosed with breast cancer everything changes. Emotionally, we are faced with our own mortality, physically, we are faced with many treatment decisions that will forever effect the way our bodies look and feel. Then the treatment starts and we start experiencing all sorts of strange and uncomfortable things going on.

I know when I went through treatment for breast cancer, I felt like I lost control over my body. Exercise helped me get control back. I found that through exercise, I was able to increase my energy levels, lessen my anxiety and stress, relieve my aches and pains and in general start to feel like a whole person again.

I didn't start with a strenuous, weight lifting program. I started on the floor, trying to raise my arms over my head, just to see how far I could get them. When I finally raised my arms over my head and touched the floor behind me, I was so happy and proud of my self. I haven't stopped moving since. Of course, I went a little overboard and started a rehabilitative exercise program called MovingOn. But that's just me.

I encourage all cancer survivors to start moving. Whether you are in-treatment or out of treatment, get your doctor's approval and get moving. Some like yoga, some like running or Zumba, whatever you like, start moving. You will be surprised at the benefits of exercise, even if you start for just a few minutes a day.

I challenge the TalkAboutHealth community to get out there and get moving!! Drop me a note on facebook at http://www.facebook.com/LockeysMovingOn and tell me what you are doing to get moving!!

For more information about exercise, go to http://www.movingonfromcancer.com

One of the best ways to fight fatigue, nausea and the body aches that come with chemotherapy is exercise. Emotionally, exercise can lift your spirits, help regain self-esteem and, my personal favorite, help regain control over your own body!

A couple of precautions:
1. Get doctor approval before starting any exercise program.
2. If you are vomiting or have diarrhea, no exercise for 24 hours, you may be dehydrated.
3. Start slow. Incorporate low reps, light weight and lots of flexibility exercises in your program.

A good place to start would be with a few stretches to open your chest area and your hips, then move to body weight exercises like squats and wall pushups, then if you feel really good that day, add some resistance band exercises, like bicep curls and tricep presses.

I hope this has been helpful. For more information on exercise go to http://www.movingonfromcancer.com

First and most importantly, check with your doctor, get his/her permission to begin an exercise program.

This is a great question because fatigue is such a big part of cancer treatment. Everyone is different, I know I really struggled with fatigue issues when I went through chemotherapy. My best advice is to learn your energy cycles. Typically when a patient is going through chemo or radiation, there are days following treatment that you are more tired and have less energy. If you have chemo every 3 weeks, you might be the most tired the first week. During that week, concentrate on gentle stretches. Week two might bring a bit more energy, do a little more, add a walk and some body weight exercises (squats and wall push ups). Week three you will have more energy, keep walking and stretching, then add some exercises that include resistance bands.

If you are getting radiation treatments, you may feel fatigue towards the end of the week, use the same formula as above, just be careful using resistance bands. Again, check with your doctor before beginning an exercise program.

The bottom line is just try to move a little bit everyday and be kind to yourself!

For more information about exercise and MovingOn programs go to http://www.movingonfromcancer.com

Thanks for the great question! I always considered myself to be fairly healthy, but the reality is it was not until I got sick a few years ago that I really got the wake-up call. The gluten-free diet was a part of my whole "transformation", which has included a transition to a non-processed, primarily plant-based diet, much of which I (try) to grow myself! It has also given me a real appreciation for the amazing healing capacity of our bodies and spirits, as well a much better appreciation of what my limits truly are. While I still try to push through those limits, I'm much more accepting of my boundaries than ever before. I wrote a little about my dietary changes here: http://www.morrisonhealth.com/blog/health/dr-attais-gluten-free-diet . I also feel that what I've gone through personally has made me a much better physician; dealing with illness and recovery as a patient has taught me things that medical school and 16 years of clinical practice did not even touch!