Paige Woodward, #OurTribe’s resident Oncology Nurse Practitioner, offers you this handy guide for starting 2019 on the right foot.

As an Oncology Nurse Practitioner, I am often asked a lot of questions in the “treatment is over so now what do I do?” category. I hear women wanting to make the best health and wellness decisions for themselves, but struggling to make sense of all the conflicting information out there. Below is a summary of my most frequent recommendations.

General Nutrition
There is an overwhelming amount of information as to which fad diet or program should be followed in the wake of a cancer diagnosis. I believe everything in moderation and that the majority of your diet should include clean, unprocessed, whole foods. Processed foods contain so many harsh chemicals, sugars, and fats that are unhealthy for any population.
However, I do believe in an occasional treat such as a cookie, a glass of wine etc.
A balanced diet should include:
- Protein (3-5 oz/palm size)
- Greens
- Healthy fats (avocado, olive oil, nuts, nut butter)
- Fiber (veggies, chia seeds, flax seeds)
Fluid intake: It is very important to drink plenty of water and fluids throughout the day.
- Limit caffeine and soda intake
- For every kilogram of body weight, ingest 30-40 ml water (cheat sheet: take your weight in pounds and divide by 2.2)
- On average, you get one liter of water from your food intake, and then need to consume an additional 1-2 L per day.
- This amount can vary with illness, exercise or weather
It is also critical to keep your blood sugar (glucose) consistent. Blood sugar will rise after a meal, and generally within 2 hours postprandial, blood sugar will normalize. Consuming processed, unhealthy foods causes unnecessary spikes in blood sugar rather can keeping it balanced.
Sleep Hygiene
- Insomnia is often a huge issue for cancer patients
- There are many pharmacologic treatments and over the counter medications to treat this issue
- There are several psychological interventions to help with proper sleep
- Sleep hygiene involves changing current health practices and environmental factors that may interfere with sleep
- The National Sleep Foundation recommends 7-9 hours of sleep each night for Adults 2664 yrs old
This gives your body time for adequate rest and repair.
–From Dr. Mark Wu, MD, PhD, Johns Hopkins Medicine
Why You Need Sleep
If you have ever felt foggy after a poor night’s sleep, it won’t surprise you that sleep significantly impacts brain function. First, a healthy amount of sleep is vital for “brain plasticity,” or the brain’s ability to adapt to input. If we sleep too little, we become unable to process what we’ve learned during the day andwe have more trouble remembering it in the future. Researchers also believe that sleep may promote the removal of waste products from brain cells—something that seems to occur less efficiently when the brain is awake.
Sleep is vital to the rest of the body too. When people don’t get enough sleep, their health risks rise. Symptoms of depression, seizures, high blood pressure and migraines worsen. Immunity is compromised, increasing the likelihood of illness and infection. Sleep also plays a role in metabolism: Even one night of missed sleep can create a prediabetic state in an otherwise healthy person. “There are many important connections between health and sleep,” says Wu.
*For more sleep info, check out #Our Series on Sleep.

Exercise
Clinical Oncology Society of Australia (COSA) is now recommending exercise as part of cancer treatment!
Exercise specifically as an additional therapy for patients undergoing cancer treatment has been well-studied and associated with many benefits. In one analysisof 61 clinical trials of women with all stages of breast cancer, those who underwent an exercise program during treatment had significantly improved quality of life, fitness, energy, and strength, as well as significantly less anxiety, depression, and lower body mass index and waist circumference compared with the regular care groups. In another major analysis of 28 trials involving over 1,000 participants with advanced cancers (including leukemia, lymphoma, multiple myeloma, lung, breast, GI, and prostate), an exercise program during treatment was associated with significantly improved physical function, energy levels, weight/BMI, psychosocial function, sleep quality, and overall quality of life. (Harvard Health Publishing, Harvard Medical School)
In sum, EXERCISE IS AWESOME. ☺️
- Everybody should aim for 5-6 to days of exercise per week.
- This can be as little as 20 minutes per day (Recommending up to 160 minutes per week) including 2-3 days of resistance training.
- It can include gym workouts, group classes, exercise videos, smart phone apps, or body weight training at home
Supplements
- Vitamin D (dosage will vary based on your level). Minimum 2000 IU daily
- Hair and nails: biotin, silica
- Calcium 1000-1200 mg daily
- Turmeric, curcumin have anti-inflammatory properties. *Not recommended if on blood thinners or aspirin as it can increase risk of bleeding.
- Collagen protein (primal kitchen foods, vital proteins)
Unfortunately, not all supplements are created equally, and the FDA doesn’t actually regulate them. If supplements are a big part of your life, I highly recommend a subscription to ConsumerLab.org. They are an independent organization that tests supplements off the shelf and rates them for accuracy.
Alternative Therapies
- Acupuncture: can be helpful for managing chemo symptoms, joint aches/pains, neuropathy.
- Massage: No need to explain what this is for. However, if you have had lymph node dissection or radiation, it is best to find a massage therapist with knowledge of lymphedema.
- Reiki: an energetic technique where the practitioner channels universal energy to balance your own. The experience is deeply relaxing.
- Chiropractic care: great for muscle aches and pains.
- Journaling
- Meditation: Being present and in the moment can greatly reduce stress, lower your blood pressure, improve your immune function and even enhance your sleep. Mediation, even
Routine Health Maintenance
- Mammograms
- Colonoscopy (age 50 or earlier if family member with GI cancer)
- Up to date on vaccines (flu, pneumovax, Tdap)
- Gynecology visits
- Routine blood work
- Establishing care with a primary care physician
- Daily sunscreen use
- Skin checks with dermatology
Lastly, have fun and live your life!
Literature and social media recommendations:
Dr. Mark Hyman (Food: what the heck should I eat?)
Kelly Leveque: Body love book, Bewellbykelly
Brigid Titgemeier: Being Brigid (Instagram)-functional nutritionist
Melissa Hartwig: Whole 30
Rachael DeVaux, RD: registered dietician, rachaelsgoodeats (Instagram)
Mark Sisson: Primal kitchens foods/Books
Julie Foucher, MD, former Crossfit games athlete, now family medicine resident at Cleveland Clinic
Do you have any go to wellness tips? Comment below, or better yet, join our Private Facebook Group. We’d love to have you in #OurTribe!