Sweet Dreams

Before breast cancer, I knew that sleep was important but never realized all of the ways that it impacts your health. I have always loved my sleep and usually get about 9 hours a night which might seem like a lot to some people. When going on a trip with friends, I am always the last out of bed in the morning and I occasionally get comments poking fun at my early bedtime on weeknights.

Well, it turns out that my sleep habits could hopefully benefit me as less sleep has been linked to an increased risk of developing breast cancer and recurrence. Some doctors have suggested that lower levels of melatonin, a hormone made in the brain, could explain the higher risk of recurrance for women that do not get enough sleep. Melatonin plays a role in regulating the body’s sleep cycle and may also help regulate cell growth and repair. People who don’t get enough sleep tend to have lower melatonin levels. Lower melatonin levels may lead to patterns of breast cell growth and repair that make breast cancer more likely to develop. That is why I take 20mg of melatonin before bed every night. 

There is also evidence that longer overnight fasting is tied to reduced breast cancer recurrence. In a study that was recently released, researchers found that fasting less than 13 hours per night was associated with a 36% higher risk for disease recurrence as compared with fasting 13 or more hours per night. Obviously they cannot promise any outcomes and this is only one study but I figure that fasting for 13+ hours is something I can easily incorporate into my recurrence prevention plan:

• My husband and I usually eat dinner between 6-7pm
• Drink 1-2 cups of organic green tea before bed
• When I wake up I drink 2 cups of water (read about the health benefits here)
• Shower and get ready
• By the time I have breakfast it is usually 9-10am

Voila, 13 hours!

Cheers to Water

The jury seems to be out on whether women who have had breast cancer should continue to consume alcohol in moderation or cut it out all together. Some articles like this one say that alcohol intake can be detrimental specifically to ER+ women because it increases the amount of estrogen in the bloodstream and can lower the effectiveness of tamoxifen. The problem is that for every study like this one, you can find another one saying that 1-2 drinks a week will have no effect or could even be a positive thing. Analysis of women enrolled in the Collaborative Breast Cancer Study (CBCS) actually found that moderate drinkers before diagnosis had about a 15 percent lower risk of death from breast cancer compared to nondrinkers.

The other confusing thing is that most studies focus on the effect of alcohol on estrogen but what if your cancer was not estrogen positive like mine? What is my risk of recurrence if I have a few drinks a week? I don't think I will ever have a good answer to that question but what I am sure of is that if I want to be 100% safe, the only answer is to not drink at all. In addition to the preservatives in wine, it contains sugar (which I am trying to limit) and pesticides are used to spray the grapes (unless you are buying organic). These are the main reasons I have decided to cut it out for now, while my body is still recovering from treatment.

I never really noticed before how uncomfortable sobriety can be. I didn't realize how much of a social norm it is to go for drinks with colleagues after work, have a glass of wine at dinner or a beer on the golf course. Since before chemo when I decided to stop drinking, I have experienced countless awkward moments of people offering me a drink and when I say no, it's followed by "are you sure?" or "why don't you just have one drink?". I think anyone who has made the decision to give up alcohol gets these weird reactions from people regardless of age but being only 31 years old, I find it even harder to go out with a group of friends and I am the only one not drinking.

There is so much pressure! Got through another week of work? Someone's birthday? Cottage weekend? Vacation? Dinner party? Sporting event? Alcohol to the rescue! My answer? Order water in a wine glass with lemon/lime and no one will know the difference. Sometimes I get a little "crazy" and throw some berries in there or drink Kombucha, which has a ton of health benefits. Cheers!

Debating Between Mastectomy and Lumpectomy?

If you have been diagnosed with breast cancer, either a surgeon or oncologist would likely have discussed the options of a lumpectomy or mastectomy with you. Like me, the first thing you probably asked is whether one is more effective than the other. During the information gathering process (which can be non-existent for some women as you feel forced to make a decision so quickly), I was told that long term survival did not differ regardless of which option I chose. Not so says the following article:

Age May Affect Outcomes With Breast Surgery

This study found that women 45 or younger had a 20-year local recurrence rate of 25% with breast conservation versus 11% for older women. Rates of local recurrence after mastectomy were 13% for younger patients and 3% for the older subgroup in the study population of 1,076 patients. In my case if a mastectomy gave me even a 1% better chance of never having the cancer come back, I was going to take it. A double mastectomy? Sure, might as well remove them both and reduce my risk even more.

My point is that a lot of people have opinions on what kind of surgery is best but it's your body and you have to be the one to decide. I think it is important for women to educate themselves about their options outside of what your surgeon, oncologist, radiologist, genetics counsellor etc. recommend. For example, when I said I wanted a double mastectomy both my surgeon and radiologist were very against it. With comments like "why would you cut off a perfectly healthy breast?" and "you know it won't increase your chances of survival" I seriously doubted my decision. By the time my next appointments with both doctors rolled around, they were perfectly fine with my decision and did not question it at all. It's almost like they were testing me to see how serious I was. When someone makes the decision to cut off their breasts, I would think they are pretty damn serious but either way, I guess I passed the test. My genetics councillor on the other hand was very supportive of my decision saying that the chances of developing cancer in the other breast are small, but they increase with age meaning that in 20 years, that risk could be quite high. This is especially true if you are triple negative.

It's such a tough decision and one you probably never thought you would have to make. At this age, I thought I would be deciding on baby names but that's not the way things worked out. This is getting depressing and that was not the intent of the post so I'll cut it off here but hope this information was helpful to you in some way.

Supplements

I just watched the third episode of The Truth About Cancer which mainly focused on supplements, juicing and GMOs. It was equally as intriguing as the second episode and made me want to write a post about supplements. When I started seeing a Naturopath, my initial thoughts were that the supplements won't be able to kill cancer cells but at least taking them will make me feel like I am doing something to continue "treatment" when radiation ends.

After watching several documentaries including The Truth About Cancer and hearing about the effects of supplements like Curcumin and Green Tea extract for example, I am more convinced that they have the ability to kill cancer cells while protecting normal tissue. As they said in this episode, most people with cancer have chronic inflammation and if you stop the inflammation, you stop the cancer from forming. I know this was my case as I had my ferritin levels checked part way through chemo and was surprised at the results. Ferritin is an indicator of inflammation in the body and my levels were 3 times the maximum of the normal range.

Now I am still cautious and there are some things I will never believe like the woman they interviewed who said she expelled a tumor from juicing. Really?!? No one has to convince me about the benefits of juicing but come on. That nonsense aside, many of the supplements they talk about do have evidence behind them. I am always interested in what supplements others are taking to prevent recurrence so in the spirit of information sharing, will list out what I currently take. I am in no way suggesting that others follow this regimen.

IV Vitamin C - 50 grams once a week
Helixor (Mistletoe) - once a week with Vitamin C (amount changes)
Alpha Lipoic Acid - 150mg three times a day
Green Tea Extract - 700mg three times a day
Curcumin - 120mg twice a day
Melatonin - 20mg once a day
Coq10 - 100mg once a day
Vitamin D - 5,000 IU once a day

This may seem like a lot and odd coming from someone who asked their Oncologist for more chemo after 4 rounds of AC and 4 rounds of Taxol, however, now that I am educating myself about natural therapies, I am feeling much more comfortable with the drug-free path that I am on.

The Truth About Cancer

I signed up for The Truth About Cancer docu-series because I saw an advertisement pop up on Facebook. 90% of my internet searches these days are cancer related so it is no surprise that these ads are what show up in my feed (interspersed with celebrity gossip ads). I watched the first episode and wasn't really buying it. The way that Ty Bollinger introduced the series and the barrage of e-mails I had been getting leading up to the release of the first episode seemed too over the top. After the first 10 minutes I closed my laptop and went back to whatever other shows I was watching (likely an episode of the Real Housewives). A few days later I over heard some ladies talking about how informative they found it so today I decided to give it another chance. Episode 2 was well done and I am glad I watched it!

Although there were parts I didn't agree with (mainly about mammograms, how they are dangerous and lead to over diagnosis), there was other advice that rang true, specifically 'let food be thy medicine'. The individuals being interviewed went on to say that sugar isn't just a poison for cancer patients, it is bad for all of us. Dieticians and Nutritionists will agree with this, entire countries are starting to acknowledge it, for example the UK just recently implemented a sugar tax, yet Oncologists still stand by the fact that sugar does not feed cancer and "everything is fine in moderation". There is clearly a disconnect here.

It's also interesting what they said about essential oils, especially frankincense and using natural oils on your body instead of synthetic lotions and potions. I had the 'ah ha' moment a few months ago when it sank in that skin is our largest organ so why was I using lotions every day that were filled with chemicals. Sure, they smell lovely but all of those toxins were being absorbed into my body. Since then, I have stopped lathering up every morning with my Bath and Body Works lotions. They have now been replaced with all natural lotions and oils like the ones sold at Pure and Simple which is one of my favourite new stores.

All in all, watching the episode was an hour well spent. If you're interested in signing up for the docu-series, here is the link....just be prepared for a ton of e-mails every day which you can delete promptly after receiving.

The Truth About Cancer: https://go.thetruthaboutcancer.com

Now What?

Now that chemo, surgery and radiation are done, it is scary to think that you are really on your own. The doctors don't need to see you for another 3 months, there are no more appointments and you are left with a feeling of 'what the hell just happened'? The part that scares me the most is my doctor's lack of information about how to prevent recurrence going forward. My last doctors appointment went something like this:

"How are you going to monitor that I remain healthy and cancer free?" - Me
"We are going to schedule follow up appointments with you every 3 months" - Doctor
"But those appointments are just a quick physical check up and conversation...no bloodwork or scans" - Me
"We have found that ongoing scans are not helpful for prevention and cause the patients more anxiety. If you have any headaches, bone pain or other symptoms in between appointments you can always call" - Doctor
"I'm fucked" - Me

I didn't actually say that last part but it's definitely what I was thinking. My doctor did offer to at least do a mammogram on my unaffected side and an ultrasound of both breasts and axilla approximately 4 months following the end of radiation. After pushing for bloodwork, they also added it but that's all.

Aside from my concerns over the lack of follow-up, there was no discussion about how, especially with triple negative breast cancer, a low fat diet and regular exercise can lower your risk of recurrence by up to 54%. There was also no mention about how to rebuild my immune system after it has been severely compromised. It makes me so angry to think that after poisoning you with chemo, impacting your physical appearance with surgery and burning you with radiation there seems to be no interest in helping you put yourself back together.

Thankfully this is where my friends, family, social worker and naturopath come in. I have put together my own after care team that can give me the support I desperately need while trying to figure out how to move on from here. So that's what I'll focus on until my next "follow up" appointment in 3 months.

Here We Go Again

How is it possible that my eyelashes are falling out again? Almost 5 months to the day since finishing chemo, when I was washing my face at night, I started to notice my eyelashes on the facecloth. Thank goodness for the internet and other blogs I had read that warned me this was coming.

Apparently a lot of women experience losing their eyelashes and eyebrows a second and even third time post chemo because eyelashes go through the process of loss and regrowth in repetitive cycles. After chemo, your eyelashes all grow in at once which means that as part of their cycle, they also fall out all at once. This usually happens about 4-5 months post chemo. Based on what I've read, the only thing you can do is to wait for your body to naturally restore itself after your treatment meaning that this could happen a few more times...great! I was hoping the Latisse I had been using would help but no such luck.

At least both my brows and lashes have just thinned dramatically but not fallen out completely. Nothing that a little mascara, eye liner and eyebrow pencil can't fix. What really would have helped is if one of my many doctors would have warned me about this. Sometimes I think they forget that hair loss, although maybe less traumatic than some of the other side effects from cancer treatments, does have a profound impact on people and warning them about things like this goes a long way. I guess that's what blogs like this one are for!