Grief is a sacred journey

Strength When You Need It: Nutrition and Complementary Therapy during Cancer Treatment

This piece continues the discussion of how my husband Vic Mansfield is getting through cancer therapy in one piece. He has a rare, aggressive T cell lymphoma that was treated with four months of “CHOP” chemotherapy, a type of therapy commonly used in T-cell lymphomas, followed by high dose chemotherapy and a stem cell transplant. My June 2007 article in Master Trainer, “Strength When You Need It: Fitness and Cancer Therapy,” discussed Vic’s exercise routine during cancer therapy. Here I discuss nutrition and other modalities that helped Vic survive treatment with his vitality and spirit intact.
 

Vic’s strength continues to improve. He has reached 100% of his record strength (PR) in most upper body exercises, slightly exceeding pre-cancer PRs in a few exercises. His lower body exercises such as squats and deadlifts are about 90% of pre-cancer PRs. His aerobic fitness is excellent again, even though high dose chemotherapy often damages the heart or lungs. It obviously didn’t damage his. In general, he feels terrific with a few improving side-effects such as numbness and occasional pain in his feet, skin sensitivity, and stiffness in his hands and feet. His monthly blood tests have shown no sign of cancer since February. With this disease, each healthy month is a milepost.

Before high dose chemotherapy and stem cell transplant, we were given Autologous Stem Cell Transplants: A Handbook for Patients (1) to read. This book states: “It may take six or more months before the transplant survivor is well enough to resume a normal routine and return to school or work.” The book made it clear that most people never regain full vitality. Vic’s doctor guessed that Vic would feel reasonably well in about six months and would be recovering for a year. It was clear that at age 66, Vic might never regain his full strength or vitality. He not only resumed a full schedule a few months after hospitalization, but regained full strength in 3 ½ months. We attribute this to his naturally strong constitution, but mostly to his past fitness training and good health habits coupled with his knowledge of how to train himself to regain strength.

Nutrition: We have had an excellent diet for forty years, high in mostly organic vegetables and fruits, vegetable proteins, and whole grains—a cancer prevention diet if there ever was one. It didn’t prevent cancer, but it seems essential to surviving it. The oncology nutritionist on Vic’s medical team was thrilled with the quality of Vic’s diet and that he had not lost weight in the four months of initial chemotherapy. Her analysis showed Vic’s calcium intake was slightly low from food sources. We were aware of this and have supplemented his diet with calcium citrate and vitamin D for many years. His protein intake was slightly low, but acceptable because we’ve recently added fish to our diet. Vic has a strong allergic reaction to dairy foods, but in the past, legumes and eggs filled the protein gap. During chemotherapy treatment, legumes other than tofu became indigestible, so without fish the protein sources became hopelessly limited.

If you eat fish, look at the website Everyday Health for reliable information about fish safety, human health, and the ecological effects of fish consumption. We eat sustainably harvested wild salmon, both fresh and canned.

What to eat when nausea is a problem: Most chemotherapy patients have extreme problems with nausea, digestion, and loss of appetite. Because of this, the focus of an oncology nutritionist is preventing weight loss. Vic jokes that he is the only person he knows who gained weight on chemotherapy. I helped put on those pounds by cooking creatively, but Vic also has a strong digestive system and didn’t experience extreme levels of nausea that are common with chemotherapy.

During the first four months of chemotherapy, we experimented with a variety of foods to find which were appetizing and digestible. It was a moving target, but Vic usually could eat pureed vegetable soups, fresh vegetable juices, fish, eggs, tofu, sweet and white potatoes, winter squash, whole grain breads, whole oats, and cooked vegetables and fruit.  Largely because friends delighted in baking him high calorie foods like whole-grain apple cake and because he stopped watching calories, Vic finished the four month round of CHOP chemotherapy heavier than when he began treatment. The medical team congratulated Vic on those extra pounds as he entered the high dose chemotherapy and stem cell transplant phase of treatment.

Surviving hospital food: Hospital food is generally unappetizing and unhealthy with few wholesome choices. Vic’s otherwise excellent hospital had little to offer for someone used to natural, unprocessed foods. During the 17 days of hospitalization for Vic’s high dose chemotherapy and stem cell transplant, I stayed at an American Cancer Society lodge near the hospital that had a kitchen where I prepared food for both of us. The hospital transplant unit had microwaves, toasters, and a refrigerator, so I brought in pureed vegetable soups, whole grain bread, steamed sweet potatoes, tofu, cooked fruit, etc. Vic poached eggs in the microwave. All this took effort, but it gave me a constructive way to support Vic and kept us both well nourished during his ordeal.

Fluid intake: During the four months of CHOP chemotherapy, Vic was instructed to drink ample fluids after each chemotherapy treatment to flush the chemicals from the body quickly and minimize damage. Along with lunch, we packed a few quart bottles of a mix of 1/10 orange juice and 9/10 well water for our day trips to the cancer center. Vic usually drank one quart on the way to the hospital and during treatment. After treatment, he tried to drink another quart on the 1 ½ hour drive home. He nearly always managed it, although often fighting nausea.

In the hospital during high dose chemotherapy and stem cell transplant, the medical team had one request beyond getting out of bed, eating something each day, and walking—drink lots of fluids. Vic soon realized he could avoid being attached to his IV machine for 24 hours each day by drinking just 50 ounces of fluids a day. This was easy because fitness training had built a habit of drinking ample liquids. Vic drank bottled water provided by the hospital, sometimes mixed with small amounts of juice, and never had trouble taking in twice the prescribed amount. This kept him off the IV except when needed for medication or electrolytes.

Nutritional supplements: Vic’s medical doctors suggested a multi-vitamin along with prescription drugs to help him avoid fungal and viral infection. We go well beyond that. We supplement Vic’s diet with a multi-vitamin and mineral, omega-3 oils, calcium citrate, magnesium, vitamin D, and coenzyme Q-10 to protect his heart from the chemotherapy drugs. A naturopathic physician advised taking supplements in capsules or liquid form, because hard tablets can be difficult to break down. She also suggested supplementing Vic’s diet with raw organic vegetable juices when he had trouble with nausea.

During the stem-cell transplant, Vic’s electrolytes were monitored daily. Minerals were supplemented by IV as needed.

Complementary Therapy: As you can imagine, Vic received a full range of advice about cancer cures, from the wise to the ridiculous. In the summer of 2006 when Vic was growing sicker by the day with no diagnosis and no treatment, we understood why people go to exotic tropical islands for unusual cures. We were ready to try anything. Fortunately, Vic got a diagnosis in time and was responsive to treatment, but we felt he needed all the support he could get to withstand chemotherapy. Because we’ve used complementary therapies for years, we were aware of the possibilities available in our community and explored various ones immediately.

Dealing with Vic’s therapy and figuring out an appropriate support system to encourage healing consumed our lives for months. This was possible because Vic was on disability leave from college teaching and I stopped teaching fitness classes and worked privately with only a few clients. After considering many possibilities, Vic narrowed complementary therapy to the options that felt most supportive. The alternative modalities he chose have as much to do with his feelings about the practitioner as with the therapeutic mode.

Healing and pleasant touch seem essential to someone undergoing cancer therapy. Vic’s medical team is exceedingly competent and kind, but the poor body is poked, needled, cut, and filled with harsh chemicals. Touch is usually through rubber gloves. Other than a reassuring pat on the back and one terrific woman doctor who gave hugs, medical touch is invasive and unpleasant. For Vic, it is important to counteract this discomfort with pleasurable as well as therapeutic touch.

Chiropractic Care: Our first experience with an alternative therapist was 35 years ago with Dr. John Perestam, a chiropractor and applied kinesiologist, who has returned to our area after being away for many years. After Vic began chemotherapy treatment, my heart jumped with joy when I heard that Dr. Perestam practices a few mornings a week despite his retirement. We had been seeing other chiropractors, but we trust this man’s hands and his ability to work with the body mechanically and structurally. His muscle and lymph work is an essential addition to the medical approach that focuses on blood tests and high tech scans. Vic sees Perestam about once a month for an hour-long session. Perestam uses a variety of techniques, but always includes the self-help approach discussed in a book called Touch for Health: A Practical Guide to Natural Health with Acupressure Touch and Massage. (2) With this book and Dr. Perestam’s guidance, I work on Vic’s body with therapeutic massage between chiropractor visits.

Perestam focuses on Vic’s damaged lymph system, encouraging the flow of lymph fluid with massage and adjustment. He works on Vic’s whole body, but pays special attention to his feet and legs to improve symptoms of neuropathy (nerve damage) caused by one of the chemotherapy drugs. Our medical doctors can’t offer help other than pain killers, but hope that Vic’s nerves will heal over the next year. Painkillers didn’t help, but symptoms are slowly improving.  I massage Vic’s feet daily to encourage blood flow and promote healing.

Trigger Point Therapy: We first learned about Trigger Point Therapy from Stuart McRobert’s books. This mechanical approach to body discomfort has helped with side effects from chemotherapy such as muscle pain, hand cramping, and weakness and discomfort in the calves and feet. I highly recommend The Trigger Point Therapy Workbook (3) for self-care. Vic occasionally works with a physical therapist who practices Trigger Point Therapy, but following Davies’s advice, he can do much for himself with a small hard ball for foot massage and a special tool called a Thera Cane for reaching areas on the back.

Massage and Healing Touch: Vic has weekly hour-long sessions with a massage therapist, Janet Wylde, who practices deep muscle massage in a peaceful and aesthetic environment. Janet also practices a type of “energy healing” called Jin Shin Jitsu, a Japanese system of balancing the body by applying pressure to acupressure points to release tension and increase circulation. Janet’s weekly sessions foster deep relaxation and a sense of well-being that has been essential for Vic. He trusts her expertise, the healing atmosphere she creates, and her sincere desire to help him heal.

Stretching and Yoga: Vic continues to do yoga-style stretching as he has for many years. This helps with stiffness that comes with nerve damage in his legs, feet, and hands. We both find stretching to be a good balance for strength training.

Deep Relaxation and Developing a Healing Attitude: Anyone who has seriously engaged in resistance and aerobic training knows the importance of mental attitude. Within the context of healing, mental factors are essential. I therefore briefly discuss those that have been crucial for Vic.

Meditation: Vic and I have meditated for over 35 years. His meditation practice has become even stronger during this illness. The American Cancer Society suggests meditation for reduction of stress, anxiety, high blood pressure and chronic pain. Local workshops supported by the American Cancer Society teach “mindfulness” meditation to cancer patients. Benefits include diminished pain with lowered needs for pain medication, reduced stress hormone levels, improved immune function, and improvement in mood. Meditation seems to help cancer patients alleviate the harmful physical effects of stress and lessens negative psychological responses to illness. Meditation helps Vic deal with the inevitable fear of death and suffering he faces. It helps me, too.

Positive Visualizations and Acceptance: We both include a healing visualization exercise as part of meditation. It involves embracing the cancer treatments as positive healing agents washing through the body and then imagining the body filling with health. I have devoted my life to natural healing and considered the chemicals and procedures of cancer treatment to be toxic and frightening. When these therapies became necessary to save Vic’s life, my attitude had to change, so I visualize the medicines and other procedures as rescuers rather than toxic enemies. When Vic received his chemotherapy infusions, we asked for the quietest area of the room so we could turn off the TV and focus on healing. It helped to turn our minds from fear and the violent images broadcast from CNN toward something positive. Vic does not feel like a victim who doesn’t deserve cancer or difficult side-effects. Instead, he focuses on the challenges and the resources he’s been given to meet them.

With these positive attitudes, Vic is a compliant patient. They suggest that he drink; he drinks. They ask that he walk; he walks. They say it’s important to be mentally positive; he works on that, too. As he walked around the transplant unit at his weakest and sickest, he focused on the love showered on him from his family and friends, the kindness of the staff, and the heroic interventions he and other patients were offered to prolong their lives. He focused on his good fortune that there was a treatment available and that he was responding to it. Few people in the world receive the high level of medical and personal care he was given. We are lucky.

Healing Power of Nature: Bluebirds in their nesting box, white hawks gliding over our fields, lettuce seedlings pushing up through the soil—awareness of the preciousness and beauty of life is heightened with cancer nipping at Vic’s heels. Contact with the natural world helps us stay hopeful and positive. Vic would often return home from a day of chemotherapy infusion and take a slow walk outside. He could relax into a realization that life is still beautiful and that his body, along with his sickness, is a part of the natural cycle of life and death. During his hospitalization, I left Vic’s room each afternoon to take long rejuvenating walks in a park-like cemetery near the hospital, breathing in the air, the ancient trees, the flocks of crows, and the natural light. Humor helps, too, as we note that the cemetery is “conveniently located” across the street from the hospital.

Staying Positive: This brush with death teaches us to acknowledge the good things in life. We’ve been happily married 39 years, but we’ve never appreciated our partnership as we do now. We’ve never felt the joyful surge of spring as we do this year. Everyday experience is heightened and enhanced by having illness and the possibility of death so close. As Vic smacked the tomato stakes in the garden in May, instead of complaining about the job, we appreciated that he is strong enough to do it.

This has been the worst and the best of years. Despite the stress and grief, I’m grateful for the fuller experience I have of how precious and fleeting life is. I plan to enjoy our second chance rather than fretting about the future. I’m taking on more clients and will resume teaching in the fall. As I write this, Vic has an inch of new hair after eight bald months. He learned that a book he finished writing just before his cancer diagnosis has been accepted for publication. He is starting new projects and will return to part-time teaching in August. His resilient body has stepped back from the edge of the abyss. We plan to continue to do all we can to keep it that way, knowing well that even ageless athletes eventually die.

[1] Stewart, SK. Autologous Stem Cell Transplants: A Handbook for Patients. Blood and Bone Marrow Transplant Information Network, 2000.

[2] Thie, J, DC. Touch for Health: A Practical Guide to Natural Health with Acupressure Touch and Massage. DeVorss Publications, Marina del Rey, CA, 2001.

[3] Davies, C. The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief. New Harbinger Publications, Oakland, CA, 2001.