#gyncsm Community: "What is OK During Treatment" August 8, 2018 Chat

Tonight we had the chance to learn "What is OK during treatment?". We covered what is OK in terms of exercise, food, sexual intimacy and vitamins. We also allowed our participants to ask their own "Is it OK to..." question at the end of the chat. It was a pleasure for us to have Sangeeta Agarawal RN, Ms, CAS (@sanHelpsy), founder of Helpsy join us as a guest for this evening's chat and provide valuable information on a number of topics.

You may find our transcript here and analytics here.

We are happy to share a few highlights from tonight's chat below. Resources may be found at the bottom of this post.

T1: Is it OK to… take supplements and vitamins during chemotherapy? How about during radiation therapy?

It is important to let your MD know any vitamins/supplements you are taking to ensure that they will not counteract your chemo

For example, antioxidants can counteract the effect of chemotherapy by clearing out the free radicals that damage the cancer

We recommend a simple multivitamin during treatment for cancer

You can find more information about herb supplements on NCCIH's HerbList App and Memorial Sloan Kettering's About Herbs app

Avoid taking high doses of antioxidant supplements during chemotherapy and radiation treatments as they may interfere with treatment

T2: Is it OK to… exercise during treatment? Are there specific exercises that are good to do after abdominal surgery?

We absolutely encourage exercise during treatment for cancer - it can help reduce stress and manage symptoms such as fatigue

Start with light exercises - slow with yoga, walking or stretching, work your way up to cycling, swimming, aerobic exercise once you feel ready. Talk to your oncologist and care team to design the right fitness routine for you

After abdominal surgery, it's important to avoid anything that strains your core/abdomen, stick w walking & low impact exercise

Supervised resistance training is good during and after treatment as it helps maintain muscle and bone mass

Try exercises like finger rolls, finger taps to help with neuropathy in your hands and fingers; exercises like calf raises, ankle circles, standing heel to toe for neuropathy in feet

There are even tutorials for seated yoga - you can get in your movement in many different ways.

Maintain a diary to record exercise sessions. Plan exercise for good and bad days, days when you experience intense symptoms

And exercise (appropriate for your current level of health) is excellent for your mental health, too

Exercise reduces fatigue at 40-50%, provides muscle strength, flexibility & general conditioning, control weight. Avoid swimming if on R/T chlorine irritate radiated skin as per reading

T3: Is it OK to… eat raw fruits and vegetables during treatment?

Try to include colorful fruits and vegetables, at least 2.5 cups every day, be sure to wash them thoroughly

Include citrus fruits like grapefruits and oranges and deep yellow and dark green vegetables

very imp to wash them thoroughly before eating. Check any warnings about breakout of disease

Vegetable sprouts such as mung bean, alfalfa, broccoli and radish should not be eaten raw, only consume pasteurized juices

Do not consume from outside - fresh salsa or salad dressings found in refrigerated sections of the grocery store; shelf-stable salsa and dressings are okay

This literature review found no need for a neutropenic diet: https://t.co/FBixFWj5Nt

In case of loss of appetite or desire to eat, talk to your health care team about nutrition consult so they can suggest recommendations to help improve taste and appetite

No need to avoid raw food completely! Avoid outside raw food. Avoid raw sushi

I also tell patients that beware of coffee and soda. You don't get proper hydration from those products.

T3 cont'd - What about soy and soy products?

Soy products contain phytoestrogens and not estrogen, soy contains essential amino acids, magnesium, potassium, fiber, and other vitamins. Try picking organic sources of soy

Soy dietary supplements may not be a healthy choice, consult your physician

No harm in eating soy. Just ensure your body can digest it. Eat organic soy products.

T4: Is it OK to… have sexual relations while in treatment?

No reason to avoid sexual relations, it is not sexually transmitted or contagious and won't cause the cancer to return

You can absolutely have sex during treatment - there is no risk as long as you have the energy for it!

If you are in the mood or have energy for it! Go for it! Sex releases happy chemicals and builds closer bond with partner.

Fatigue, pain, and discomfort after surgery could interfere with sexual relations, use vaginal lubricants to alleviate the pain

Radiation may cause vaginal swelling and bladder inflammation, sexual relations may be comfortable after a short healing period of about 2-4 weeks

Cuddling, kissing and other forms of intimacy feel good too! :)

It's very important to bring up this topic and discuss any questions. Many times providers and patients both avoid it, but it's an important part of our life that needs discussion and clarity

T5: We’ll now open the floor to allow our participants to ask other “Is it OK to...” questions. What haven't covered?

Question: How about getting your flu shot? I think it is ok with chemo and radiation but they aren't sure about getting it with immunotherapy and other new kinds of treatment....

Usually it's given, but based on some treatments like immunotherapy - it may be held for a bit. Important to check with oncologist

Question: Is it ok to be around kids or adults ( shingles ) who have had vaccines?

Most are safe, but when WBC is very low, better to avoid contact during days of nadir/lowest white blood cell count

Question: For nutrition and exercise... any different recommendations for immunotherapy vs. more standard treatments? Or is there not much studies on that yet?

so far, our recommendations for nutrition and exercise don't change for immunotherapy - we are still learning though

Thank you everyone who took part in our discussion. Remember if you are a patient or caregiver you may continue this discussion on the Smart Patients Platform ( https://www.smartpatients.com/gyncsm ).

We hope you will join us for the next #gyncsm chat: Wednesday, September 12, 2018 where in addition to chatting about on We need support - Where do we find it?. We will also be celebrating the #gyncsm Community's 5th Anniversary.

See you in September.

Dee
#gyncsm co-founder

RESOURCES

Taking vitamins/supplements:

https://blog.dana-farber.org/insight/2014/02/should-i-take-vitamins-and-supplements-during-cancer-treatment/