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I will be reviewing the book Life Over Cancer coming up here soon and I thought I would share an excerpt from the book. Cancer touches so many of our lives, whether it be ourselves, our loved ones, our friends, we all have known someone who has been affected by it. For myself, my grandma had kidney cancer that then proceeded to take over every part of her body, imbedding itself into her bones, she lost her battle to it when I was 14, but it still hurts to think about it. Before I give you the exercpt from the book, let me give you some information, should you be interested in it before I review it. You can visit www.lifeovercancer.com, www.blockmd.com, Facebook: Life Over Cancer and Block Center for Integrative Cancer Treatment. I wanted to get this out there now because you might need it now vs when I get done reading the book. If I am sent any more articles from Keith I. Block, M.D. I will make sure to post them for you!
Symptom Management Tips
By Keith I. Block, M.D.,
Author of Life Over Cancer: The Block Center Program for Integrative Cancer Treatment
Undergoing treatment for cancer, not to mention having the disease itself, can cause a number of side effects ranging from unpleasant to debilitating to dangerous. Below are listed some common side effects and advice on how to combat them.
Loss of Appetite
Chemo can kill not only your cancer cells but also your appetite. First, be sure that nausea and vomiting are not the underlying problem; if so, they must be addressed first (see below). Otherwise, consider when your appetite is at its best. For many patients, it is at breakfast time. If so, try to get most of your nutrients and calories for the day then. Just be sure to follow the meal with mild exercise for proper digestion and metabolism.
I also recommend healthful sources of carbohydrates to raise energy levels between meals. Dried fruits are great for this; even people who are not hungry can usually manage to chew and swallow some raisins, prunes, or dried apricots. To avoid the glucose spike (hyperglycemia) that can feed cancer cells, combine the dried fruits with a protein such as some roasted seeds or nuts, a nut butter or soy product, or small amounts of fish or whey protein.
Exercise can also stimulate appetite. Try it. If it does, exercise shortly before mealtime. If it has the opposite effect, wait an hour or more after exercising before you try to eat.
I urge all our patients and their loved ones to attend cooking classes to make food more appealing. They learn to make meals more appetizing and more inviting to the eye, nose, and mouth by using garnishes and plenty of color. If you learn to think creatively about cooking and food selections — adorning boring-looking rice or cauliflower with red and green peppers, chives, and the like — you may find you have more desire to eat.
Pain and pain medications can interfere with appetite. Get treatment for pain, and if you’re taking pain meds, schedule your meal or snack at least thirty minutes after you take the medicine. In intractable cases of appetite loss, you may need pharmacological appetite stimulants such as Megace, Oxandrin, or Marinol. But you can accomplish a lot on your own.
Tips for Low Appetite
- Eat small amounts frequently throughout the day. Rather than regular-size meals, have a snack every two to four hours, even if you don’t feel hungry. Snack before bed unless this disrupts your sleep.
- Keep ready-to-eat snacks such as nuts, dried or fresh fruit, crackers with nondairy cheese or nut butters, pretzels, vegetable juice, and appropriate nutritional supplement drinks handy. Carry snacks when you go out, and keep easy-to-prepare foods available so you are not deterred by the idea of food prep and cooking. Consider preparing food in quantity and refrigerating or freezing it for later. If family members or friends offer to help, take them up on it. Nothing increases appetite like someone else doing the cooking!
- Try to make every bite or sip count by choosing foods that are rich in calories, protein, and other nutrients and limiting low-calorie foods that fill you up (such as broth or lettuce). Eat more fruit, fat, and sweeteners, but in the healthier forms (for example, olive oil, nuts, and avocados as fats; agave, rice syrup, and barley malt as sweeteners).
- Make eating more enjoyable by creating a pleasant, relaxed mealtime atmosphere. Try setting the table with pretty dishes and flowers, or playing music. Experiment with eating in different surroundings. Eat with others, or while watching a good television program.
- During meals, limit the amount of liquid you drink, since drinking may make you feel full.
- Try softer, cool, or frozen foods such as a shake, a frozen juice bar, or pureed frozen fruit.
- If you don’t feel like eating solid foods, try juice, soup, and shakes.
- Herbal teas such as fennel or anise, mixed with verbena or mint, may stimulate appetite.
- Since stressors can interfere with normal appetite, seek assistance for relaxation strategies that can help relieve tension.
Nausea and Vomiting
Nausea and vomiting are all too familiar to many chemotherapy and radiation patients. Cisplatin, cyclophosphamide, doxorubicin, and dacarbazine are particularly notorious for causing nausea and vomiting, although these can also be symptoms of tumors themselves. Merely thinking about chemo can make you nauseated, an effect called "anticipatory nausea." Whatever the causes, nausea and vomiting can now be tamed by antiemetic drugs such as Aloxi (palonosetron) and Emend (aprepitant). Your doctor may, however, start you out on an older antiemetic, such as Reglan (metoclopramide) or Zofran (ondansetron), which may be effective for you.
Complementary therapies can also combat nausea. In one study, ginger was about as effective as the antiemetic drug metoclopramide but not as effective as ondansetron. Many of my patients have used ginger, as a tea or supplement (500 mg every four hours), successfully.21 Ginger should not be taken when your platelet count is low due to chemotherapy, since it may have anticoagulant effects. Aromatherapy with peppermint oil may also tame nausea; you can carry a small bottle of peppermint oil with you throughout the day and sniff it occasionally, something some of our patients find helpful.22 Mild exercise such as walking or using an exercise bike for ten to thirty minutes can also help.23
Acupuncture, acupressure, and acupuncture point electrical stimulation can also relieve nausea.24 Stimulating a point on the underside of the wrist called the P6 point, even by drumming it with the fingers of the other hand, seems to be quite effective. Ask someone experienced in acupressure how to do this, or go to our website, www.lifeovercancer.com, for instructions. You can also buy a wristband with a small button that presses on P6; often used for seasickness, it is sold under the name SeaBand.
These remedies for nausea should control vomiting, too, but because vomiting can lead to electrolyte imbalances and land you in the hospital with dehydration, you need to do all you can to stay hydrated. Try sucking on ice chips, sprinkled with a little salt and fruit juice or rice syrup, to keep your electrolytes balanced. Try to drink 8 cups of water a day. You can also try electrolyte-restoring drinks based on fruit juices and natural products, such as those at www.knudsenjuices.com or www.ceralyte.com. Once the vomiting is controlled, go back to normal foods slowly, starting out with 1 tablespoon of clear liquids at a time, then ¼ cup, moving on to plain, easily digested starchy foods.
Tips for Nausea and Vomiting
- Eat small amounts of food frequently throughout the day; feelings of nausea may be intensified if you get very hungry.
- Choose foods that appeal to you and that you feel you can tolerate. Your tastes may change from day to day and hour to hour.
- Try dry toast or cereal, plain crackers, pretzels, rice cakes, pita bread, plain rice, cold pasta salad, potatoes, hot cereal, applesauce, canned fruit, fruit-juice-sweetened sorbets or ices, tofu, egg whites or omega-3 whole eggs, and cooked vegetables.
- Foods that are served cold or at room temperature may be easier for you. Avoid foods with strong odors as well as smelly cooking areas, smoke, perfume, and warm stuffy rooms.
- Avoid fatty, fried, spicy, and overly sweet foods.
- If there is a bad taste in your mouth, rinse your mouth before or after meals, or suck on a hard candy made with two-star or three-star sweeteners (such as Sweet Rice Candy made by Mitoku).
- Don’t go overboard with your favorite foods, or you may begin to associate them with feeling queasy.
- Try eating a small amount of grated or finely chopped fresh ginger (if your blood platelets are less than 60,000 cells per microliter, check with a medical professional first), or a teaspoon of gomasio (a seasoning made from crushed sesame seeds and salt), or try sucking on the pit of a umeboshi plum. Gomasio and umeboshi plums are available in the macrobiotic section of health food stores. Herbal teas (such as ginger, alfalfa, chamomile, fennel, and slippery elm), oranges, or tangerines may also help.
- Eat slowly and try to relax. Distractions may help keep your mind off nausea while you are eating. Try listening to music, books on tape, the radio, or looking out a window.
- Avoid stress, noisy environments, and commotion, and limit conversation if the effort of talking worsens the nausea. Stress reduction strategies may be useful if stress worsens or triggers your nausea.
A NOTE ON REFERENCES AND RESOURCES
Complete reference notes for each chapter, keyed to the superscript numbers in the text, are posted at www.lifeovercancer.com, together with a description of how to use the PubMed online database to retrieve articles and abstracts. Please be aware that most of the reference numbers in the book chapters are supported by two or more articles, books, or websites.
The website also includes continuously updated resources to support the Life Over Cancer program.
The above is an excerpt from the book Life Over Cancer: The Block Center Program for Integrative Cancer Treatment by Keith I. Block, M.D. The above excerpt is a digitally scanned reproduction of text from print. Although this excerpt has been proofread, occasional errors may appear due to the scanning process. Please refer to the finished book for accuracy.
Copyright © 2009 Keith I. Block, M.D., author of Life Over Cancer: The Block Center Program for Integrative Cancer Treatment
Keith I. Block, M.D. is Director of Integrative Medical Education at the University of Illinois College of Medicine; Medical Director of the Block Center for Integrative Cancer Treatment in Evanston, Illinois; and founder and Scientific Director of the nonprofit Institute for Integrative Cancer Research and Education. He is also editor in chief of the peer-reviewed professional journal Integrative Cancer Therapies and a member of the National Cancer Institute’s Physician Data Query Complementary and Alternative Medicine (CAM) Editorial Board.
For more information, please visit www.lifeovercancer.com and www.blockmd.com. Become a fan of Life Over Cancer and the Block Center for Integrative Cancer Treatment on Facebook.