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Your Questions, Our Answers

I’ve gained weight since starting treatment. I’m worried about the effects on my health. How can I prevent further weight gain?

STACY KENNEDY: Many people who are diagnosed with cancer expect to lose weight with treatment, but weight gain is a common side effect of some cancer treatments. Unwanted weight gain may be related to the cancer or cancer treatment or to lifestyle changes during treatment. Sleep disturbances, reduced activity levels and taste and appetite changes can all contribute to weight gain.


Stacy Kennedy
Senior Nutritionist and Registered Dietitian at Dana-Farber Cancer Institute in Boston | Photo courtesy of Stacy Kennedy
 
During treatment, it’s important to follow a healthy diet and incorporate physical activity into your day to support a healthy weight and a healthy immune system. Ask your doctor, nurse or dietitian to help you identify an appropriate weight loss strategy. Don’t be tempted by the latest fad diets or dietary supplements, which could interfere with your treatment.

Some general tips include eating smaller, more frequent meals that contain plenty of fruits and vegetables. When snacking, pair healthy protein with a healthy carbohydrate. For example, add chopped almonds to oatmeal or spread peanut butter on apple slices. Incorporate lean proteins, such as fish, eggs, nuts, seeds or protein-rich whole grains such as quinoa, into your meals. It’s also important to drink plenty of water.

Physical activity not only helps in maintaining a healthy weight, but is also effective in combating side effects of treatment, including fatigue, nausea and constipation. Start slowly. If you normally run for exercise, try slower jogs or walks.

Ask friends or co-workers to help by replacing those break-room doughnuts with a fruit bowl or by taking a walk with you at lunch. If you are eating healthfully, drinking water and exercising, but the weight still isn’t budging, look at other areas of your life. Perhaps you aren’t getting enough good rest or are under stress.

More than likely, the weight won’t come off by itself once treatment has ended. But studies have shown that people with cancer who ate five or more servings of fruits and vegetables a day and walked for 30 minutes, six times a week began to feel better even before they lost weight. These healthy habits have also been linked to improved survival in women with breast cancer. Stay the course and remember: Weight management is a marathon, not a sprint.

EATING WELL DURING CANCER // The Dana-Farber Cancer Institute provides a video series exploring how diet can help support your health and well-being during and after cancer treatment. // The American Cancer Society shares tips and recipes for healthy food choices. // The National Cancer Institute offers a booklet on eating before, during and after cancer treatment.


Now that I’ve finished treatment, my loved ones expect me to be happy, but I’m struggling with side effects and readjusting to life after cancer. How can I explain this to my family and friends?


JENNIFER FORD: It’s not uncommon when treatment has ended for cancer survivors to continue experiencing side effects along with feelings of anxiety or worry. Survivors might worry about cancer coming back or about other aspects of their health.

Jennifer Ford
Assistant Attending Psychologist at Memorial Sloan Kettering Cancer Center in New York City | Photo courtesy of Memorial Sloan Kettering Cancer Center
 
It can be challenging to go from an environment during treatment, in which there is a lot of support from doctors, nurses, family and friends, to find at the end of treatment that you are “done.” It can be a lonely and uncertain time. You may find yourself re-evaluating your goals when it comes to work, family responsibilities or other aspects of your life.

Of course, reaching the end of treatment is a positive step. It may be difficult for loved ones to appreciate the many challenges that come with transitioning back to normal life. And that may leave you feeling misunderstood.

You may feel reluctant to burden family members, but open communication is key to helping them understand how you feel. The level of detail you wish to share with your friends and family will likely vary depending on the relationship.

If there is a person in your life who is more difficult to talk to face-to-face, consider using an intermediary, such as a family member or counselor. Different modes of communication may also be helpful. Write a letter or direct the people in your life to websites or other written materials. You might also consider bringing a close family member or loved one along with you to a follow-up appointment with your doctor to help the person understand the issues you continue to face.

FACING THE FUTURE // The National Cancer Institute provides a booklet on life after cancer. // The National Coalition for Cancer Survivorship’s Cancer Survival Toolbox introduces skills to patients who’ve finished treatment. // The Livestrong Foundation discusses the common emotions many patients experience after treatment.


My mother, who is usually very self-sufficient, was recently diagnosed with cancer. How can I help her without being overbearing?



MARTHA ASCHENBRENNER: It’s common for adult children and even teenage children of a parent diagnosed with cancer to wonder how they can help without nagging or impinging on a parent’s privacy or independence.

​Martha Aschenbrenner
Licensed Professional Counselor at the University of Texas | Photo courtesy of Martha Aschenbrenner
 
Often I see patients who were initially able to care for themselves and make it to appointments on their own after a cancer diagnosis. Their condition might start to worsen, and they don’t tell anybody about it. The family may not know until there is a real problem.

A good way to get started is to consider others who may wish to be involved in your mother’s care—especially siblings if you have them. Talk as a group about how you would like to approach this new challenge together. That way, you won’t each take an independent path and risk overwhelming your mom with questions or offers to help.

It’s always a good idea to have another set of eyes and ears at doctors’ appointments whenever possible, particularly with a new diagnosis. If your mother is reluctant, you might say: “Mom, I’ve read that it’s recommended to have somebody there with you at the doctor’s office to hear about treatments and likely side effects. I would like to be there so you don’t have to take this all on yourself.”

You don’t have to call your mother every day, but consider incrementally increasing the number of calls you make. Simple questions such as “What did you have for dinner last night?” can help you assess her condition. Perhaps your mom can manage most meals on her own, but you might consider taking her out to dinner now and then. Offer to cut the lawn or help with groceries. Get names and numbers for her close friends and neighbors and consider reaching out to them for insight.

To encourage deeper, more emotional conversations, try saying something like, “You know, Mom, I was thinking if I were diagnosed with cancer, I would sometimes feel scared. I wonder if you get scared.”

It’s a very delicate dance when a loved one is diagnosed with an illness, and sometimes the cues are subtle or unspoken. The best thing you can do is put yourself out there and let your mom know you are there for her. Remember also that caregivers don’t always have to be cheerleaders. When you or your loved one is having a down day, it’s OK just to find a good movie and lie low.

CANCER TALK // The American Cancer Society provides tips on what to say to someone who has cancer. // The National Cancer Institute shares a guide for teens whose parents have cancer. // Cancer Care offers online support groups for cancer patients and their loved ones. ​

10/01/2015
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