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Healing Physically After Breast Cancer
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COPING’S 2006 FOCUS ON BREAST CANCER
by Julie Silver, MD
he great irony with breast cancer is that women usually feel much better before treatment begins than when it is over. Oncologists have to contend with the dual and opposing mandates to save lives and adhere to the Hippocratic Oath, “first, do no harm.” If I had gotten pneumonia instead of cancer, I would have gone to the doctor with a raging fever, difficulty breathing and profound fatigue. My physician would have prescribed antibiotics that would have improved my general state of health. While I am truly grateful that there are treatments available for breast cancer, there is no doubt that when I finished my last chemotherapy session, I was in a much frailer state than I had been a few months earlier. Since I spend my working hours helping people heal from all types of serious injuries and illnesses, I knew what I had to do to facilitate my physical recovery. First, I formulated a plan. I was pretty sick, and I needed to focus on those things that are most important in physical healing – beginning with small goals that I could
to help themselves physically heal. While physical recovery is a very important topic by itself, in women with breast cancer it is particularly critical because early research has shown that
Focus on those things that are most important in physical healing. achieve and build upon. What kept running through my head was the mantra, “I want to heal faster, better, and stronger.” It took me many months to heal myself, and after I did, I started a program called RESTORE (Recovering Energy and Strength Through Oncology Rehabilitation Excellence) at my hospital that focuses on physical recovery in cancer survivors. RESTORE is now a model for other hospitals across the country. Though there are many facets to healing that we focus on with RESTORE, the following are three key things that survivors can do
40 COPING ❑ September/October 2006
exercise (an important component of physical healing) may help prevent cancer recurrence. Buy a pedometer and record how many steps you take each day. This is an inexpensive and easy to use device. You can purchase one online or in most sporting goods stores. Gradually increase the number of steps you take until you reach 5,000 steps daily. Most people can accomplish this goal within the first four weeks. Over the next three months, increase your steps until you reach 10,000. It’s a good idea to check with your doctor about exercise (and I recommend that you do this), but most women can safely
increase their steps unless they have a serious heart or lung problem or low blood counts. Eat three medium sized meals and two nutritious snacks every day. Good food helps to repair injured tissues and organs. Moreover, fatigue is one of the most disabling problems in breast cancer survivors. While diet isn’t the solution to all fatigue problems, going too long without food or skipping meals altogether contributes to a low blood sugar level, which worsens fatigue. Also, since many women gain weight during treatment, this meal-snack schedule can be a good way to shed unwanted pounds. Sticking to a healthy and regular schedule means that you are less likely to feel ravenous at mealtime and overindulge. Give up taking naps and sleep well at night. Poor sleep, no matter what causes it, is detrimental to physical healing. Naps tend to interfere with good sleep at night and are usually better to skip once you are finished with chemotherapy and radiation. At night, it may be hard to fall asleep or stay asleep due to worry, hot flashes, or pain. If you are not getting at least seven to eight hours of quality sleep most nights, talk to your doctor about how you can improve your rest. Optimizing your physical health after breast cancer treatment is a process that takes Dr. Julie Silver most women many months. However, there are things that you can do to facilitate healing and recover more fully. As Confucius stated, “A journey of a thousand leagues begins with a single step.” Taking the three “steps” that I outlined above will get you started on the right path in your healing journey. Editor’s Note: Dr. Julie Silver is an assistant professor at Harvard Medical School in the Department of Physical Medicine and Rehabilitation. She is a 2006 recipient of the prestigious Lane Adams Quality of Life Award from the American Cancer Society and is the author of the book, After Cancer Treatment: Heal Faster, Better, Stronger (Johns Hopkins Press). ■
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