A Functional Medicine Dietitian's Breast Cancer Diagnosis and Mastectomy (Part 1)
I am known in my circle of friends as wellness queen - I am a triple board certified functional medicine dietitian who eats well, loves to exercise and move my body and participates in all things health.
So upon receiving my breast cancer diagnosis at age 31 years old I was absolutely shocked.
At first I felt ashamed of my diagnosis. I blamed myself for getting cancer and thought I had done something wrong to bring this upon myself.
While I eventually uncovered the reason why I developed cancer (more below for curious minds), many cancer thrivers and survivors don’t share the same privilege. We don’t really need to know why, because the reality of dealing with cancer is hard enough.
Life is full of surprises and curveballs. While we can’t control what happens to us, we do choose how we care for ourselves through it. Every person’s cancer journey is so different, and it can feel confusing and isolating to navigate.
In this blog post I share about navigating my own cancer diagnosis, along with integrative modalities I used to support myself through the first year of treatment. Nearly five years later my health and my approach has evolved. Stay tuned for part two! ‘
Important to note - this post is for educational purposes only and is not intended to be used for medical advice. Any adjunct therapies should be reviewed and approved by your medical team.
How I Found My Breast Cancer
The Importance of Trusting Your Instincts & Advocating for Yourself
I was sitting on my couch on a Friday night in July (2019) when I felt a lump in my left breast. The sun was setting and my doctor’s office had already closed for the weekend.
My hands started shaking and I burst into tears. At 31 years old I knew my body well. I didn’t have a history of cysts or fibroids. Something was wrong.
I tried to distract myself over the following two days, but I anxiously awaited Monday morning when medical offices would re-open. My gynecologist was on vacation and I couldn’t wait for her to return, so I made an appointment with a different doctor in her practice.
After palpating the pea sized lump, the doctor told me that “It doesn’t feel like cancer”. This made me pause. It didn’t sound right - how can you be so sure what cancer feels like? I wondered. As far as I was aware, diagnosing cancer required extensive diagnostic tools.
“Can I still get a mammogram?” I asked timidly.
I detailed my family history as much as I could. Every single woman in my family had been diagnosed with cancer at some point - my mother had breast cancer twice, as did my aunt. My grandmother found a baseball sized tumor in her breast in her late 60s.
The doctor pushed back. He questioned the cancers, stages and age of onset of each family member There was so much cancer in my family, and I didn’t know all of the details, but I shared what I did know.
He explained the unlikelihood of my lump actually being cancerous - “You’re younger than all of your family members by at least 20 years”.
“I’d really like a mammogram” I repeated stronger this time, telling him rather than asking.
I also knew I had an increased risk for cancer because of environmental exposure from nearly two decades earlier. I grew up less than two miles from the twin towers - when the towers fell, they released over ten thousand tons of asbestos and other toxins like mercury and dioxins into the air. I understood this connection intimately, because my mom died of stage 4 lung cancer in 2013. Both lung cancer and breast cancer are well documented cancers in survivors of the Sept 11 terrorist attacks.
He could tell I wasn’t going to back down and reluctantly sent me for a mammogram.
Doctors can be hesitant to order mammograms for younger women because we have dense breast tissue, which can lead to confusing results and imaging. I also suspect bureaucratic issues around expensive imaging and stingy insurance companies.
After several mammograms, a triple biopsy, and MRI, I was diagnosed with Invasive Ductal Carcinoma - Breast Cancer.
I often think back to that day in my doctor's office. He was so quick to dismiss my concerns, but I’m so grateful I knew my patient rights and advocated for myself.
Following my instincts and pushing back on my doctor helped me catch my cancer early, and I believe it saved my life.
We are raised in a world where we’re taught that ‘doctor’s know best’ and that we shouldn’t question their expertise. But in reality, we know our body’s better than anyone.
I share this story to encourage you to get curious about what your body is communicating and begin to advocate for yourself.
You are the only person living in your body - no one will fight for you like you. If something doesn’t feel right, explore other options: get second opinions, talk to different professionals and know your rights as a patient.
Choose a Single vs. Double Mastectomy
Navigating Treatment Options and Decisions
It was clear that I needed a mastectomy.
Imaging revealed two malignant tumors in my left breast. My right breast was cancer free, and my doctor bestowed the excruciating choice whether or not to get a double mastectomy upon me.
I weighed the pros and cons of a single vs. double mastectomy.
I ran several genetic tests and tested negative for 79 cancer related genetic mutations (11 specific for breast cancer). But I wasn’t convinced this was a ‘get out of jail free card’. While science has traveled lightyears, there is still so much we don’t know. I probably carry a genetic mutation which hasn’t yet been discovered. In addition to my family history, I also had toxic exposure from living next to the twin towers. I considered these risk factors while making my decision.
I was still stuck on the choice. I wanted to start a family and felt tremendous grief when grappling with the understanding that I wouldn’t be able to breastfeed my future children. This would be the sole benefit of keeping my right breast.
But the decision seemed completely obvious after having a conversation with my oncologist. She explained that if I got a single mastectomy, I would need to get a mammogram every six months for the next 50 years. And I knew my chances of getting cancer again were high - both my mom and my aunt had recurrence a few years after their single mastectomies. I needed to learn from their mistakes. I couldn’t live with this level of anxiety, nor could I willingly put myself through this journey again.
I finally decided to undergo a double mastectomy.
Going into surgery I still didn’t understand the full scope of my cancer treatment. My oncologist couldn’t determine the stage of cancer based on my MRI.
While the goal of surgery was to remove the tumor and all other breast tissue, the surgery would also be partially diagnostic. It eventually revealed stage 1 breast cancer, and I luckily didn’t need radiation or chemotherapy.
But a mastectomy is technically considered an amputation and is an incredibly challenging surgery, even without other treatment. I knew I needed to prepare myself well by enlisting all the tools I could.
Although I didn’t need chemotherapy or radiation, my doctor prescribed Tamoxifen, a hormone blocker, to reduce my risk of recurrence. Tamoxifen blocks hormones and helps limit the growth of hormone-fueled tumors. However, it was also a very difficult medication and wreaked havoc on my body. I will share in the next post more about my journey with tamoxifen and the difficult choice I made to discontinue using it.
Building Your Holistic Cancer Care Team
Integrative Approaches to Support Healing and Wellness
Having a background in the medical world, I understood the importance of having a holistic medical care team.
Medical school teaches doctors how to save lives - this is life saving and essential in acute illness, like when someone has a heart attack or if they have already been diagnosed with cancer. But it doesn’t emphasize wellness and longevity.
My surgeon and oncologist’s jobs were to remove the tumor and ensure it wouldn’t come back. But it was up to me to seek out additional wellness modalities in order to support my quality of life and optimize my healing.
I built out my integrative care team. I didn’t do this all at once, but over time different needs popped up. Here’s who was on my team within the first year following my treatment.
Acupuncturist - before surgery my acupuncturist helped prepare my body for the anesthesia. Immediately following my mastectomy she made home visits and supported me with cupping which eased back tension from my lack of mobility. After surgery she helped manage my pain and ultimately side effects from hormone treatments. Acupuncture can also break up scar tissue once the wounds have healed.
Therapist - going through a cancer diagnosis is a hard thing to accept and navigate! While I have been in and out of therapy for years, I knew I needed mental health support during this period. A lot of people also don’t discuss the challenges of post-cancer life, which is when I needed the deepest support from my therapist.
Naturopath oncologist - I recruited the support of a naturopath oncologist in order to support me through my cancer journey and use complementary modalities. She worked with my oncologist to integrate my care. Before my surgery she created a supplement protocol including homeopathics designed to support healing after ( I have included my surgery supplement plan below). I also planned to keep her on my team had I needed chemo or radiation, as the landscape of health changes during different stages of treatment.
Lymphatic drainage specialist - I hired a manual lymphatic drainage specialist who came to my home for lymphatic massages which greatly reduced my pain and swelling. If you are interested in this, be sure to find a certified MLD therapist.
Physical therapist - After my surgery I could barely lift my arms and I had more pain than I had ever experienced. Like I mentioned above, a mastectomy is an amputation and requires proper rehabilitation. Physical therapy helped me rehabilitate my body and build my strength back. The combination of a home exercise program and body work has been critical for my recovery. This is not something that was recommended by my surgeon, which still shocks me. Every patient going through a major surgery needs physical therapy support!
Before surgery I had a lot of body work and energy clearing to help prep my body and mind for surgery. I did a lot of yoga (especially yin yoga which is deep nervous system relaxation) and meditation before surgery. I avoided high intensity workouts which can be particularly stressful on the body
Float tank
Reiki and hypnosis
Yin yoga
Acupuncture
Massage
Meal Prepping for Surgery
Stocking Your Freezer with Nourishing Options
In the weeks before surgery I prepped meals like a mad woman. Eating my own food is so comforting, and I knew it would be a long time before I could cook again.
In order to create a few weeks worth of meals I used my freezer to make meals, burgers, and snacks like bliss balls and healthy muffins.
I used jumbo silicone ice cube trays to freeze soups, stews and sauces. Once they were frozen I put them into a gallon sized zip lock bag and stacked these in my fridge. I like storing them in soup cubes because I could defrost one meal at a time rather than the full recipe. Here’s a video where I explain how to use soup cubes to store leftovers!
This is a list of a few of the items I made.
Mushroom and tempeh bolognese (easy to pair with rice, zucchini noodles or chickpea pasta, etc).
Beef bolognese - same re: above but with grass fed beef
Bone broth - warm and nourishing snack to sip
Lamb burgers
Carrot-ginger and coconut soup
Tomato basil soup
Chicken veggie soup
Date and collagen energy balls
Paleo blueberry muffins
Pumpkin spice muffins
My freezer was packed to the brim, but it felt so deeply supportive to have healthy tools available. It made meals super easy to assemble (some we would pair with greens, other times rice and sometimes pasta).
Community Support for Recovery
Organize a Meal Train for Surgery
People often want to provide support but don’t know how to help. A meal train is a really great way that people can provide support, especially if you don’t know what to ask for.
You can be as specific as you’d like (you can probably already tell that I was very specific!).
My friend set up a meal train for the 6 weeks following surgery.
I asked for meals 3 days a week which I could layer with all of my delicious meal prep.
I asked her to share my dietary restrictions and preferences, and gave a list with examples.
I also provided a list of local restaurants that I liked in case select people wanted to bring food but didn’t want to cook.
Not having to think about what we were having for dinner for a few weeks after my surgery helped me be well nourished while focusing on my own healing.
Essential Tools and Items for Mastectomy Recovery and Hospital Stay
Here are essential tools I purchased that helped me rest properly after surgery as well as improve my comfort at home.
Pillows
I’m a side sleeper so sleeping on my back was a big transition. I bought a bunch of pillows that made this way easier and created a nest so I could sleep through the night with minimal shifting / repositioning. We used these pillows and about 10 more to position me perfectly.
Foam wedge pillow- helps elevate your back, like a hospital bed, so you don’t need to lay flat which can be painful after surgery.
Pregnancy pillow - wrapped around both sides of me to create a nest. This was helpful and really supportive as I’m not used to sleeping on my back. Also helped keep my arms supported and in place through the night.
Mastectomy Pillow - this is the one I had that I used for everything - being on the couch, sleeping at night and even traveling in the car. It was a really helpful tool for me and I have been able to use it in subsequent surgeries.
Seatbelt Pillow - I use this in addition to the mastectomy pillow for traveling in the car. My chest sensitivity was amplified after surgery, so having a barrier between my body and the seatbelt made it much easier to drive.
Side arm pillow - I was gifted an arm pillow that I could wedge under my elbow while resting on the couch. This was really helpful because it helped me relax my arms without pain.
Clothing
Lots of button up shirts - I couldn’t elevate my arms after surgery so shirts to pull overhead can feel challenging. Soft button up shirts were key!
Robe with drain belts - this robe is so soft and actually comes with a belt where you can stick your drains post surgery. It’s so amazing that I still wear it even after my drains have come out!
Misc tools
Drain belt - helpful for the first 1-2 weeks following surgery. The one linked here came with a shower add-on that was helpful when I still had my drains in but wanted to shower. The belt was helpful if I wasn’t (or couldn’t) wear my robe with drain belts attached.
Grabber tool - because reaching is hard!
Eye mask - helpful for sleep, at the hospital and for naps! I have a few of these - stored them near my couch for day naps and by my bed stand for nighttime.
Alcohol-free baby wipes are helpful for giving yourself a ‘sponge bath’ in case you can’t shower immediately after surgery.
Spray deodorant - can be hard to lift your arms after surgery! Rolling on deodorant was uncomfortable for me because of the lymph node dissection and nerve pain.
Non-slip socks or supportive slippers - the hospital gave us a ton of socks upon our departure. These were helpful at home because we have hard wood and prevented slipping that the normal socks usually have. My worst nightmare was falling so a little grip was a nice form of insurance.
Silicon gel - applied to my scars daily to help with healing and minimize scarring.
Move all plates and cups to counter height. Think of your arms being T-Rex arms so you will not be able to reach far.
What to bring to the hospital
Cough drops - my throat was really dry post-anaesthesia and cough drops were so helpful.
Button up shirt - loose and soft for going home. Consider that you will have extra binding and will need something loose to travel home in.
Bluetooth headphones - helpful in the hospital and even at home to avoid wires getting tangled. I also really like listening to meditations before I fall asleep, or binaural beats when sleep felt challenging.
Eye mask and ear plugs because hospitals can be loud and bright.
Car / seat belt pillows for going home (re; above)
Nourishing meals while you are in the hospital. The quality of hospital food is sad and for me food is such an integral part of the healing process. I made myself veggie chicken soup with bone broth that my ex husband warmed up and brought with me.
Supplements for Surgery Recovery
One of my friends had undergone a mastectomy a few years before me. “You’re going to look like you were hit by a truck” she warned.
About a week after my surgery I visited my doctor to remove my bandaging. The nurse looked confused as she unraveled the gauze stuck to my chest, and I nervously glanced down expecting the worst. It turns out that she had never seen a mastectomy patient this far out from surgery with so little bruising. I felt as though I had gotten an A++. I attribute this piece to my pre-surgery supplement protocol.
I will share my supplement protocol below, but if you have an upcoming surgery I urge you to work with a medical professional who can help you navigate what supplements are right for you.
Some supplements support healing and others can increase the risk of bleeding, which is why you need to be extremely careful with what you take, and when you take it. Furthermore if you are being treated for active cancer, the type of supplements that you are allowed to take will be much different than when your chemo and radiation has been completed. For example, what I would take to prevent cancer recurrence would be really different than if I was actively fighting the disease.
Before surgery discontinue any supplements that increase the risk of bleeding. These include:
Fish Oil (1200 mg/day is OK)
Garlic pills (300mg/day is OK)
Vitamin E (400 IU is OK)
Ginger
Ginkgo (Ginkgo biloba) Ginseng
Kava-Kava
Licorice
Hypericum (St. John’s wort) Valerian
Ephedra (Ma-huang)
Feverfew
This was my personal surgery supplement protocol. It is extremely comprehensive.
Please note that each person is so different. If you or someone you love has been diagnosed with breast cancer and undergoing a mastectomy, it is essential to work with your provider to ensure safety of this program. Each person’s cancer journey is so unique. This is for educational purposes. This program was created by my naturopath oncologist, customized for me. Always work with a provider to ensure efficacy and safety of your medical care.
I have compiled all the below supplements into an easy to access protocol via Fullscript. Click here to access my mastectomy supplement protocol.
One week before surgery:
START: Fractionated Pectin powder or Modified Citrus Pectin powder - mix 1 scoop/1 teaspoon/5,000 mg into water or juice and drink 3 times per day for one week prior to surgery. This helps to prevent the spread of microscopic cancer cells during surgery or biopsy. Resume this after surgery.
START: Beta Carotene 25,000 IU- 1 per day with food for 7 days (best if the meal contains some fat). This provides nutritional support for wound healing and tissue repair.
START: Ascorbic Acid (Vitamin C) 1,000 mg- 1 per day with food for 7 days. This provides nutritional support for wound healing and tissue repair.
START: start the herbal immune support formula “Phytobiotic” by Wise Woman Herbals. Take 2 capsules 2 times per day with food. This is to help prevent infection from surgery.
***Stop these formulas the evening before surgery and resume them again as soon as possible after surgery (once you resume eating solid food) ***
Bowel Cleansing:
General anesthesia and pain relievers with opiates will dramatically decrease your gut transit time and bind up your stools. If you have not received specific instructions about bowel cleansing from your surgeon, you should use something like "Laxablend" by Vitanica or a similar Senna product, the night before surgery, to avoid a painful impacted colon after surgery.
You may need continued support for 1-2 weeks afterwards.
The Day before surgery:
Homeopathic Phosphorous 30C/30CH/30K 3 pellets under your tongue three times today, to help prevent bruising and hemorrhage
Take homeopathic Arnica 200C/CK 5 pellets under your tongue, twice today to address trauma and improve wound healing
The Day of surgery:
Take homeopathic Phosphorus 30C/30CH/30K 3 pellets under your tongue ONCE, the morning of surgery
Take homeopathic Arnica 200C/CK 3 pellets under your tongue ONCE, the morning of surgery
Post Surgery Protocol
As soon as possible after waking from anesthesia start taking Arnica 200C/CK 5 pellets under your tongue 3 times per day, for the first 3-5 days. This is to hasten wound healing, reduce pain, reduce swelling, and to reduce bruising.
START: Phytoprofen (Thorne Research) 2 capsules 3 times per day with food to help reduce swelling, reduce inflammation, and improve wound healing. Take for 10 days (60 capsules).
RESUME: Fractionated Pectin powder or Modified Citrus Pectin powder - continue taking 1 scoop/1teaspoon/5 grams mixed into water or juice 3 times per day for at least one week after surgery or until the jar is gone (more than 7 days is best). This helps to prevent the spread of microscopic cancer cells from surgery or biopsy.
RESUME: "Phytobiotic" as instructed to help prevent infection. Take it for 7-10 days.
RESUME: Basic Nutrients V 2 capsules 3 times per day with food for 30 days.
RESUME: Vitamin C (Ascorbic Acid) 1,000mg twice per day with food, to help re-build healthy connective tissue
START: Omega-3 fatty acids (EPA/DHA from fish oils such as Pro Omega 2000/Ultimate Omega 2X from Nordic Naturals). Take 1-2 soft gels per day with food. Omega -3 fatty acids are to improve nerve conduction,reduce inflammation, and speed healing.
START: Zinc Picolinate 15mg 1 per day with food for 30 days.
Other holistic surgery support strategies:
If you are inactive or confined to bed massage (or have someone massage) your calves every two hours while awake, using movements directed towards your heart. This is to improve circulation from the lower extremities (to help prevent blood clots).
Be careful making postural changes after surgery as anesthesia and surgery can cause light-headedness. Take a deep breath when moving from sitting, lying down (or when getting up from using the toilet) to a standing position, for several days after surgery.
For minor surgeries or cosmetic procedures, try to walk around for 2-3 minutes every 2-3 hours to increase circulation and prevent blood clots in the lower extremities.
Drink lots of water and maintain a liquid diet, if necessary, for at least 24 hours (or until all nausea has passed and your hunger returns).
Transition slowly into eating solid foods during the first few days. Eat simple, easy to digest foods such as soups,broths, diluted juices, cooked vegetables, or cooked fruits (avoid raw foods at first since your digestion is likely compromised). When these foods are tolerated well, re-introduce protein into your diet twice per day, as it is needed for wound healing.