Cancer is life-altering, that’s no secret. But how it changes things will be different for each person. It’s something I’ve been thinking about a lot lately—did cancer change me, and if so, in what ways? Here’s what I’ve noticed so far.

1. The hair on my legs grew back finer, and in some places, not at all. Same goes for under my arms. Because I have no feeling under my right arm after lymph node removal, shaving there feels strange. So I’ve embraced the French way and keep it natural.

2. I’m able to be in the present moment more. “Life is short” is no longer just another platitude when you’ve looked death square in the face.

3. I think about protein, and if I’m getting enough, way more than I used to.

4. Cancer crystallized my priorities. I don’t know how long I have here (no one does, but after cancer I can no longer ignore this reality). I’m not going to spend these precious days on things that don’t align with my values.

5. My libido is near zero. My cancer’s favorite food is estrogen, so I’ve had to cut off its supply. That’s good for prevention, and not great for sexual desire. There are no clear answers on how to manage it, so I’ve been left figuring it out on my own. Turns out there’s not much research on it. Women’s health and all that.

6. Bending down is no longer easy. I feel 100 years old when I try to stand back up, and my knees and hips creak and ache.

7. I’m less precious about taking medicine. I used to have this skewed idea that I needed to keep my body as “pure” as possible—I would balk at popping an ibuprofen for a headache. But during treatment, I pumped my body full of chemotherapy drugs, and here I am, standing strong and healthy. Sometimes medicine is necessary.

8. I’m more confident. If I find myself spinning out about something, the thought pops into my head: “You beat cancer.” Everything pales in comparison.

9. I lift heavy weights at least three times a week, and I love it. It helps me feel strong in a body that didn’t always feel that way. It also helps maintain muscle, protect against osteoporosis, and support the hormonal shifts that come with menopause.

10. I’m more aware of the seasons changing and the passing of time. Because I’m still afraid that my cancer will come back, I find myself noticing the changes around me, and wondering how many more summers I’ll get, or birthdays, or Christmases. On one hand it’s a blessing (I stop and savor the small joys) but it also comes with sadness. Even if I live to 80, I’m acutely aware that we only get a finite number days.

11. Rest is non-negotiable. Before cancer, I rarely rested, choosing instead to push through tiredness. Now, I incorporate it into my day the way I would a workout.

12. I value my relationship with my husband in a new way. “In sickness and in health” takes on new meaning when cancer knocks on the door. Seeing how he showed up for me during treatment—his deep care and love and selflessness— made something very clear: Marrying him was the best decision I ever made.

13. What’s good for others isn’t necessarily good for me. I used to be susceptible to all the latest health fads. If an influencer I admired cut out dairy, I’d do the same. If someone said Pilates was the reason for their washboard abs, you bet I’d start researching local studios. I know now that each body is different, and what’s right for one person might not be right for another. I have specific needs after cancer, so I can’t compare what someone my age is doing who hasn’t been through what I have.

14. I feel more connected to my parents. I lost both my mom and dad to cancer, and now I have a deeper understanding of what they went through that can only come from lived experience.

15. It showed me I can pull off short hair. I would never have cut my hair before cancer—my long hair was a core part of my identity. So shaving my head during treatment was a little scary, but I was surprisingly okay with the results. And more than that, I loved the feeling of freedom it brought me. No more hair dryers, expensive products, and angst over frizz. Honestly, I might just do it again one day, but next time it will be on my own terms.

16. I stopped drinking alcohol. Completely. At first, I wanted to lessen the load on my liver during treatment, and now it’s about preventing recurrence and easing my menopause symptoms. Research shows that alcohol increases breast cancer risk, so I’m not taking any chances. Cutting it out has been easier than expected, and I really like not waking up with a parched mouth and sore head.

17. I meditate most days. Chronic stress has been linked to an increased risk of cancer, so I’m doing what I can to keep it in check.

18. I’m less hung up about my appearance. I look in the mirror and I see all my scars, a reminder that I’m still here. I view my body now as more of a vessel that keeps me here, rather than the defining aspect of me. Who cares what it looks like? As long as my heart is still beating, I’m good.

19. But… I also miss the mental freedom that comes from taking my body for granted. Now I’m aware of how vulnerable and soft it is. It motivates me to treat it with even more care and respect.

20. I’m less afraid to communicate my needs. If I’m really tired, I tell my husband I need to rest. If I’m asked to handle something at work after hours, I firmly say I’ll get to it tomorrow.

21. I no longer get my period, and I miss it sometimes. Not the cramps, but what it represents.

22. I know myself better. Cancer showed me that I’m generally a positive person. I’m not talking about toxic positivity, but rather looking at things from a glass half full perspective. Eight out of ten lymph nodes were cancerous? Well, at least two weren’t. White blood count too low for chemo this week? Great, no nausea tomorrow.

23. I don’t care as much what people think of me. It was cancer that finally pushed me to start this Substack and put my personal writing out there.

24. I put less pressure on myself. I was diagnosed one month after turning 40. I remember feeling anxious about the birthday, worried that I hadn’t achieved enough—I hadn’t yet written that novel, or earned more money. Now I’m just grateful each day that I’m still here. That other stuff is nice, of course, but getting to hug my kids and see another sunset is what matters. I feel this deep in my bones.

25. I only wear soft, mostly non-synthetic fabrics. When I found out I would need surgery and chemotherapy, I stocked up on comfortable loungewear. I realized how good it feels to treat my skin gently, as I would a baby’s.

26. I listen to my body and honor what it’s telling me. Hungry? Eat. Tired? Lie down. Anxious? Slow down.

27. I realized that I’m not special. When I was diagnosed, I briefly fell into the “Why me?” line of thinking. Believing you’re special is protective, but illusory—if you’re special, it means you’re exempt from the pain and hardship that others endure. Cancer doesn’t make exceptions.

Thank you, as always, for reading. I’m curious—what has cancer changed for you? Do any of the above resonate? If you’re up for sharing, I’d love to know. xo

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It’s one of the most familiar tropes of being a cancer patient: At some point during treatment, you’re likely going to lose your hair. It’s also one of the hardest parts of the journey. Most scars you can hide, but hair loss is the giveaway, the flashing sign that announces, “I have cancer.”

That’s why getting your hair back feels so important, even urgent, after cancer. It’s a signal to others, and more importantly to yourself, that you’ve made it through. With each additional inch, you start to recognize yourself again.

When I was little, my mother would cut my dark brown hair into a bob, and blow dry it straight (now that I’m a mom, the idea that my daughter would allow me anywhere near her with a drier and brush is comical).

Around the age of 7, I decided I wanted long, Rapunzel hair. I somehow got the idea that if I slept with my hair tied back, I would wake up the following morning with cascading locks. I don’t need to tell you how that story ended, suffice it to say I burst into tears when I looked in the mirror and my hair still grazed my chin.

It did finally grow out, past my shoulder blades, and there it remained, give or take a couple of inches, for the better part of three decades. It was thick and wavy, although the changing hormones after two pregnancies left it finer.

I remember thinking, on more than one occasion, that I would never, ever cut my hair. I was attached to my long hair—short hair wouldn’t suit me, I thought, and it would be too unruly, too frizzy.

So I was surprised at how okay I felt when my oncologist informed me I’d lose my hair. Looking back, I think I was so focused on getting rid of the cancer, on just getting through each step toward that goal, that I saw my hair as a necessary casualty. I was also more terrified of chemo’s other side effects. At least my hair would grow back, I thought.

I chose to shave my head after my second chemo session. I was finding long strands of hair on my pillow and on the bathroom floor, and I decided to take control rather than walk around with a checkerboard of bald patches. I was pleasantly surprised by the results (you can see my cancer hair journey in pictures here), and even more pleased that I no longer had to spend time styling my hair or spending money on expensive hair products.

And yet, I missed my long hair. Or rather, I missed the “me” before cancer. As easy as my new hair routine was, I longed to see the familiar reflected back at me in the mirror.

So I’ve been studying my hair growth like a scientist might an experiment, noting when it reaches the tips of my ears, then below my ears, my jawline, and most recently, my shoulders. I’ll call it a success once it reaches the bottom curve of my shoulder blades.

One nice surprise through all of this: my hair has grown back thicker and healthier after cancer.

Before I dive into what’s helping, I want to emphasize that there’s no magic bullet (even though a lot of influencers will have you think otherwise). So many factors go into a healthy head of hair, genetics being a big one.

But in my experience, there are certain things that can help it along. None of these tips veer into pseudoscience or woo (I won’t be recommending you bathe by moonlight using the tears of a thousand frogs).

Read on for simple, practical strategies that I’m convinced have made a difference.

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Today I’m chatting with Emma Vivian, the voice behind Attempts at Optimism, where she writes about how to live life with courage and heart, even when things get hard.

Emma has faced her fair share of challenges, including a breast cancer diagnosis in her late twenties and losing her childhood best friend to the same disease.

We talk about how cancer reshaped her identity, what it meant for her plans to have a family, and the simple routine that helped anchor her during treatment.

I’d love to start at the beginning. Can you tell me what type of cancer you had and how old you were when you were diagnosed?

I was diagnosed with Stage 1 Grade 3 triple-positive breast cancer in 2018, at the age of 29.

When you look back, what were the first signs that something wasn’t right?

I decided to start performing self-breast exams after the diagnosis of a childhood best friend. On my very first attempt, I thought I felt a lump. After consulting with Google, I waited a few weeks to see if the lump went away, but when it quickly doubled in size, I knew I needed to see a doctor.

What was it like to be diagnosed in your twenties? Did your age affect how doctors or others responded?

I was fortunate that doctors took me seriously from the get-go.

Even though I’d immigrated to LA from the UK four years previously, I didn’t have much experience with the US healthcare system. I didn’t have a primary care doctor or know who to see about my concerns, so I popped along to an urgent care centre the day before Thanksgiving. After an exam, I was referred for an ultrasound and then a biopsy.

In hindsight, I was lucky to be treated with such care and referred for additional testing so quickly. However, at the time, I was so panicked that even waiting those few weeks was agonizing!

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What was treatment actually like, day to day? What surprised you most about how you responded?

What surprised me most about my treatment was just how long it lasted. I had a close friend who’d been in treatment for triple-negative breast cancer, and her treatment had been completed in about a year. I had no concept that there were many different subtypes of breast cancer, each of which has its own gold standard of care.

In my case, I received 6 rounds of chemotherapy, then a bilateral mastectomy, then an additional 14 rounds of immunotherapy with chemotherapy added in, plus over 5 years of hormone suppression and another year on a targeted daily therapy.

I remember being almost speechless when hearing how long my treatment would last. It felt like I’d been tasked with climbing Everest.

It may be a cliché, but the only way to get through it was day by day. Some days were awful, and others were OK. And each new aspect of my treatment came with its own challenges.

Was there anything you wish someone had told you before treatment started?

I wish I’d known more about the mental health aspect of treatment, particularly the depression that can hit after finishing active treatment. It felt as if I’d been spat out on the other side of a hurricane, completely dishevelled and disoriented, with little understanding of what I’d just experienced.

Now I know that this is a common experience for those who are lucky enough to complete cancer treatment. We go from being in survival mode to suddenly having the time and capacity to process what we’ve been through. That juxtaposition is jarring, to say the least.

If you’re comfortable sharing, how did fertility or future family planning factor into your treatment?

This was another aspect of cancer treatment that I had no awareness of. I had always wanted to be a mother, so fertility preservation was important to me. In fact, my husband and I had planned to start trying for a baby when I turned 30.

Again, I was extremely fortunate to have a medical team that discussed family planning with me from my very first appointment. Even though my cancer was early stage, it was extremely aggressive, and that meant any fertility preservation measures needed to be taken immediately.

Luckily, I was able to freeze my eggs prior to starting chemotherapy, and I was also given shots throughout my chemotherapy that put my ovaries into a sort of dormancy, thereby protecting them a little from being targeted.

I’m overjoyed to share that I’m currently 23 weeks pregnant with my first child, conceived naturally. I credit my medical team for their hindsight, care and support in getting me here safely!

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What changed once treatment ended? Did you feel any pressure to be “okay” or grateful before you really were?

Absolutely. As I mentioned before, my mental health really took a hit post-treatment. This was compounded by my friend, Emily, passing away while I was still in treatment. I really struggled with survivor’s guilt, coupled with fear of a recurrence of my own.

I was having multiple panic attacks a day, dealing with chronic insomnia, and depression. This was when seeking support became more important than ever. For the first time, I joined an online support group. I was also prescribed antidepressants and anti-anxiety medications that were incredibly useful during those difficult few years.

How has your relationship with your body evolved since treatment ended?

I underwent so many surgeries on my breasts — not just the initial mastectomies, but then many more reconstruction surgeries, and I’ve often described that process as desexualizing my body.

For years, I was hyper-critical of my breasts. Any time I caught sight of them in a mirror, I’d see nothing other than what I perceived to be imperfections: There’s a wrinkle here, or an indentation there.

Because of this, I decided to take a break from having any more reconstruction surgeries, and I believe this really helped me. It gave my brain time to catch up with the changes my body had experienced. Now that I’m used to my new appearance, I don’t find myself being so critical. When I look in the mirror, I simply see myself.

Did cancer change how you see yourself, not just your body, but who you are?

I’ve always been someone who’s obsessed with the concept of identity. Who am I? What do I like? What do I stand for?

Cancer definitely has a huge impact on one’s identity. How could it not? It’s not only impacted by how you feel about your diagnosis, but also by how others feel about it. Suddenly, people are treating you like a sick person. Or you’re spending all your time in hospitals. Or you’ve had to take a break from work.

I felt this keenly as a young person with cancer. Overnight, my life completely changed. I was too sick to work, my friends were supportive but also inexperienced with helping someone with a life-threatening disease, and my family was on the other side of the world.

For a time, my identity felt strongly rooted in that of a person with cancer. I think that’s a natural response to such a life-altering diagnosis. But with time, I resonate with that less and less.

Now I see cancer as being part of my story, not the whole of me.

What still feels hard, even now?

For the most part, I’m in a great place! Follow-ups can always be a little bit scary. Or if I’m experiencing a new symptom I’ve never noticed before. It can be really hard to trust your body again after cancer.

We have to find a balance between vigilance and not living life in fear.

Lightning Round

Something you brought to chemo/treatment that was actually useful?

A heated blanket! All those IVs can make you so cold.

A small comfort, routine, or habit that made a big difference?

Trying to take a walk every day, even if it was just to the end of the street and back.

A form of movement that feels good in your body today?

I still love walking! It’s so good for your physical and mental health. Bonus points if you have dogs!

Thank you so much, Emma! Be sure to check out her Substack.

And as always, thanks for reading. I’m so grateful. If you can’t become a paid subscriber, feel free to like this post to show your support (it helps!).

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So I know that title sounds a little like a Dear Diary entry. But period talk has a way of transporting me right back to when I was 12 years old, an age when one’s period (aka: the curse, Aunt Flo, that time of the month, the monthly visitor) consumes hours of waking thought.

For nearly 30 years—through middle and high school, college and first jobs, falling in and out of love, moving cities and countries, getting married, between pregnancies— that crampy, annoying, inconvenient monthly period accompanied me through it all.

Until it didn’t.

A month after my fortieth birthday, I was diagnosed with breast cancer. Suddenly, I was a passenger on a high-speed train, careening through an unfamiliar and hostile landscape.

I was told I would need surgery within a week, followed by chemotherapy. Then there was this little detail, mentioned almost as an aside: I would need to get a shot to shut down my ovaries. The reason was twofold—one, chemo drugs can damage the ovaries, so putting them “to sleep” could help protect them, and two, estrogen was my cancer’s food of choice, so cutting off my supply could prevent it from growing.

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Here’s how it went: After I had surgery to remove the guilty party (my right breast, RIP), a very nice nurse came to my house and administered the ovarian suppression shot into the fleshy top of my left butt cheek. The needle was long, and I shut my eyes and dug a fingernail into my palm to distract from the pain.

Still, I got a version of a period soon after, a few days before my first chemo session.

“C’est normal,” my French oncologist said, waving her hand, explaining that the medication can take some time to work.

What I didn’t know then was that would be my final period… 4EVA (I warned you, my 12-year-old self is steering this ship).

I continued hurtling along on the bullet train, attending chemo after chemo, shaving my head, lying in donut-shaped scanning machines, eating rice cakes and cheese to curb the nausea.

What I was not doing was getting my period.

Once the so-called “active” treatment was done (16 rounds of chemo, 25 sessions of radiation), it was on to the maintenance phase—daily pills to suppress estrogen, and the monthly shot to keep my ovaries asleep. I would need to do both for five years, maybe more, to lower the risk of the cancer coming back.

I was no longer on the speeding train. Now, I found myself sitting in a regular, unremarkable train carriage, still snaking through foreign terrain but at a more stable pace. I could finally take a beat and start noticing the details around me, one of which was this: I was now a mono-boobed woman whose childbearing years were likely behind me. At this point, there was still the possibility that my period would return in a few years, once I had passed the riskiest window and I could stop the monthly shots.

And then I made the decision to surgically remove my ovaries. My mother had died of ovarian cancer, so my doctors thought it prudent to take them out. Blessedly, I already had two beautiful children, but it was still gut-wrenching to finally close the door on having more. I felt too young to be here. My friends were only starting to notice some vague symptoms of perimenopause, if any, and here I was already in full-blown menopause, and about to lose the two small, almond-shaped things that had played a pivotal role in creating my children.

The surgery was fine, easy. I was left with three small scars, one in my belly button and two above my hip bones. I felt better about the decision, glad to have taken my future into my own hands.

A couple of months passed, and I found myself at the drugstore, walking through the “feminine products” aisle. I glanced at those rows of tampons and pads and felt overcome by longing.

I would never have a period again.

For all those years, it had served as a way to anchor my months. Perhaps an unpleasant, nuisance of an anchor, but an anchor nonetheless. During times of uncertainty, at least I could rely on its monthly appearance. And in recent years, with all the talk and awareness around cycle syncing, I had started to treat my period as a monthly reset, a forced pause to allow my body to rest.

Now, my months are missing that cyclicality. There’s no luteal or follicular phase for me, no time when I should be choosing yoga over a run or eating sweet potato over steak.

But it runs deeper than that.

Each month, the lack of a period is a reminder that I had breast cancer. If it weren’t for the diagnosis, I would still be complaining about cramps and mood swings with my girlfriends. I would still be thinking about menopause as something far off in my future. I could still entertain the possibility of having another child.

My period represents the before, its absence the after.

Is this how a man feels? His insides humming along, month after month, without the peaks and valleys of hormonal fluctuation. I’m adrift, no longer in sync with the moon’s expansion and contraction.

Will I ever feel whole again?

Xo,

Alison

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So I spoke with nutritional therapist turned researcher Dawn Waldron who studies metabolic health after cancer. On her Substack, Fluxable, she explores how mitochondria, metabolism, and lifestyle shape long-term recovery. Dawn also writes from lived experience—she beat advanced triple negative breast cancer nearly 30 years ago.

In our conversation, we talked about why some doctors may only be “doing half the job” when it comes to cancer care, why she cautions against relying too heavily on supplements, and what it actually looks like to rebuild your body after treatment. We also discussed how the microbiome and mitochondria influence recovery, why chronic stress may play a role in cancer, and the things cancer survivors tend to over-focus on—and the ones they neglect.

You write a lot about metabolic health and “flux” after cancer. In plain language, what does that actually mean?

Flux is the electrical potential that moves along the membranes of mitochondria in all of our cells. It’s responsible for making energy—ATP—and ATP drives every reaction in the body. It drives gene expression, memory retrieval, breathing, movement, everything.

Researcher Martin Picard has said that the difference between a living person and a corpse is flux. Everything else is essentially the same. It’s only flux that changes.

Mitochondria are often described as the organelles that make energy, and that’s true, but they do much more than that. They regulate cell behavior. In fact, they may play a bigger role in cell behavior than DNA.

The key idea is that mitochondria are trying to keep this electrical current steady— not too much, not too little. A bit Goldilocks.

What fascinated me is that once you understand flux, many things we already know help in cancer suddenly make sense: exercise, sleep, antioxidants, melatonin, even the ketogenic diet. They all fit into the same framework.

When we say “metabolic,” what do we actually mean?

At the broadest level, metabolics refers to every chemical reaction in the body.

But quite often when nutritionists talk about metabolics, we mean the way we use fuel, this energy production process that takes place in the mitochondria. That’s the easiest way to think about it.

Many patients are told they’re in remission and then sent on their way. From a metabolic perspective, what’s missing from that moment?

That’s often one of the hardest moments for cancer patients.

When treatment finishes, people frequently feel depressed, exhausted, and a bit lost. And that isn’t just emotional. Metabolically, the body has taken a huge hit.

The microbiome is often at an all-time low. The gut wall may be damaged. There is usually significant inflammation in the body and even in the brain. And patients may have lost a lot of mitochondrial capacity along the way.

So yes, you may have no evidence of disease, which is wonderful, but your health still needs rebuilding.

Your tumor burden may have been massively reduced. But in the process you’ve been subjected to some of the most toxic medicines on the planet.

What’s missing is the next step: rebuilding resilience. Rebuilding mitochondrial health. Supporting the microbiome. Increasing exercise capacity again. Reducing inflammation.

At the moment we’re only doing half the job. We’re getting rid of the tumor cells, but we’re not rebuilding a healthy microenvironment that makes it less likely for new tumor cells to form.

You’ve said we should be tracking more things when patients are first diagnosed. What kinds of markers do you think matter?

We should simply be asking more curious questions.

Does this person exercise? Do they spend time outdoors in the sunshine? Are they drinking more than recommended alcohol levels? What are their vitamin D levels? What are their inflammatory markers like C-reactive protein? What are their blood sugar markers such as HbA1c?

I remember when I was diagnosed they were interested in some of my inflammatory markers after treatment, when I was clear. And I remember thinking: why weren’t you tracking that from the beginning?

We should be taking a much fuller statistical picture of patients and tracking it over time. We now have the computational power to do this easily. It would help us to find new avenues to explore. I can’t understand the lack of curiosity about this.

If cancer involves a metabolic shift, is recovery about reversing that shift?

In simple terms, yes.

If someone has no evidence of disease, recovery is largely about supporting the body so it can produce ATP smoothly and consistently again.

That means not constantly overloading the system with calories or carbohydrates, keeping insulin under control, matching food intake with physical activity, supporting antioxidant status, and rebuilding a healthy microbiome.

Circadian rhythm also plays an important role. Having long overnight periods without food, getting daylight during the day, and darkness at night all support mitochondrial function.

You can never say with certainty that cancer will never return, but supporting healthy metabolic function dramatically reduces risk.

We hear a lot about mitochondria. In daily life, what does mitochondrial support actually look like?

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One day a while back, I was out for lunch with a group of girlfriends, a farewell for one who was moving to Portugal, an increasingly popular destination for Americans looking to flee to Europe.

It was one of those perfect late spring days in Provence, not too hot, with a soft breeze. A French friend arrived and she was glowing. “You look amazing!” we all exclaimed.

“Merci,” she said, with a small smile. “I just came from acculift.”

Acculift?

I’d never heard of it. She went on to explain it was acupuncture to tone and lift the face. One by one, the other women at the table piped up that they too had visited this same acupuncturist. I was intrigued. After lunch, I sent her a message and booked an appointment.

That was two years ago, and I still see Nathalie Claude-Sollier once a month. I had to shift from cosmetic treatments to traditional acupuncture when I was diagnosed with breast cancer, and I credit her with helping me manage the side effects of chemo. I’m pretty sure she’s one of the reasons I was able to keep lifting weights, hiking, and swimming throughout treatment.

Each session starts off with me going over all that’s been ailing me since I last saw her. While I’m talking, she’s furiously scribbling notes in a notebook. Like a mathematician solving an equation, she mutters various numbers and letters under her breath, connecting invisible dots with her pen. We then settle on what she’ll work on for the session. But before we start, she almost always has a recommendation or two for me. These aren’t tips you’ll find on WebMD, and they nearly always surprise me.

Here are the things she recommends again and again, including an “immortal” oil and her number one product for aching joints:

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Today, I’m speaking with Hannah Brown, whose newsletter Inner Monologue explores what it was like being diagnosed with endometrial cancer at 32 while trying to start a family.

Hannah and I chatted about scanxiety, what it's like being diagnosed so young, how cancer impacts marriage, and her #1 tip for getting through chemo.

Below you’ll find highlights from our interview, or you can watch the full interview by clicking the play button above.

Alison: How are you doing today?

Hannah: I’m good, honestly. I’m doing a lot better. Last week I was having the come-downs of scan anxiety, I’m sure you understand. It’s like a roller coaster. You’re so anxious leading up to it, then you get the scan, then the results. For me, I’m so lucky to have good results, and then you just crash. You have that emotional crash of, woof, that was a roller coaster. You’re really tired at the end.

But every day away from that scan, I’m doing better and better.

How often are you doing scans these days?

Every three months for the first year. Then every six months for five years, I think. And then once a year after that. So the further I get out, the less I’ll have to be scanned.

Three months feels like a lot, but after being in treatment for so long, doing something every single day, three months actually feels like a decent break.

Do you feel like it gets easier as time goes on?

I’ve talked to people on Substack and they say the further you get out, the better it feels. But I wonder if that’s true for everyone.

I’m starting to learn that this is just… a lifelong thing. One thing I didn’t know about cancer is that the anxiety doesn’t just disappear when treatment ends. It’s not like, “Okay, you’re cured, move on.” It’s a relationship you have to manage forever.

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During treatment, someone said to me, “It’s like living with a chronic illness.” That really hit me.

Yeah. And maybe that’s why this last scan was such a hard come-down. My husband even said, “It seems like this one is hitting you harder.”

Maybe it’s clicking with me that this roller coaster is going to be part of my life long-term. And physically, too—my body is never going to be the same. I had a hysterectomy. I’m in menopause. I’m learning my new body every day.

As sad as it is to say, thinking of it as chronic makes sense.

Let’s go back to the beginning. What type of cancer did you have, and how old were you?

Hannah: I had endometrial cancer, specifically uterine cancer. I was 32.

We had just bought a house. We wanted to start a family and had just moved closer to family for that. I’d had miscarriages kind of in a row over two years, so I went to a fertility clinic just to see what was going on.

They did blood work and an ultrasound. The doctor said, “It looks like you have half a uterus—the shape looks abnormal.” They weren’t alarmed. They thought maybe I’d just be high-risk in pregnancy. But she ordered an MRI for clearer imaging.

That’s when I got the call: “This isn’t what we thought. It looks like you have two masses on both ovaries.”

It was a nightmare.

I went to Memorial Sloan Kettering (MSK) in New York. They did a biopsy. On the MRI they give a probability score for malignancy, and mine was high. But because of my age, the doctor said there was still a possibility it wasn’t cancer, maybe endometriomas [cysts] from endometriosis. So there was this small glimmer of hope.

The flash-freeze sample during surgery came back malignant.

At first, they thought it was ovarian cancer—stage two—because it was on my ovaries. But after my full hysterectomy, when they sent everything to pathology, they found more cancer in my uterus. So they said it was uterine cancer that had spread to my ovaries, and I was upstaged to stage 3B.

It was such a roller coaster, having the type of cancer and staging changed mid-process.

You preserved eggs in between. How did that happen?

Initially, my oncologist told me there was no way to preserve fertility. He wasn’t worried about the IVF hormones. He was worried about the egg retrieval, the needle going into the ovaries and potentially spilling cancer cells into my bloodstream.

I was devastated. This whole journey started because I wanted to start a family. My brain was so hyper-focused on losing that.

My husband asked for another call. He said, “If the issue is the egg retrieval needle, why can’t she do the IVF medication, and then at the time of the hysterectomy, when they’re removing everything anyway, take the eggs then?”

The fertility doctor literally said, “Oh. We didn’t think of that.”

They coordinated with Cornell and my oncologist. I did IVF, they timed my surgery, and during the hysterectomy they retrieved eggs.

It was the first time at MSK they’d done it that way. They recorded it. It’ll be in medical journals so other women can hopefully have that option.

I’m just so grateful. To my husband for even thinking of it. And to the doctors who were willing to try.

When I was diagnosed, I kept thinking—did I cause this somehow?

I think everybody goes through that blame game. You want the answer. When I was first diagnosed, I changed my whole diet. I threw out anything “toxic.” I researched everything. You just want control.

Eventually I had to let go of that. It’s not because I ate chocolate. So many different people with so many different habits get cancer. If there were one consistent cause, we’d know.

But there is a body betrayal feeling, especially being young. I was angry at my body. Like, what happened? Why didn’t you catch this?

Over time, that shifted. Watching my body go through surgeries, radiation, chemo, and still keeping me alive… and then watching my body recover itself.

How did it feel watching your peers have babies while you were going through this?

Isolation has been a huge part of this year. At first, you have support. But as treatment goes on, you start to feel the disconnect.

Most of my peers are building families right now. So not only was I going through something they didn’t understand, they were going through something I didn’t understand.

What helped was saying that out loud. “I feel disconnected.” I have friends I can say that to.

And honestly, the Substack community helped so much. And my hospital had a young cancer support group—under 45—which was huge. Oncology waiting rooms are mostly older. There’s a natural isolation when you’re diagnosed young.

How did this change your marriage?

The biggest shift was going from romantic partners to caretaker and patient.

He went into full caretaker mode—driving me to appointments, managing medications, cooking, cleaning, running our life. And he put his own emotions on pause.

After treatment ended, he finally had space to feel. And shifting back from caretaker mode to romantic partner mode takes time. We’ve had to go back to relationship 101—date nights, intentional time together.

And our experiences were different. There were moments I was drugged up and kind of not fully present, and he was completely sober watching it happen.

For example, during my first biopsy, the doctor told him it was cancer while I was still under anesthesia. We weren’t together when we found out. I can’t imagine that experience for him.

We talk about it now. But healing from a year like that takes time.

What would you tell someone at the beginning of this?

My oncologist said, “You’re going to have to get into the arena.” At the time I was like, absolutely not. But you do. You get in it.

It’s going to be extremely hard. I won’t sugarcoat that. But you’re going to be able to do it.

And: community. Ask for help. Don’t feel like a burden. I struggled with that so much. But the people who love you want to show up.

Lightning Round

One thing that genuinely helped you get through treatment?

I’ll do practical and emotional.

From a practical standpoint: electrolytes. And Epsom salt baths. There were so many symptoms—nausea, everything—but just keeping up my water intake with electrolytes made a difference in me feeling better. And Epsom salt baths, just to relax, but also physically, your muscles, your body is going through so much.

Emotionally, voice memos from loved ones. When you’re in treatment, you can’t always see people, and sometimes you don’t even want to have a full phone call because it’s draining. But getting little voice memos, like people hyping me up or just sending sweet notes, that meant a lot.

Something you brought to chemo or radiation that was actually useful?

A heated blanket. That was really the only thing I needed.

And ice packs for my hands and feet. I bought reusable ones. I’d bring them frozen, keep them in the freezer at the treatment center, and alternate them. I’d have two for each hand and two for each foot. When one got soft, my husband would switch it out.

I don’t have any neuropathy, and I really attribute that to those ice packs.

You tried cold capping too, right?

Yes. Luckily it was covered by my insurance. It didn’t work for me, but I’m glad I was able to try.

But yeah, between the cold cap and the ice packs, I was freezing. So the heated blanket was essential.

Anything people recommended that didn’t help?

Ginger chews.

I have like 20 packs of them in my cupboard. So many people put them in care packages. And maybe they help some people, but for chemo nausea, I just didn’t want a chewy candy stuck in my teeth. That was not the experience I wanted.

Peppermint essential oil helped me more, smelling it. And ginger tea felt easier than the chews.

A small comfort or routine that made a big difference?

My sister would stay at my house during treatment weeks and make my bed with fresh sheets and clean the house. Coming home after treatment to clean sheets and a calm house made such a difference.

And getting myself into the sun, even if it was just for a minute. Sometimes I would literally walk outside, sit for a minute, not feel good, and go right back to bed. But just getting my face in the sun once a day helped.

Hannah, thank you so much. I’m really grateful we got to talk.

Me too. This has been so, so nice. I’m so grateful to meet people who understand.

I feel the same.

Thank you so much for reading! xoxo

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For a long time, I’ve been on the fence about whether or not to get reconstruction after breast cancer. When I was diagnosed a little over two years ago, one of the things I joked with friends was, “At least I’ll get amazing new boobs out of this!” I wouldn’t consider surgery under normal circumstances, so this felt like a free pass to an upgraded me.

But breast reconstruction was way down on the priority list in those first few months. My focus was on getting through cancer treatment and staying alive. I had a single mastectomy, meaning I had my right breast fully removed (the one with the tumor) while the other one was left intact.

Some women have the option of having reconstruction done at the same time as their mastectomy, but that wasn’t offered to me. I would need radiation, which can damage reconstructed tissue and increase the risk of complications or repeat surgeries.

As the weeks ticked on, I was surprised by how little I missed my breast. I would shove one of those “chicken fillet” inserts in my bra and get on with my day. I was handed pamphlets at the doctor’s office about getting a prosthetic fitted, but I couldn’t be bothered. My life felt like an endless series of medical appointments, and I wasn’t about to add another one to the roster.

The only time I felt my scar constrained me was when I was in a changing room with other women, or changing out of my swimsuit on the beach after a cold swim with girlfriends. While I knew they wouldn’t judge, seeing a scar where a breast should be would be jarring for anyone. I was never self-conscious about nudity before, and I hated that I was now.

Once six months had passed following my final radiation treatment, I got the OK from my doctors to start the reconstruction process. It was January, and my oncologist framed it as a gift to myself after all I’d gone through.

“Just in time for summer!” she said.

I gave a smile, trying to appear excited. But inside, I felt tired at the thought of yet more doctor’s appointments, more people assessing my body, more needles, more days in bed. I was finally starting to feel a little like myself again—my hair was growing back, I had more energy—and I didn’t want to interrupt this seemingly upward trajectory.

Still, I met with a breast reconstruction surgeon. The appointment was in an old stone building in Marseille’s 8th arrondissement, not far from the sea. Inside, it felt more like a luxury cosmetic clinic than a medical office. It was a far cry from the drab hospital rooms I’d been inhabiting for months, and I felt out of place and vulnerable.

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An assistant took photos of me topless before I met with the surgeon. He was polite as he outlined the plan: silicone implant, followed by a fat transfer to soften the contour, and later a third surgery to reconstruct a nipple.

I wanted to cry the entire time, and bit my inner lip to stop the tears.

As soon as I got in the car, I broke down. My husband squeezed my hand and listened.

“I don’t think I’m ready,” I said.

I realized I needed to have a long break from making any medical decisions. I was also wary of silicone implants. I had read accounts of women who later had them removed because of chronic fatigue and other unexplained symptoms.

So I waited.

Another summer came and went, and I did just fine minus a breast. Maybe I could live flat on one side forever?

And then I had my ovaries removed. The process left me with more scars, more taken from me. So much of what made me feel like a woman was gone: My breast, my long hair, my fertility, my sex drive. My thinking around reconstruction started to change. Getting implants wouldn’t replace all that had been lost, but it felt like one small way I could reclaim something for myself.

Suddenly, I felt a sense of urgency. If I was going to do it, I needed to do it soon. What had initially felt empowering (I’d decide if and when I was ready), now was making me feel stuck.

There was another factor: I was also considering removing my left breast to lower my risk of developing another breast cancer. Doing so wasn’t obligatory, but my doctors supported me if it would give me peace of mind. And a bonus: it could be done at the same time as the reconstruction surgery.

So, I could reduce my risk of another cancer and resolve the reconstruction question in one go. I’m a sucker for efficiency.

I’ll have the surgery in the spring. The new breast will look perfectly round, and the fat to soften it and the nipple will come later. I know the surgery won’t give me back the body I had—that body is gone. What it will give me is agency. Cancer made so many decisions for me. This one is mine.

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A few days before my mother died, I was sitting at her bedside, holding her hand. I held her hands a lot in those final days, trying to commit the feel of them to memory. They were practical hands, the hands of a piano teacher: Nails neatly trimmed, no jewelry save for her wedding band.

She was in a hospice in the English countryside, her body slowly shutting down after a year of failed cancer treatments. It was springtime, and the woodlands outside her room had turned violet with bluebells.

The hospice was in a converted 14th-century manor house, its windows tall and arched. I stared at those windows while we talked about death and the afterlife, as if they were a portal to a world beyond ours, where she would soon go.

I asked her if she would send me signs once she had passed, something to let me know she was still out there.

She was quiet for a moment, considering my question.

“Feathers,” she told me, giving my hand a soft squeeze. “I’ll send feathers.”

In that moment, neither of us could be sure if what she said was true. After all, neither of us had died before. Was sending signs even possible where she was going? But it brought us both comfort, living in the possibility that we could remain connected after she was gone.

My mother died two days after that conversation in the early hours of the morning.

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The following afternoon, at my parents’ house, I stole away to their bedroom. I took out my phone and opened up the last message from my mom.

“When [your dad] brings the watermelon will you send one sweet apricot? Love you so muchxxxxxx.” She was nauseous and the sweetness of the apricots helped.

I typed a new message. “I love you. Are you there?”

I pressed send and waited. For 32 years she had answered me when I reached for her. The silence seemed impossible. And yet, there it was.

My chest tightened. I felt panicked. She would never answer me again. I went downstairs and slipped out the front door. It was an ordinary street in an ordinary neighborhood in England. But I felt as if I were walking through a kaleidoscope of color and sound. The trees were greener, the sky was bluer, the birds were louder.

I sat down on the edge of the sidewalk and the thought came to me, “She’s in everything. Those trees. That sky. The birds.” I said out loud, “I can feel you. Are you really there?”

And I can’t tell you why, but I chose to turn my head to the right at that moment, and watched as a lone gray feather gently floated toward the ground, landing a few feet from me.

It’s been nearly 10 years since she died, and more often than not, a feather enters my path at the exact moment I’m worried about something or thinking about her.

Whether or not it’s actually her doesn’t really matter, though I hope it is. What matters is that it makes me feel connected to her, and maybe that’s enough.

Have you received signs from loved ones who have passed? I’d love to know, if you’d like to share.

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I shared an earlier version of this as a Note, and readers responded with stories of their own signs from loved ones. Here’s a taste:

Rachael Lala: Our mums would never leave us. Mine sends me white butterflies and compliments from kind strangers about my hair (which I used to fret about postpartum). Often the timing of these signs has been too immaculate for me to even consider that it might not be her! It makes me believe in life beyond, in magic and in the steadfastness of the love we share.

Janet Stahl: This week I hugged a friend and she smelled wonderful. I asked her what her scent was. She said “hairspray.” My mom was a beautician for 34 years and hairspray was an underlying scent. I took it as a kiss and a message from my mom. They love us.

Laura Apfelbeck: My dad loved the song “Heart of Glass” by Blondie. He was a dedicated country music fan while I prefer rock, so this was one song we loved together. He passed 6 years ago. It “randomly“ pops up on the car radio at perfect times in my life.

Marcia Diederich: My deceased husband plants words that have special meaning for us in the NYT crossword puzzles on birthdays and anniversaries. I’m sure of this.

Tantra Maat: Same with my son Jeremy who died over 40 years ago. He leaves a penny. Coming back from Hawaii my BP spiked. I was quite scared yesterday and walked into the kitchen and I saw a single penny right in the middle of the kitchen chair. Love never dies.

Jill Raisig: So awesome! Recently read the book Signs. So to test this theory, I asked my Dad to communicate with me through Eagles. I first saw an abstract eagle painting which kind of disappointed me. I said this outload….come on, I know you can do better. The next day while driving in the bayou in Louisiana, a golden eagle soared over our car! I’m a believer. Sure makes losses a bit easier.

Donald Johnson: My mom said a quarter. Like who drops quarters? Sure enough, when I’m missing her and chatting with her in my prayers, one will show up. I miss you, Mom.

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During my own breast cancer treatment, it didn’t occur to me to turn to Substack for support. Now that I’m in recovery, I’m grateful to have discovered so many smart, talented writers sharing their own cancer experiences, along with doctors who are helping patients understand and navigate their care.

These aren’t all Substack bestsellers with thousands of subscribers. Rather, they’re writers who have opened my eyes and helped me understand my own cancer experience more clearly.

Dr. Corinne Menn

I started following Corinne Menn on Instagram soon after I was diagnosed. A breast cancer survivor herself, her Substack is a treasure trove of clear, practical advice on navigating menopause, including after breast cancer. Women are too often left to manage their menopause symptoms alone once treatment ends, but Menn makes me feel seen and better informed.

Start Here:

Dr. Corinne Menn

Menopause & Cancer? Start here.

This is the #1 question I get from both doctors and patients…

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3 months ago · 27 likes · 8 comments · Dr. Corinne Menn

Wajeeha Nadeem: Enchanted Letters

Any time I read Wajeeha Nadeem’s posts, I find myself nodding along. We were both diagnosed with breast cancer around the same age (she was 38, I was 40), and her writing captures something I’ve struggled to articulate myself: what it’s like to have a new identity handed to you without your consent.

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Enchanted Letters

It’s Been 82 Days Since I Was Diagnosed with Breast Cancer

One evening in late March, my life changed as I knew it. It was a pleasant night, as I sat with my 11 year old, discussing our travel plans. And then as I brushed my hair back, I felt a small, seemingly innocent lump. Little did I know…

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10 months ago · 57 likes · 52 comments · Wajeeha Nadeem

Daniel Flora, MD: Curative

I don’t know how he does it, but Daniel Flora somehow manages a successful Substack while also working as a medical director of oncology research in Cincinnati. He’s worth following for his Substack notes alone—thoughtful and smart, with zero fear-mongering. It’s clear he genuinely cares about demystifying the complex world of cancer research and treatment.

Start Here:

Curative

Letter to My New Cancer Patients:

"To most physicians, my illness is a routine incident in their rounds. To me, it’s the crisis of my life. I would feel better if I had a doctor who at least perceived this incongruity…

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a year ago · 148 likes · 47 comments · Daniel Flora, MD

Emma Vivian: Attempts at Optimism

Emma Vivian writes about rebuilding her sense of self after her breast cancer diagnosis at 29. “I had made the mistake of imagining the trauma to be entirely physical,” she writes. Her work captures how cancer—especially when you’re young—permanently alters how you see your body and the world.

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Attempts at Optimism by Emma Vivian

Who I became when the old me was gone

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6 months ago · 47 likes · 34 comments · Emma Vivian

Tiffany Troso-Sandoval MD

With more than 25 years of experience as an oncologist, Tiffany Troso-Sandoval’s Substack is jam-packed with practical, patient-forward guidance. Her writing has helped me understand not just my treatment, but the system around it, and how to push back when something doesn’t sit right.

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Tiffany Troso-Sandoval MD

What Your Oncologist Wishes You Understood Before Your First Appointment

Last Tuesday, I watched a woman sit across from me, clutching her phone with her pathology report pulled up in her email. She’d been diagnosed with breast cancer three weeks earlier. Since then, she’d seen a surgeon, had more scans, met with a genetic counselor, and now she was in my office…

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6 months ago · 7 likes · Tiffany Troso-Sandoval MD

Katie Colpaert: Presence and Pilgrimage

I’ve teared up more than once reading Katie Colpaert’s writing. She often writes in fragments—poems, notes—about her recent Stage 4 cancer diagnosis. Her work captures the pain and strangeness of facing one’s own mortality when you still have so much life ahead of you.

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Presence & Pilgrimage by Katie Allen

Trees and Dying and Whatever

Context: This is a writing practice entry from a 10-minute prompt from back in 2022, not long after I completed my first, week-long silent retreat at Spirit Rock in Woodacre, California. It was an intense, difficult, and incredibly profound and transformative experience, all of which I'm sure contributed to the more woo-woo quality in the piece below…

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5 months ago · 109 likes · 39 comments · Katie Colpaert

Hannah Brown: Inner Monologue

I’ve come to look forward to Hannah Brown’s daily notes popping up on my feed. Her tagline, “F*ck Cancer,” always makes me smile. Diagnosed with endometrial cancer at 32 while trying to have a baby, she writes about all that cancer takes away, but she doesn’t linger there for long. Her posts are honest and hopeful.

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Inner Monologue

Goodbye To The Year That Almost Killed Me

I have never been one for New Year’s resolutions or holding sentimental feelings for the entirety of a specific year. The idea of listing out goals was never something I felt called to engage in. Sometimes, I would choose a single word I would carry with intention into the year, but that was as far as I would go when it came to tying myself to what a ye…

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3 months ago · 46 likes · 24 comments · Hannah Brown

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Rebecca Herring

Rebecca Herring (“Becks”) writes about living in the liminal space of a terminal illness. Her writing is both raw and meditative. Here’s a taste: “In a world that makes sense, I wouldn’t be offered hospice before the age of 50. I wouldn’t be offered hospice decades before my husband can retire. I wouldn’t be offered hospice before my children have graduated from college. I wouldn’t be offered hospice before I have buried my parents. This is all backwards. This is all cattywampus. None of this makes sense!”

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Becks

The discord between dying and feeling alive

I had an appointment on Monday that has left me on edge. I am hoping that, as I write tonight, I can somehow make sense of the feelings it evoked…

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4 months ago · 120 likes · 54 comments · Becks

Suleika Jouad: The Isolation Journals

Probably the most well-known writer on this list, Suleika Jouad is a bestselling author and three-time cancer survivor (and wife of prodigiously talented singer Jon Batiste). I found her memoir Between Two Kingdoms when I was in cancer treatment. Reading it was both a harrowing and comforting experience (her chemo journey was prolonged and intense). She writes like a poet about cancer, art, and survival, and I especially enjoy her weekly journal prompts.

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The Isolation Journals with Suleika Jaouad

A personal update

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4 years ago · 4438 likes · 496 comments · Suleika Jaouad

Dr. Amy B. Killen, MD

Not a cancer Substack per se, but so much of Amy Killen’s writing is relevant to breast cancer survivors. I recently had my ovaries removed for prevention, and her post “When Your Ovaries Leave the Building” was illuminating. I assumed I’d simply entered menopause early. Instead, she helped me understand that surgical hormone loss can be more abrupt and profound than natural menopause (bummer for me). Her writing is casual and zippy, a nice change from dry, jargon-heavy medical advice.

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Dr. Amy B. Killen MD

Busting the BRCA Hormone Therapy Myth

If you have a BRCA mutation, you’ve probably been told you can’t take hormone therapy. Your doctor may have said it’s too risky. That the estrogen will “feed” a future cancer. That you just have to white-knuckle your way through surgical menopause at 40…

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3 months ago · 18 likes · 1 comment · Dr. Amy B. Killen MD

Nancy Stordhal: Nancy’s Point

Nancy Stordhal has been writing about her breast cancer experience for over a decade, first on her blog and now on Substack. She pushes back on tired cancer tropes like “stay strong” and “you’re so brave.” This line hit me: “Cancer is a horrible disease, not an enlightenment program.” She emphasizes connection and conversation—she wants to hear from her readers and learn their stories.

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Nancy's Point

Cancer Rebel

Hello, Friend…

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6 months ago · 86 likes · 90 comments · Nancy Stordahl

And here are 4 new-to-me Substacks in the cancer community. Comment yours below!

This Life With Cancer

No Bad Ideas

The Returnist

In Good Time

Thursday Thoughts

As always, thank you for reading. I’m so grateful. If you can’t become a paid subscriber, feel free to like this post to show your support (it helps!).

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There’s a Sex and the City episode where Miranda, newly pregnant and deeply ambivalent about it, feigns joy when her housekeeper reacts giddily to the news.

That’s sometimes how it feels to be a cancer survivor. People assume that when you’re done with treatment, cancer is behind you. You’re healed! You smile and nod. “Yes, I’m really grateful. Modern medicine, huh?” But inside, what you’re thinking is: “This will never fully be over. Because the cancer could come back.”

The cancer could come back.

And if my cancer does return, it could be stage 4. It could have metastasized, meaning it has spread to other parts of the body—perhaps the spine, the liver, or the brain.

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My cancer was stage 3, which gives me a 30–50% chance of recurrence. The first two years after treatment ends are the riskiest, and that risk decreases over time. Most recurrences happen within five years, though some cancers can return decades later.

I get regular scans to check that I’m still in the clear. We all want clear scans, of course. But that doesn’t mean there isn’t a lone Frankenstein cell still lurking, too small for a machine to detect.

I’m doing all I can to prevent recurrence. I had the mastectomy, chemo, and radiation, blasting my chest and under my right arm to kill any lingering disease. Now I’m taking various pills to prevent any leftover cancer cells from growing. I’ve stopped drinking alcohol, exercise regularly, eat well, and try to meditate most days.

Even so, the cancer could still come back.

As I sit here, looking out the window at the sea, I wonder: Did one tiny damaged cell evade death? Did it manage to escape the poison, traveling blindly in the dark, finding refuge somewhere else in my body? Is it staying quiet while it settles in, until it feels ready to split in two?

I feel superstitious even naming it.

I’m trying to figure out how to live now. I see my future ahead of me, grouped by decades. I hope I make it to 50, when my children are grown. I ask God, the Universe, I’m not sure who: Please give me the chance to usher them through their childhood. Maybe losing me as young adults would be easier than losing me younger. I see a sixty-something actress, and I hope I can look half as good as her when I’m that age… if I make it that far. Reaching 70 feels like asking for too much. But maybe?

Most days, I don’t have these thoughts. I’m caught up in the business of living— standing at the front door, telling my kids to get their shoes on or we’ll be late, laughing at a TikTok video with my husband, running shrieking into the cold ocean with girlfriends.

We’re all living with the specter of death in the background. We will all die, someday. Cancer reaches back and brings forth this understanding, which is both a blessing and a curse. It sits like a black crow on your shoulder, its squawking difficult to ignore.

“You could die,” it says.

“Yes,” I say, stroking its head. “But not today.”

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In 2026, the term biohacker might prompt more than a few eye rolls. It conjures images of billionaire tech bros chasing ever more extreme forms of optimization.

But in 2018, it was a concept that was still creeping into the general consciousness, and many of the ideas (cold plunging, collagen protein, intermittent fasting) hadn’t yet gone mainstream. That’s the year I started working for Bulletproof, a startup founded by Dave Asprey, often described as the “father of biohacking.” It was an eye-opening experience. As an editor and writer for the company’s blog, I met with him weekly over Zoom, where I’d pick his brain for story ideas and get his take on emerging health trends. Soon, I started incorporating a lot of the advice I was researching and writing about.

Below are the everyday habits I still use years after working in biohacking, and the ones I’ve dropped.

Habits That Stuck

Fasting During Flights

One habit I’ve kept is fasting during flights, especially long-haul ones. I love the mini

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I knew I was going to lose my hair during cancer treatment, but what I didn’t know is how liberating it would feel. I’ve had long brown hair for as long as I can remember. If it weren’t for cancer, I don’t think I ever would have dared cut it short, let alone shave it. My long hair was very much a part of my identity.

I considered cold-capping, but it seemed like too much of a schlep. Often women have to bring their own cooler boxes filled with dry ice and multiple cool caps to the hospital, and a nurse or friend usually helps swap the caps on a strict schedule. I was already nervous about chemo and focused on, well, staying alive, that I didn’t have the mental bandwidth to worry about hair.

My oncologist warned me that my hair would start to fall out around 15 days after my first chemo session. So I decided to approach it in stages. Before I started treatment, I cut it to just below my shoulders. I planned to shave my head at some point, rather than deal with bald patches interspersed with strings of hair. Night of the Living Dead was not the look I was going for.

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As I approached my second round of chemo, I started noticing long strands of hair on my pillow and on the floor. When I brushed my hair, clumps of hair would come out.

“I think it’s time,” my husband said.

We had decided he would shave my head for me. So a couple of days after Christmas, we shut our bedroom door, leaving the kids to watch a movie with my father-in-law. We positioned a chair in our ensuite bathroom, in front of the mirror. I was deep in a Taylor Swift phase (this was peak Eras Tour), so I put on Folklore and gave my husband the go-ahead to start shaving.

“It doesn’t actually look that bad,” I commented halfway through, turning my head to assess the shaved side. The roots were gray, streaked with my natural brown color.

When it was done, I was surprised at how much I liked it.

“You look beautiful,” my husband said.

The kids were a little slower to accept it. I no longer looked like “Mommy,” and that was hard for them.

I had bought a wig, but I ended up never using it. I just didn’t feel like myself. I did wear headscarves sometimes, especially at the start, when all I had was a bit of peach fuzz. But soon I started ditching those too, and decided to simply embrace what was. If I was cold, I’d simply wear a beanie. It helped how supportive my friends and family were, affirming how “rock star” I looked, like Sinead O’Connor and the like.

It’s been a journey, and my hair is finally almost shoulder length once again. I’ve gone through phases of total acceptance, as well as phases of impatience. Now, I want long hair again, perhaps as a way to feel like my old self. If I ever cut my hair short again, or shave it, I want it to be on my terms, and my terms alone.

If you’re curious, here’s my hair journey in pictures.

Before

Going Short

In early December, 2023, soon after my mastectomy, I visited my hairdresser and got the chop.

Shaved

After Treatment

Now

Thank you for reading! I’m so grateful, as always x

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I’ve now been in medical menopause for a little over two years. I don’t want to jinx it, but my experience really hasn’t been that bad (I wrote more about what it’s been like). I think a lot of that comes down to certain wellness practices and routines I’ve adopted since my breast cancer diagnosis.

Read on for what’s helping me navigate menopause, including the one supplement I won’t skip, my non-negotiable morning routine, and the best thing I’ve done for my body:

What’s Helped Me Navigate Menopause So Far

A science-backed exercise routine

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I lay on a table, stark naked, while two women rubbed warm herbal oil all over my body, their movements synchronized. I kept my eyes closed, trying to ignore the fact that every bit of me was exposed.

It was Day 3 of a weeklong retreat in Greece for women who had gone through cancer. The room was candlelit, perfumed by wisps of incense. My mastectomy scar was on full display. Up until now, no one but my family and doctors had seen it.

And then I realized something. After months of grueling cancer treatment, a time when my body had been cut, injected, scanned, and pumped with medication, this was the first time I had been so lovingly and attentively touched. For a full hour, two women, one of whom had had breast cancer herself, were putting all their energy into simply making me feel good.

Marinated in oil, I left the room and blinked at the bright sunlight glittering on the sea.

A year before I had been lying under the radiation machine. Now I was here, doing yoga, meditating, napping, eating fresh vegetarian food, and having my body oiled.

Sounds like heaven, right? But here’s the thing: At first, I really didn’t want to go.

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Prior to a scan, you have to lie still for 45 minutes while an IV injects radioactive sugar throughout your body (cancer cells use more energy, so they absorb more of the sugar, lighting up on the scan). It’s an excruciatingly tedious process. You aren’t allowed to read, listen to music, talk, or even think too much, and you have to stay as still as possible.

My mastectomy scar was still fresh, and I was starting chemo within a matter of days. I felt painfully alone, lying at the mercy of all these needles, machines, drugs, and doctors.

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I tried to ignore the IV in my arm and stared up at the ceiling, tracing a watermark with my eyes. I started to cry, tasting the saltiness of the tears on my lips, forgetting I wasn’t allowed to move. I took slow, gentle breaths, trying to calm myself.

That’s when, unbidden, I imagined my mother, who died nearly 10 years ago, standing next to me, holding my hand.

I looked down and visualized her hand, every inch of which I could still recall so clearly, resting on mine. I sunk into the feeling of being somebody’s daughter again, something I hadn’t experienced for years. I told her I was scared.

“It’s okay, my darling, I’m here,” I imagined her saying.

My dad then entered the room, tall and distinguished in a suit. He had died two years after my mom. He took my other hand and simply said, “Ali” in that sweet, loving way only he could.

Next came my husband and our two kids, followed by my sisters. Then, my inlaws and nieces and nephews. And finally, one by one, my dearest friends. After five minutes, the room was full. Everyone that I loved, and who loved me, was there, surrounding me. And they were all cheering me on. I could see every one of their shining faces smiling with encouragement.

The hospital room was no longer a scary, empty place. I felt held and cherished.

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It was a visualization I came back to throughout my cancer treatment, at subsequent scans, during chemo, and lying under the radiation machine.

It showed me that even when my body is in pain or discomfort, I’m not trapped inside of it. I can step back mentally and inhabit a place of love and light and tenderness.

If you’re going through something hard, imagine someone you love entering the room and standing beside you. Take your time. When it feels right, invite the next person in. And the next. No one has to say anything. They can simply be there with you.

You can stop when the room feels full enough and you’re reminded just how loved you truly are.

Who would you invite into the room with you? Do you have any visualizations or techniques to help you through difficult moments?

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Like so many of us, I have a complicated relationship with rest.

Growing up, I was never permitted to “lie in” on the weekend. I have memories of my mom sweeping into my bedroom and flinging open the curtains while I was still asleep. Or, if I was watching TV, she would ask, “Shouldn’t you be achieving something?” I believe her intentions were good—she wanted her children to be engaging with the world, but the message I received was, “Rest was not okay.”

This belief followed me into adulthood. Any time I felt tired or burnt out and wondered if I should just sit down already, my thoughts would turn judgy.

“You’re lazy.”
“If you give in now, you’ll never get off the couch.”
“Everyone else is working hard and you’re not.”
“You have too much to do today, tomorrow, next week, next month, forever.”
“You can’t let the kids see you in bed in the middle of the day.”
“This is so indulgent.”
“If you try to nap and can’t, you’ve wasted an afternoon.”

And on they would go.

I’d listen to these thoughts, heed their warnings. Instead of resting, I’d drink more caffeine and go for a 4-mile run. Keep working rather than take a 20-minute nap. Vacuum rather than turn on my Kindle. Productivity was god.

And then I got cancer.

For what felt like the first time, I was told that I had to rest. It wasn’t optional. Suddenly, my husband was ordering me to nap every day, “for at least two hours.” He made a sign for the bedroom door that said, “Mommy’s resting” so the kids would know to give me space.

And here’s the big epiphany: Things didn’t fall apart because I took a nap. On the contrary, I could be more present for those around me when I wasn’t running on empty.

Now, instead of pushing through when I’m tired, I’m learning to listen to my body and notice its cues. Some days I wake up and I know I need to take it easy. Maybe my body feels heavier, or I’ve read the same sentence 10 times without it registering, or I’m snapping at the kids over nothing. On those days maybe I’ll skip a workout, watch an episode of a show in the middle of the day, or shut my computer and read a book.

The negative self-talk still creeps in, and it probably always will. But the other voice is equally as strong.

“I know what I need. It’s okay.”

Your Resting Starter Pack

Define what rest means to you

For a long time, I didn’t really know what it meant to rest. It’s taken some trial and error to figure it out. Ask yourself what true rest means to you. Is it staying in bed for an afternoon, binge watching a show? Sleeping in till 10? Sitting with a cup of tea looking out the window at the trees? Cuddling your cat? Or maybe rest is more active for you, like doing some restorative yoga, or going for a walk. I’m learning that what counts as rest is personal.

Figure out what’s actually possible

If you have a job and kids, staying in bed for the morning probably isn’t feasible. When my kids were toddlers, I was lucky if I got five minutes of quiet. Now that they’re a bit older, I can take a short nap knowing they’ll be fine. You have to work within the constraints of your current circumstances. If right now, rest means sitting in your car and closing your eyes for 10 minutes while your kid is at soccer practice, that’s okay.

Set boundaries

Once you’ve defined what rest looks like to you, protect that time. One option is to put it on the calendar. For me, Fridays have loosely become a day when I take my foot off the gas. Once I get my work done, maybe I’ll go for a long walk in the forest near my house, or take myself to a movie. But it isn’t always possible to plan for rest. Sometimes, it comes as a surprise. You wake up and you’re bone tired. That’s when you tell your partner and/or your kids, “I need half an hour.” Everything else can wait.

Notice any negative self-talk

When the critical thoughts come up, and they probably will, simply notice them. They’re the result of years of conditioning in a culture that elevates busyness and constant doing. The goal is for the other voice, the one that knows the true value of rest, to grow louder over time.

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What Rest Can Look Like

• Take a nap. Arguably the most simple but effective way to give your body the rest it needs. And it doesn’t have to be long to reap the benefits.

• Read. Make yourself a cup of coffee or tea, get cozy under a blanket, and read a chapter of a book.

• Take a bath. Otherwise known as my favorite way to rest. I take a bath almost every day, usually in the evening, but sometimes in the afternoon. Throw in some Epsom salts, nice-smelling bubbles or oil (I’m partial to this one), light a candle, and read a book or watch a show on the iPad. Done.

• Lie on the bed and do nothing. I mean it. Just stare out the window. Before kids, this might have sounded depressing, but now a small moment of quiet feels like the height of luxury.

• Go to a movie. When I was in college, I’d take myself on a solo movie date every Tuesday afternoon, when my local theater had a half-price ticket deal. It feels like you’re playing hooky in the best way, escaping from the world for a couple of hours. Salty popcorn and dark chocolate are optional but highly recommended. I always leave the theater feeling inspired and refreshed.

• Get out in nature. Go for a long, slow walk. Listen to a podcast or simply to the birds and the breeze.

Whatever it is you choose, know that to rest is okay. You have permission to exhale and treat yourself with gentleness and care. Life can be hard, and carving out that space to allow your body (and your mind) to recuperate is something we all deserve and need more of.

What is your relationship to rest? And what are your favorite ways to rest? I’d love to know!

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Like most cancer survivors, I’ve collected my fair share of scars since being diagnosed.

Before, the only scars I bore were a ridge above the heel of my left foot, the result of stepping on broken glass when I was 5, and a tiny indentation on my forehead, a remnant from a childhood bout with chicken pox.

But in the last two years, I’ve quickly added to this collection.

I’m surprised by how at peace I feel about these new marks on my body. I used to place an inordinate amount of pressure on myself to look a certain way, to be considered “pretty”—a painful and obsessive concern. Over time, I realized I would never be pretty enough, because the goalposts were always moving.

Cancer forced me to release the control I thought I had over my outward appearance, and it’s been freeing. Now, when I look in the mirror and see the scars left behind from treatment, all I see is someone who is still here, still alive. Without those scars, that wouldn’t be the case. Seen in that light, being pretty fades in importance.

Here’s an inventory of my scars. Maybe you’d like to share yours, too?

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My Mastectomy Scar

About 6 inches long, starting near the center of my chest, just below my right breastbone, and stretching across to my right armpit.

I see it every day, when I take off my top to get in the shower, when I get dressed in the morning, and when I change into my swimsuit at the local pool. It’s turned white over time, a streak of lightning.

I let my children see it, too. At first I worried it might be strange or disturbing, but I decided that it was nothing to be ashamed of, and I wanted them to know that. I don’t parade around with the scar on show—I simply choose not to hide it from them if they happen to be nearby.

I hope it sends the message that you don’t need to be perfect to be loved. If I choose to get reconstruction, which is still a big if, my scar will still be there, cutting across my new, silicone breast. But I don’t mind—the scar is the reason why I’m still here. That makes us friends for life.

My Chemo Port Scar

This one is a small horizontal line, right above my left collarbone.

Before you start chemotherapy, a surgeon places a port in your chest. It’s a small device inserted under the skin that gives doctors easy, repeated access to a vein without constant needle sticks.

During my mastectomy, my surgeon made the small incision above my collarbone, before snaking the circular port and tube downward, where it rested for nearly two years.

Last month, I finally had it removed. I used to absentmindedly run my thumb around the outline of the port, which would bring me comfort and also make me feel a little queasy. Now it’s gone, but the scar remains. Instead of feeling for the port, my fingers now trace the raised path that got left behind.

My Biopsy Scar

A small discoloration, a muddy puddle, on my lower back.

After I’d completed chemo and was in the midst of radiation, my white blood cell count remained worryingly low. This was an issue that plagued me throughout treatment, and forced me to delay chemo at various points in an effort to get the count back up. If your white blood cell count is low, your body has a hard time fighting off infection.

My oncologist was convinced the low count was due to my body still recovering from the harsh chemo drugs, but there was a very slight chance it was a sign of blood cancer. In rare cases, chemo can cause leukemia. [Yes, you can treat one form cancer but create an entirely new one as a result]. Cancer is a grab bag of surprises.

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So she sent me to an oncologist specializing in blood cancer. He looked over my blood tests and decided there and then to take a bone marrow biopsy from my back.

A spontaneous biopsy is not something I’d wish on anyone.

I was instructed to lie face down, and he proceeded to give me a shot to numb the pain. It worked, but I was uncomfortably aware of him digging deep into my lower back, scraping out my cells. Although it only lasted five minutes, it felt much longer, and I was relieved when it was over. For days after I hobbled around, my back aching.

Luckily, I didn’t have leukemia, but the scar from that biopsy remains.

My Oophorectomy Scar

This is a new one, just 5 weeks old. It’s a purple crescent moon inside my bellybutton, accompanied by two tiny slits, like what you might find atop a cherry pie, on either side above my hip bone.

My mother died of ovarian cancer, so my oncologist suggested I remove my ovaries to both lower my risk of breast cancer recurrence and reduce my risk for developing ovarian cancer, which is notoriously difficult to detect. Once it’s finally discovered, it’s often too late.

My ovaries and fallopian tubes were removed via my belly button, while the two small incisions on the sides served as entry points for the camera and instruments used during the surgery.

All three of these scars will fade and disappear over time.

My IV Scar

A permanent bruise sits in the crease of my left elbow.

Even though I’m done with active treatment, I still have blood taken every 2–4 weeks to monitor my counts, and a PET scan every six months—which means another IV each time. I had cancerous lymph nodes removed from under my right arm, which makes it more vulnerable to swelling and infection, so I can never have blood drawn from that arm again.

That leaves only three usable veins in my left arm, and they’ve been poked and prodded dozens of times. Techs often struggle to find one that will cooperate, but it’s the only option they have.

I think of those veins as tired and damaged, and during a draw I look longingly at the bulging vein on my right arm, ripe with blood.

The Scar No One Can See

What most people don’t realize is that cancer isn’t over once treatment ends. I remember very clearly the day an oncologist friend told me that cancer is akin to managing a lifelong chronic illness. My heart sank at the news. I thought I would beat it and move on with my life. But there are the years of pills, the annual scans, the monthly blood tests, the ever-present fear that the cancer will return.

Alongside all this is the long, slow process of picking up the pieces of your life following treatment. My oncologist likens it to the aftermath of a hurricane.

Something I’m learning is that I wouldn’t wish any of these scars away. I’m not sure I would go so far as to say I’m glad I got cancer, but I also can’t imagine who I’d be without it. I’m clearer now, more sure of what matters and what doesn’t. And when I look in the mirror, I see a survivor, and I’m grateful to see her still standing there.

What scars do you have? What stories do they tell?

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If you’re a woman of a certain age (shoutout to my fellow elder millennials), talk of menopause is everywhere, and almost all of it is overwhelmingly negative. Hot flashes, mood swings, no sex drive, weight gain, thinning hair, insomnia, face collapse (okay, I made that one up, but there’s a lot of talk about jowls and sagging skin)...

If you’re in your late thirties/early forties, it feels like you have maybe a handful of good years left before falling off a cliff into sad land where everything is dry and everything hurts.

I’ve been in medical menopause for two years and I’m here to tell you: it hasn’t been that bad.

Now, that doesn’t necessarily mean that’s always going to be the case. However, considering how difficult this whole cancer thing has been, I’m going to grab the silver linings where I can.

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I was put into medical menopause at 40 after I was diagnosed with breast cancer. The type of cancer I had was hormone positive, which in simple terms means estrogen feeds the cancer cells and helps them grow. So part of the treatment is to cut off all sources of estrogen so the cancer has nothing to fuel it.

For me, that looked like a monthly shot to shut down my ovaries (the body’s main estrogen producer), followed by a daily medication after chemo and radiation to keep estrogen levels low. The shot alone puts you into menopause because it stops your period.

And what most women with breast cancer will tell you: Your oncologist will brush over the menopause side of things, and very little time will be spent walking you through what to expect, and more importantly, how to manage the side effects.

One day you’re a fertile woman walking around with both breasts, the next day you’ve lost one or both said breasts and your period has stopped, sometimes forever. And you’re just meant to manage that transition while also fighting for your life.

It’s a lot.

But here’s the truth: my symptoms have been manageable, and some barely show up at all. Here’s what I’ve dealt with so far, including a couple of surprises.

My Menopause Symptoms

Hot flashes

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I expected the experience to be a little like morning sickness—a combination of nausea and food aversions. And for the most part, it was.

When I was pregnant, the sickness was around-the-clock. With chemo, the nausea was typically really bad the first night, like lie-in-a-dark-room-can’t-move bad, but then it would slowly start to ease in the following days.

As I progressed further along in my treatment, I figured out what worked for me and what didn’t, including what I could tolerate during an actual chemo session. For instance, I learned very quickly that I absolutely could not eat the hot hospital lunch they provided during an infusion. Just thinking about it still makes me gag.

Here’s a list of foods that got me through cancer treatment. And remember, a balanced diet is all very well but that isn’t always possible when you’re nauseous and exhausted, so be gentle with yourself. If you can’t stomach lettuce, don’t stress—you can get back to your salads when you’re done with chemo. Most doctors will tell you not to worry and to simply eat what you can.

Greek Yoghurt

My oncologist suggested I up my protein during treatment. Chemo can break down muscle tissue more quickly, and it can also make it harder to eat full meals because of nausea, appetite loss, and mouth sores. That means you might get less protein over the course of a day. Greek yoghurt is packed with protein (1 cup has 15-20g), so I’d eat it for breakfast topped with berries, ground flaxseeds, walnuts, and honey.

Frozen Fruit

I felt hot a lot during treatment, mostly due to hot flashes (I was put in medical menopause to lower the estrogen in my body). My acupuncturist also told me chemo increases the body’s “yang,” which translated to more heat in the body. Frozen fruit was a simple way to cool down while also getting some nutrition in. I’d regularly make a PB&J smoothie using frozen raspberries, or a mango smoothie with spinach and yoghurt.

Potatoes

The baked potato. Humble yet perfect. I’m talking a steaming potato fresh out the oven, sliced open, slathered in butter and sprinkled with salt. I ate this multiple times a week. Sometimes I’d mix it up and use sweet potato instead.

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Granola Bars

A great item to throw in your bag on infusion day. I was partial to the Deliciously Ella brand—I’m obsessed with their cacao and almond butter oat bars (made with just dates, almonds, almond butter, cacao, coconut oil, and salt). Also good are the peanut butter bars, my daughter can’t get enough of them.

Sparkling Water + Fruit Juice

When I was pregnant and nauseous, my husband would make me a “juicy water”—Perrier with a splash of fruit juice (apple, pineapple, cranberry…whatever you fancy!) and lots of ice. So when the nausea rolled around during chemo, I got back on the juicy water train. The cold and sweetness helped with the metallic taste in my mouth (another chemo side effect).

Cheese

I liked simple sharp cheddar, but grab whatever cheese sounds good. Pretty much all I wanted the day after chemo was cheese on bread or crackers. Maybe with some sliced tomato and coarse salt on top. Or ask your loving boyfriend/husband/partner to make you a grilled cheese, ideally alongside a bowl of creamy tomato soup.

Beans

Remember what I said about protein? Beans and pulses are full of it. Chickpeas, kidney beans, black beans, white beans, lentils… just stock your pantry with a variety of tins and chuck them on whatever you’re eating. Mash up some butter beans with lemon juice, garlic, olive oil, and salt and top your baked potato with it. Or make the famous “Jennifer Aniston Salad.” I ate it for lunch almost everyday during chemo. A quick google search brings up lots of recipes for it. I like this vegan version with a lemony tahini dressing.

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Herbal Tea

I’ve never been a coffee drinker and I stopped drinking black tea in the morning during treatment. It’s generally safe to drink caffeine, but I already felt kind of “high” and spacey from the drugs, and I didn’t want to exacerbate that. If I felt like drinking something warm, a ginger or mint tea was nice to have on hand. I was also partial to “Christmas Tea” from YogiTea—the cinnamon and spices were comforting.

Eggs

Sensing a pattern here? More protein! Scramble, fry, or poach three eggs and you have nearly 20g of protein. Put them on toast with sliced avocado if you can stomach it, and you’ve got yourself a great breakfast.

Popsicles

The bright, cold pop of flavor was the perfect antidote to nausea and the metallic mouth taste. I probably ate one a day the week after a chemo session. My favorite flavors were mango or lemon.

Bananas and Peanut Butter

A snack I discovered during treatment: Slice a banana in half lengthways, spread both sides with peanut butter, then sprinkle some chocolate chips on top. We call it a “banana boat” in our house. I omitted the chocolate during chemo because I just didn’t have a taste for it (something I’ve rectified since).

What foods did you eat during chemo? Anything you’d add to my list? I’d love to know!

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