How I Beat Breast Cancer
When my ob-gyn told me I had breast cancer on September 19, 2008, I was so angry, I actually screamed “Cancer jihad!” For the first time in my 52 years of life, I understood what it was like to feel all-consuming rage. You see, I thought I had been doing everything right. Not only was I a physician myself, but I ate organic foods, I exercised, I grew my own herbs and vegetables, I didn’t smoke or drink alcohol—or even coffee!—but I still got cancer.
Three months earlier, I had had an upper-respiratory infection, and at the same time I felt a small lump—about the size of a pea—on my left breast. A lung specialist gave me powerful antibiotics for the infection, and after taking them for 24 days, the lump practically disappeared. But when I visited my family physician, Donald Spencer, MD, in early August, we discovered the lump was growing back at an alarming rate—doubling in size about every three weeks. Dr. Spencer said it could be cancer and recommended a mammogram. So I made an appointment to see my ob-gyn, Michelle Quinn, MD, at Duke Women’s Health Associates in Chapel Hill, North Carolina, and Kelly Marcom, MD, an oncologist and head of the Hereditary Cancer Clinic at Duke University Medical Center.
Along with the mammogram, the doctors ordered an arsenal of tests, including an MRI, an ultrasound-guided biopsy, a CAT scan, and a PET scan. They also did genetic testing. We discovered I carry the BRCAI gene mutation, which makes me 60 to 80 percent more likely to get breast cancer. I’m also more likely to get ovarian cancer, as my mother died from the disease when she was 45. The BRCAI gene made everything more complicated. For starters, it meant my cancer would be more aggressive. And it turned out that the lump in my breast was a triple-negative tumor, which means it bears none of the common hormone markers of breast cancer and is more difficult to treat, as it is resistant to standard antihormonal therapies. Plus, during the PET scan—in which you drink a glucose solution that causes cancer cells to glow—my chest lit up like a Christmas tree. I had a tumor the size of a golf ball near my lungs and needed surgery to remove it. My prognosis wasn’t good. My husband and our two kids were devastated. My oncologist at Duke University Medical Center, Kimberly Blackwell, MD, an associate in medicine in the Division of Hematology-Oncology, recommended an aggressive action of treatment. But along with surgery, chemotherapy, and radiation, she suggested I check out the complementary therapies at Duke Integrative Medicine.
Kimberly Blackwell, MD: I always talk to my breast cancer patients about integrative therapies because in my experience, patients who use complementary therapies recover faster. The longer I take care of cancer patients, the more I realize how much support the body needs to fight this disease. The body is actually working harder than the chemotherapy or radiation. In traditional medicine, we just focus on killing the cancer. But complementary therapies also help patients recover from having cancer.
I urge all of my patients to feel empowered about their health and treatment options. Medical professionals don’t know everything—especially in regard to complementary therapies. Patients should do their own research and suggest new treatments to their doctors. A good doctor will be willing to explore additional treatments with you—in addition to the traditional ones, of course.
Maria Claudia: One month after my diagnosis, I started making appointments with the practitioners Dr. Blackwell suggested. Along with mind-body therapy, integrative nutrition, and hypnotherapy at Duke Integrative Medicine, I also decided to get acupuncture and biofeedback treatments through the University of North Carolina. I started all the treatments immediately; going to appointments and staying healthy became a full-time job. I’m an immunologist, and I’ve spent most of my career in research or consulting, though recently I’ve been working on a foundation I’m starting. I still worked on my foundation for a few hours every afternoon, but the bulk of my time was spent on treatments to help me beat this cancer.
The Duke Integrative staff told me it was their job to keep me alive and help me recover, but it was also their job to give me hope. As for me, I had to do everything I could to make my body as hostile an environment as possible for cancer. It was a bold new territory for me! My first mode of attack: an appointment with Jeanne van Gemert, a mind-body therapist at Duke Integrative who has a master’s degree in counseling psychology.
Jeanne van Gemert: Maria Claudia came to me—like many patients do—in a kind of chaotic storm. Dealing with cancer can call for emotional efficiency, so that’s what I tried to help her achieve. Mind-body therapy is about lining up the head, heart, and gut so the patient can make more informed decisions. A fast way to do that is through art therapy and mindfulness meditation techniques. Maria Claudia made drawings with her nondominant hand, which we analyzed together. I also asked her to think about everything that could go wrong with her cancer or surgery, put that anxiety in a box, and give it to someone else for safekeeping. With cancer, the most prevalent emotion patients feel is fear, so we use meditation to learn to neutralize and normalize that fear by stepping back from it and even befriending it a bit. We also worked on establishing and maintaining a positive attitude about the outcomes of various cancer treatments. Within a short time, Maria Claudia was confident that she was going to get through this.
Maria Claudia: These mind-body techniques have been excellent for me. As a newly diagnosed cancer patient, I tended to worry too much, so Jeanne’s exercises helped me quiet all that noise. When she told me I needed to give my box of anxiety to someone, it took me awhile to decide whom to give it to. But then I saw the head football coach at the University of Alabama, Nick Saban, doing a press conference. When someone asked him a question he didn’t like, he said, “I don’t have time for this BS,” and got up and left! I knew he was the guy to watch over my box of anxiety. I needed his level of emotional efficiency—I didn’t have any time for BS!
Next on my list of Duke Integrative sessions was a meeting with Beth Reardon, a registered dietician who specializes in using nutrition to promote health and healing.
Beth Reardon, RD: Breast cancer patients are typically put on a low-glycemic diet because high-sugar, processed foods lead to chronic inflammation—which cancer cells use to grow and multiply—while a low-glycemic diet that contains powerful anti-inflammatories, antioxidants, and immune boosters makes the body inhospitable to cancer cells. To her credit, Maria Claudia was already eating a remarkably healthful diet when I met her, so my role was just to tweak it and add cancer-fighting foods and supplements. Her new regime consisted of eating six to eight small meals a day—to keep her glucose levels steady—that included lots of vegetables, brown rice, quinoa, and sweet potatoes. All of these foods are powerful immune-system boosters and inhibit cancer cells from multiplying. I also recommended drinking green and white tea with sliced oranges, which enhance the bioavailability of the anticancer compounds in the tea.
As for supplements, here are some I often recommend for breast cancer patients: Co-Q10, an antioxidant that protects the heart • Milk thistle, which helps detox the liver • Melatonin, which promotes sleep, inhibits cancer-cell growth, and reduces toxicity from radiation therapy • L-carnitine, an amino acid that protects the heart from chemotherapy toxicity • Vitamin D, which boosts immunity and regulates cell growth • Mushrooms, another powerful immune-system booster • Vitamins E and C, two antioxidants that protect healthy cells • Flaxseeds, which decrease inflammation in the body.
Of course, patients should check with their doctors before taking any supplements, as some could interact badly with chemotherapy. Maria Claudia did her own research on supplements and really ran with it—she took most of these and a few additional ones each day.
Maria Claudia: This was an easy part of the program for me. I love to eat and cook, so I made it a point to make my own food every day. Tweaking my diet with Beth’s help felt like spring cleaning—I was doing an internal overhaul and becoming healthier. And even though taking that many pills each day seemed a little extreme at times, each one had a specific purpose, so I was happy to do it.
I was also happy to try hypnotherapy with Dr. Jeffrey Greeson of Duke Integrative, though I admit I was a bit skeptical at first. But when you’re in desperation mode, you’re open and willing to try anything your doctor suggests and hope for the best.
Jeffrey Greeson, PhD: I saw Maria Claudia five times in the two months between when she was diagnosed and when she started chemotherapy. She had both of her surgeries during that time, and we did several sessions that centered on those procedures. Hypnotherapy has been proven to decrease anxiety and pain before and after surgery, as well as limit the length of hospital stays and lower the amount of pain medication a patient requires. We had hour-long sessions and would record them for Maria Claudia to listen to on her own time—even during her surgeries. Having the CD to listen to gives patients repetitive suggestions about pain relief or heart rate stability or whatever they want to work on controlling.
My patients typically say they feel less anxious and stressed and much more in control after working with me, but after the surgeries Maria Claudia also took fewer pain medications and had less bruising at her incision sites. And then before her chemo started, we did a session on alleviating possible side effects such as sores in her mouth, hair loss, nausea, and fatigue. While she did lose her hair, she had very little nausea, her energy remained high, and she never lost her appetite. Her amazing results surprised not only me, but also many of her doctors.
Maria Claudia: One example of the profound effects of hypnotherapy happened about three months after my diagnosis, during thoracic surgery to remove the tumor in my chest. Dr. Greeson suggested I listen to my hypnotherapy sessions on my iPod during the surgery, and my surgeon was very open to the idea. This surgery was risky: They made an incision between two of my ribs, collapsed my lung, and inserted a video camera so they could get to the tumor behind my lung. It’s so serious they have a cardiac team in the room—just in case. Luckily, the tumor was benign and my breast cancer hadn’t metastasized.
After the surgery, I took pain medicine in the hospital. But once I left, I didn’t need it! I filled the prescription and then never used it. My doctors couldn’t believe I was in such great shape after my surgery. And when I had my lumpectomy three weeks later, I listened to the hypnotherapy sessions, and I didn’t need any pain medication at all. The difference in pain from other surgeries I’ve had was incredible.
During this time I was also getting acupuncture treatments with Dr. Wunian Chen at the Integrative Health Center of Chapel Hill.
Wunian Chen, MD, LAc: Acupuncture—inserting tiny needles into specific areas of the body to boost blood flow and energy to those spots to help relieve specific symptoms—is beneficial to cancer patients because it can help reduce stress and anxiety, improve overall well-being, relieve the pain associated with cancer or surgery, and reduce the side effects of chemotherapy, such as hot flashes and nausea. I saw Maria Claudia for about 10 sessions from October through December.
Maria Claudia: I know the principles of acupuncture, but I don’t really understand it. All I know is it made me feel better. I felt happier and had a clearer mind after our sessions. Also, before the treatments, I used to get upper-respiratory infections often, and since having acupuncture, I haven’t had any!
After three months of this intense schedule of complementary treatments, I started chemotherapy on December 23, 2008. I was scheduled for six three-week cycles of treatment. Chemo patients tend to have nausea the week of and the week after the treatment—usually the 10th day is the low point for the white blood cells. And then as soon as you start feeling better that third week, they hit you with chemotherapy again. Amazingly, I only had nausea on the day of treatment, and I’m convinced listening to chemotherapy-specific hypnotherapy sessions was a big reason why.
After the first round of chemotherapy, it was difficult to maintain my complementary treatment schedule. All things considered, I had a lot of energy. But keeping up with that many appointments wasn’t feasible. Plus, my doctors didn’t want me out and about so much, because the chemo made me more susceptible to illness. But those months of intense therapies before the chemo started really changed me. I followed all the integrative therapy doctors’ recommendations to the letter. Their exercises were my prescriptions to get better, so I did them every day.
Though I had to stop the other integrative treatments, I was able to do a few weeks of biofeedback sessions with Betty Wolfe, a certified practitioner at the UNC Medwell Biofeedback Clinic.
Betty Wolfe, biofeedback practitioner: Biofeedback is a way of monitoring physiological activity through muscle tension, heart rate, skin conductivity (sweating), and hand temperature. With the help of sensors, patients see their results in real time, and learn to control what their body is doing. This is especially helpful to cancer patients, as they learn how to modulate or reduce pain, anxiety, muscle tension, and gastrointestinal issues.
In my sessions with Maria Claudia, we worked on her posture, breathing, and the tension she holds in her head, face, and shoulders. The goal was to make her body work as efficiently as possible. We also talked about the importance of exercise. Research has shown that it has a profound effect on the brain. She had an incredibly positive outlook and was diligent about listening to relaxation CDs and exercising at home each day.
Maria Claudia: Biofeedback was the most enlightening treatment for me. I could see the real-time data of how stress was affecting me, so I was able to learn to manage it better. I also relearned how to breathe—I was a shallow breather—improved my posture, and rediscovered an overall awareness of my body.
My alternative practitioners were amazing, but I also had a great support team at home. My husband, Michael, and my children, Ashley, 23, and Michael, 22, were devastated in the beginning. But I told them, “We’re going to fight this, and we are going to win as a team.” They were fantastic—they dropped everything to take me to appointments and were very helpful around the house—and I think it encouraged them to see me fight. My other relatives, friends, and neighbors were also really supportive by bringing us meals and assisting in any way they could. I think all that support and encouragement helped me recover faster.
My breast cancer was declared in remission on May 27, 2009—just over eight months after diagnosis. I was taught through all these therapies to make up my mind that I wanted to be cured. And that’s what I did.
To celebrate, my husband, my children and I went to the North Carolina mountains. And I threw a big party—I’m half Spanish and half Italian, so I’ll use any excuse to party! I needed a break from all the treatments and hospitals—something to help me relax and then shock me back into life. I’ve always loved noise and chaos, but now I love them even more. A new world has opened to me.
My life has completely changed since starting integrative therapies. Looking back, I realize that I didn’t sleep enough—I had so much to do that sleeping more than three or fours hours a night was just an inconvenience. I was gaining weight, and I didn’t handle stress as well as I thought. I just ignored it. But now, I’ve learned how to eat better, sleep better, breathe properly—I’ve even lost 20 pounds! Don’t get me wrong—it has been a difficult journey. But it has been an amazing one. I am more enlightened now.
At first, I was skeptical about trying all these therapies. I thought all this integrative medicine stuff was fluff and not as effective as treatments. But I realize now that cancer patients need conventional medicine and alternative therapies to beat this disease—I’m living proof.
At the time of publication, Maria Claudia had just begun radiation treatments and was scheduled to have surgery to remove her ovaries—which reduces estrogen and progesterone in the body, thus lowering the chances of a breast cancer recurrence—in October. She’s using integrative therapies to prepare her body and mind for both procedures.