Dr. Roseanne Gichuru and Dr. Monique Gary joined us to discuss the topic of body image challenges during and after cancer treatment. These are their answers to your follow-up questions:

“Do doctors still shy away from estrogen based creams for the dryness? My understanding is that the estrogen is not systemically absorbed. So we should be able to use these.”

From a generalist position, vaginal estrogen is ok for patients on tamoxifen. For women on AI, the decision to use is based on a discussion between the patient and care team  oncology/breast surgeon etc. Breast data shows it may be used as a last resort.

“I have a lot of concerns about loss of feeling and sensation with mastectomy. Can you comment on this?”

Loss of sensation is quite common post mastectomy. Studies show numbness or loss of sensation is more likely to decrease the further out from surgery one is and as nerve tissue regenerates. However, it may not fully return to pre surgery levels.

“Is breast reconstruction not recommended for someone that has Stage 4 Breast Cancer? If not, what do you recommend for breast that is sagging and shrinking in bra size?”

There is mixed data on reconstruction for stage 4. This maybe determined on a patient  by patient basis. Getting resized for bras is a good place to start. These services are offered at many department stores for free. Using cupped bras and or mastectomy bras may also be helpful.

“Advice for preparing for mastectomy mentally and emotionally? Preparing for loss of feeling, the big change, etc.”

Briefly – optimizing mental and emotional health, finding or aggregating a support team.  Physical exercise and PT will help.

“When on hormonal therapy (Tamoxifen & Lupron) that will eventually go to an AI, how do you get your libido and sexual desire back?”

Recognize that sexual wellness is multifaceted so managing mental, physical, nutrition, rest, hydration, etc then start to think about what used to turn you on and start a plan to get back to that. Sometimes low confidence interferes with libido too.

Engage the partner in the journey as well. Just as the woman is navigating this stage, so is the partner. It is a time of exploration and discovery for both parties.

“What if your surgeon and you don’t see eye to eye on where scars will be? I don’t feel like my doctors listen to me and what I want for my body and focus too much on the medical side only.”

A candid conversation with the surgical team regarding your concerns is a good place to start. Writing down your questions/concerns beforehand and taking a friend with you to the appointment is helpful. Discussing the anticipated consequences of your concerns is also  an important part of the conversation with the team. This conversation may need to happen over several appointments.

“I would like information on side effects or risks for having my implants removed?  I had a second surgery for capsular contraction but it came right back.  This is my second time with breast cancer so I had prior radiation. I am so uncomfortable all the time.”

Risks – bleeding, infection, risks associated with receiving anesthesia, seroma and hematoma formation, return to OR for additional surgery, pain, numbness, increased scarring, poor healing and cosmesis, and changes in cup size.

Watch the full video April Virtual Hangout: Navigating Body Image Challenge and Cancer at uniteforher.com/herlibrary

As the temperatures climb, it’s crucial to find ways to stay cool and nourished during the scorching late-summer months. Focusing on nutrition year-round aids in maintaining overall health, managing treatment-related side effects, and supporting the body’s everyday processes. These refreshing tips will help you beat the heat, while staying healthy and cool – all summer long!

Hydration is Key:

Start by keeping your body hydrated. Staying hydrated not only keeps us feeling our best, but it also helps to alleviate potential side effects of treatments, like fatigue and dry mouth. Not the biggest water fan? Try infusing your water with slices of cucumber or citrus fruits.

Herbal Infusions:

Experiment with herbal infusions like hibiscus, chamomile, or lemongrass tea. These caffeine-free beverages offer soothing properties and can be enjoyed hot or cold.

Embrace Fresh Fruits:

Indulge in a variety of fresh, seasonal fruits abundant during the summer. Options with high water content, like watermelon, cantaloupe, and berries not only hydrate but also provide essential vitamins, minerals, and antioxidants. Their natural sweetness can give a juicy twist to your favorite summer dish.

Balanced Snacking:

Opt for pairings of protein and carbohydrates – like seed butter with sliced fruits, hummus with cucumber or carrot sticks, or a crunchy trail mix. These snacks keep energy levels stable and provide essential nutrients.

Cool Off with Cucumber:

Cucumbers are a quintessential summer vegetable, known for their high-water content and refreshing crunch. Enjoy them as crunchy snacks, in salads, or blend them into cooling gazpacho soups for a hydrating and delicious option. 

Stay Minty Fresh:

Fresh mint leaves can add a burst of flavor to your dishes and beverages. Infuse water with mint and lime for a zesty twist or use it as a garnish for salads and fruit bowls. Mint also aids digestion and can soothe GI discomfort.

Snack on Parfaits:

Yogurt parfaits layered with fruits, nuts, and a drizzle of raw honey offer a delightful and protein-packed summer treat. Yogurt’s probiotics can support gut health, making parfaits a cool, tasty snack with an added nutrition kick.

Enjoy an Icy Treat:

Create refreshing homemade popsicles using pureed fruits and coconut water. These sweet treats can be tailored to your flavor preferences and nutritional needs, making them a fun and cooling way to stay nourished.

Try Chilled Soups:

Explore the flavors of chilled soups like gazpacho or cucumber soup, which provide a burst of flavors and nutrients without adding heat to your body. These soups can be easy to prepare, making them a convenient option when in a pinch.

As you embark on your summer adventures, don’t hesitate to experiment with new and seasonal flavor combinations, infusions, and recipes. Whether you’re lounging by the poolside, picnicking in the park, or simply enjoying the breeze on your balcony – stay cool, stay refreshed, and most importantly, stay nourished!

By: Aubrey Redd, MS, RDN, LDN

If you are one of the many cancer patients who report feeling fatigued, you’re not alone. According to the National Cancer Institute, it is the most common side effect of cancer treatment with 80% of patients reporting fatigue while receiving chemotherapy or radiation.

What’s the difference between general fatigue and cancer-related fatigue (CRF)? CRF is not improved with rest or sleep. And while it usually improves after treatment is completed (for those not requiring ongoing treatment), for others it may continue for months or years.

While a person’s cancer treatment is usually the biggest reason someone experiences CRF, there are other factors that could contribute. These include hydration status, anemia, nutritional deficiencies, anxiety, depression, not sleeping well and certain medications.

How do you know if dehydration is affecting how you feel? Try doing a self-check:

• Do you have dry mouth, lips or gums?
• Are you feeling thirsty?
• Has it been several hours since you last urinated?
• Do you notice dark-colored urine when you visit the bathroom?
• Do you feel light-headed or faint?

If you answered yes to any of these questions, you may want to start sipping! Try these tips…

Start with the Sunrise

After several hours of sleep, the body needs rehydrating. Keep a glass/bottle at your bedside to begin sipping as soon as you wake.

Add your Favorite Flavors

Water is our best hydrator, but sometimes it needs a little something. Try adding fresh ginger, mint, cucumber slices, berries, or a splash of juice to your glass or pitcher. Consider even reaching for sparkling water for something different!

Try Filtered or Alkaline

If you’re experiencing taste changes, consider using a filtered water pitcher or faucet filter. It may improve the taste by removing chlorine and other minerals.

In addition, we know that foods/beverages do not change the body’s pH (it’s tightly regulated by an acid-base system that includes the kidneys and lungs). However, this subtle shift in pH may make water more palatable.

Invest in a Reusable Bottle or Cup with a Straw

Out of sight – out of mind. If you need a reminder to sip, keep a bottle nearby as a visual cue. Or you could try drinking from a cup with a straw as this usually leads to swallowing larger volumes because you’re sipping for longer.

Think Outside the Box

Many foods and beverages contribute to hydration. This includes: coconut water, smoothies, milk, tea, coffee*, soup/broth, and high water content foods like cucumber, watermelon, tomatoes, greens, strawberries, bell peppers, and grapes.

*Some daily caffeine is OK, but excessive intake can cause increased urination making it more difficult to keep the body hydrated. 

Fill a Pitcher

Do you have a large pitcher that meets your daily hydration goal? Consider filling it each morning and use it to refill your glass/bottle.

Track your Progress

Download a free hydration app to record your daily hydration progress. You can even set alarms to remind you when to sip!

Erin Pellegrin, RD, LDN

Sources:

https://www.cancer.gov/about-cancer/treatment/side-effects/fatigue/fatigue-hp-pdq

https://www.eatingwell.com/article/8045761/dehydration-and-fatigue/

https://www.cancercenter.com/community/blog/2020/06/staying-hydrated

https://www.aicr.org/news/strategies-to-improve-cancer-related-fatigue-symptoms/

When it comes to living a healthy lifestyle, a little planning goes a long way! Meal planning and preparation can save you time, money, and stress, while decrease food waste and minimize those last minute, “What should I eat!?” moments. From choosing weekly menus to prepping ingredients and keeping the freezer stocked, here are a few tips and tricks to help you feel prepared for a week of healthy eating! 

 
Plan Your Weekly Meals: This can be as simple as setting a schedule of meals for the week or choosing a few main ingredients that you would like to use during week. Shopping for specific recipes is a great way to save time and money. 

 
Pre-Cut Ingredients: Instead of simply putting your groceries away, take some time to wash and prep certain food items. Fruits and vegetables can be pre-cut for easy snacking or use in recipes. Staple items like carrots, celery, and onion can be diced for use in soups, salads, or side dishes. 

Cook Ahead: Set aside thirty minutes each week to cook a batch of rice, quinoa, or beans that you can use during the week. The same goes for vegetables. Having cooked vegetables on hand for use at breakfast, lunch, and dinner is a great way to sneak vegetables into each meal.  

DIY Salad Dressing: Making your own salad dressing is as easy as olive oil, vinegar, and a touch of mustard shaken together in your favorite jar! Most store-bought salad dressings have added sugar and sodium so the simple swap of making this on your own is great for your overall health! 

 
Pre-package Snacks: Even snacks can be planned and prepped!  Healthy snack options can be pre-portioned and stashed in all the right places such as your bag, car, and pantry.  Nuts, trail mix, dried fruit, and healthy muffins are great for on the go! 

Click here for some easy ways to get started! 

Great recipes for your menu planning toolbox: 

Egg Muffins  

Turkey Tortilla Soup 

Farro and Broccoli Salad 

By: Michele DiCristofaro MS, RD, LDN 

It’s Pantry Purge Time!

When I open my pantry and am immediately met with chaos, I know it’s time for a refresh. Once a year (usually during my household “spring cleaning”) I’ll dive in and do a full clean out/reorganization. A tidy pantry not only means less stress, but it also saves you time, money, and energy. You can even use your pantry purge as an opportunity to replace ultra-processed processed foods with more wholesome alternatives or try your own DIY version! 

How to Stock Your Pantry

Take it all out!

Yes, take every single item out of your pantry. Then, give it a thorough look over, check for things that may have gone bad, and decide what stays/what goes. For unopened items you want to get rid of, but are still good, consider donating to your local food pantry.

Get Rid of Old/Expired Items
Most dry spices stay good for up to a year. As they age, their flavor and healthful properties become less potent. So, if you have spices older than a year, you may just have to use more than called for in a recipe to get the same flavor.

 Oils may turn rancid, so be sure to check the expiration date and give it a good sniff. Nuts, seeds, and grains can also turn rancid and can be detected by taste and smell. The best storage place for these foods is in your fridge or freezer.

Sanitize Your Pantry
Once all old items are removed, wipe down the shelves by filling a spray bottle with a 3-parts water: 1 part distilled vinegar solution or other non-toxic cleaner.

Store, Label and Date
While your items are removed from the pantry, take this time to store them properly. Keep items like flours, pastas, and grains in airtight storage containers. You can even use smaller mason jars or pyrex containers for spices and dried herbs. Be sure to label and date each item as you restock and anytime you buy new items.

Organize

Organize your pantry items in a way that makes sense to you. There is no one best way as we are all different cooks and have different needs. For items you reach for regularly, consider keeping them at eye level for easy grab and go. You can even label your shelves, so you remember what is stored where.

TIPS:

• For smaller items like spices, consider alphabetizing for quick finding!
• As you make your shopping list, always take a quick pantry inventory. This prevents buying what you don’t need and decreases food waste.
•  Keep a pantry inventory list to know what you have and what you need. It can even provide meal inspiration as you’re planning your next delicious dish!

Finally, be diligent about keeping things organized for the long-haul. This includes keeping newly stocked items in the back and moving up older items to be used first – first in, first out.

By: Erin Pellegrin RD, LDN

Every day we talk with our members about the benefit of adding more fruits and veggies to our meals and snacks. Well, for the same reasons, those healthy additions can also serve our furry friends! So don’t just slice up those carrots or apples for Fido, try whipping up a batch of these homemade treats and your four-legged friend will thank you!

Equipment needed:

• Medium sized bowl
• Mixing spoon
• Cookie scoop or 2 kitchen spoons
• Baking sheet
• Parchment
• Cooking rack

Ingredients:

• 1 C of all-purpose, brown rice, or gluten free flour
• 1 C of grated carrots
• 1 egg
• ½ C of unsweetened apple sauce

Directions:

1. Line baking sheet with parchment paper. Preheat oven 350°F.
2. Mix all ingredients together until dough forms. If dough is very sticky, add a bit more flour, 1 tablespoon at a time.
3. Using a cookie scoop or 2 spoons, spoon small dollops of dough onto parchment sheet. Then press dough down gently to flatten a bit.
4. Bake until golden brown (15-18 minutes) and let cool on a wire rack.

OPTIONAL: ½ tsp of salt can be added to these treats to help extend the shelf life.

How many times have you stared at the date stamped on your can of beans or package of rice and wondered, “What does ‘best by’ mean and do my beans know it’s 29 days past this date?!”   Well, this happens to me often and I end up tossing food that is actually safe to eat.  Turns out, these dates are not as scary as they seem!  

We typically see 3 types of dates stamped on our food products: 

1. Best if Used By/Before 
2. Use By 
3. Sell By  

Interestingly, these labels don’t have anything to do with the safety of the food (free of food-borne pathogens such as bacteria or viruses), but instead with the quality of the food.  Dates are not federally regulated. They are simply recommendations given by food manufacturers to indicate that the product will look, taste, and smell as intended.  

So, what do these labels mean? 

Best if used by/before: 

This date indicates that the product will look, taste, and smell as it should if used by the date stamped on the package.  If it is used after this date, the product may not be up to the manufacturer’s best standards.  It does not mean the food has spoiled or is not safe to consume. 

Use by: 

This date is very similar to the “best if used by/before” label. However, this label indicates that the food product’s quality may decline quickly, and the safety may be lessened after the date stamped on the package.  This is typical for acidic foods such as canned tomatoes or fruit.  For example, a can of beans may say “Best by 2/22/24” and a can of diced tomatoes may say “Use by 2/22/24”.  In this case, because of the acidic tomatoes, they should be consumed soon after, if not by, the date stamped on the label.  The beans, as long as they have not been opened and have been stored in a cool, dry place with no damage to the can, will most likely last longer than the date stamped on the label.   

Sell by: 

This date is provided by the store and usually pertains to meat and dairy items.  It lets a store know how long a product has been sitting on the shelf.  After that “sell by” date has passed, the store will pull it from the shelf.  It does not mean that it is unsafe to eat after the “sell by” date.  

What should we be concerned about?  

We should be concerned about how to store pantry items once we get them home.  Cans and packages that are left sealed in their original packaging can last well beyond their “best by” date and be safely eaten.  Once opened, it’s a whole different ball game!  Canned goods that have been opened should be transferred to an airtight container and stored in the refrigerator no longer than 3 – 5 days.  Keep in mind that this pertains to non-animal products such as grains or beans.  Animal products like tuna or condensed milk, should be kept in the refrigerator for only 1-2 days.  

Other pantry items such as flours, grains, dried beans, nuts, and seeds that have been opened should be stored in an airtight container and kept in a cool, dry place.  If these products are put back into their original packaging and not sealed properly, they may not make it to their “best by” or “use by” date.  

Another important thing to keep in mind are foods rich in natural oils such as nuts and seeds.  These wonderful oils can go rancid if stored for too long – especially if the product is ground into a meal or flour.  Take flax, for example. Whole flax seeds can be stored according to their “best by” or “use by” date, but once the seed is broke open and the natural oils are exposed to oxygen, it can then turn rancid.  Because of this, it may be best to store nuts and seeds in the refrigerator if they will not be consumed within a few months.  The same goes for grains.  If you are not getting through that 5 lb. bag of whole grain rice you bought in a few months, best to store it in the refrigerator or freezer so it will last longer.  No need to worry about the taste once it’s cooked – it will be just fine! 

These tips should make you feel a little more comfortable about consuming canned or packaged foods that have been lingering in your pantry.  Plus, a bonus – this helps us reduce food waste.  So next time you see a good sale, stock up!  Remember, pantry staples are the key to putting together some of the most healthy and nutritious meals. 

For more information, check out the links below to learn more about food product dating and great ways to store pantry staples. 

By: Michele DiCristofaro, MS, RD, LDN 

Sources: 
What do the dates on food labels actually mean? 
Food Product Dating 
How to Store Nuts and Seeds 
Storing Whole Grains 
Shelf Stable Food Safety 
Store It 

Sustainability is the concept of promoting a thriving, healthful future for what’s ahead. As the Nutrition Team, we often refer to our lifestyle choices as ones that we want to make “sustainable.” We want to promote the ultimate goal of finding a lifestyle pattern that supports a healthy and realistic future for you. Sustainability is such a broad topic, though – and it can refer to things like infrastructure, the environment, and even our kitchens! 

So, what does “kitchen sustainability” mean, and why is it something to consider? Kitchen sustainability is the practice of taking steps to make your kitchen more environmentally friendly. Our everyday choices impact our Earth and ecosystems, including the foods we choose to eat, and the water we drink. By taking a few simple steps towards sustainability in your kitchen, you can help to keep our Earth healthy – one meal at a time! 

Use Energy-Saving Cooking Techniques 

Skip Preheating! Most ovens nowadays preheat quickly, so there isn’t much merit to waiting for it to fully preheat. Instead of waiting for your oven to reach its final temperature, try placing your items in a bit earlier. 

Maximize Your Oven Space. If you need to use your oven for multiple items, put them all in at the same time. Meet in the middle with your temperature requirements and keep an eye on what you’re cooking! 

Give Pressure-Cooking a Try. This time-saving technique can help decrease your cooking time and get dinner on your plate in a flash! Use an Instant Pot or traditional pressure cooker to make recipes that you might otherwise cook in a slow cooker for hours. 

Buy Local Ingredients and Cook from Scratch 

When you buy food locally, you’re supporting local agriculture and small farming businesses. You’re also decreasing the “food miles” traveled by your goods and emitting less fossil fuels in the process. Now that you’ve got your local ingredients, you can cook from scratch! When you cook from scratch, you’re decreasing the amount of packaging waste found in traditional single-use meals. 

Shop in Bulk to Reduce Packaging Waste 

Buying food in larger quantities means less packaging in the end. Think about it – if you bought 1 10lb. bag of beans instead of 10 1lb. bags, you’d be saving a ton of packaging overall. You can even shop from local stores that have bulk bins, where you can scoop products into your own container to take waste reduction a step further! When you shop, try to use your own bags and containers whenever it’s available. Decrease plastic waste at the checkout, in the produce aisle, and around the bulk bins! 

Recycle and Compost 

We’ve all heard it before – “reduce, reuse, recycle.” Now, add composting to the mix! Composting is another way to eliminate food waste by turning it into usable soil for the future. Nourish your veggie garden with some homemade compost next season! Make sure to also keep a recycle bin readily available in your kitchen and be cautious of what you throw in there. Sort your recycling as needed and bring it to the appropriate facility to make sure that it’s given the new life it deserves! 

Upgrade Appliances and Cookware 

As your appliances reach their bitter end, think about upgrading with energy efficient Energy-star certified appliances. These reduce overall energy usage, and can lower your bills, too! You can also invest in long-lasting cookware, like stainless steel pots and pans. With proper care, these can outlast many other pots and pans – meaning you don’t have to replace them as often and are, therefore, creating less waste! 

By: Aubrey Redd, MS, RDN, LDN