Motivate Yourself to Eat Right!

Motivate Yourself to Eat RightI’m very excited to offer you a wonderful guest post by Dr. Ellen Albertson, PhD, RDN, CD about how to motivate yourself to eat right. Dr. Ellen is the founder of SmashYourScale.com and the author of The Diabetic and The Dietitian: How to Help Your Husband Defeat Diabetes…Without Losing Your Mind or Marriage!

Motivate Yourself to Eat Right – part one

by Dr. Ellen Albertson, PhD, RDN, CD

Eating right is challenging. I know. I’m a food psychologist. I’ve heard every excuse imaginable: “I don’t buy produce because it spoils,” “Healthy food is expensive,” “I can’t stop snacking at night,” “My spouse is a junk food junkie,” “I have to keep chips in the house… for the kids.” Hmm, if you say so…

Motivation is the key to empowerment and eating right

In 20 years of practice, I’ve discovered the key to eating right and defeating the unhealthy obstacles in your path is increasing your motivation. Boosting your motivation will empower you to ditch the excuse mindset and develop healthy new habits.

Motivation — the desire to act in a purposeful manner to achieve specific desires — is what you need to succeed. From getting in shape and losing weight, to swapping the 500 calorie Mocha Frappuccino for a healthy green smoothie, motivation is the driving force needed to attain goals. Fortunately, while the amount of motivation we have varies by person and situation, research shows that you can influence and increase your level of motivation.

External motivation virus internal motivation

First it’s important to understand the two broad types of motivation: extrinsic (external) and intrinsic (internal). Extrinsic motivation comes from outside and refers to doing an activity to earn a reward or avoid punishment. It’s the “carrot and stick” mentality that we typically associate with motivation.

In contrast, intrinsic motivation comes from within. It’s driven by interest and enjoyment, performing an activity for its own sake rather than for some external outcome or reward. With intrinsic motivation, you’re not improving your diet because you have to, others are making you do it or you feel bad about yourself. You’re eating right because it’s important to you and you value being healthy.

Here’s the surprising truth about motivation. While we tend to think the “carrot and stick” approach is better at influencing behavior, engaging in an activity because it interests, challenges and actualizes you is a much more powerful motivator. Fearing punishment may motivate you to see a nutritionist after the doctor threatens, “Lower your cholesterol or else!” It may even compel you to purchase a gym membership or give up ice cream to look good on the beach. But alas, research clearly shows that being motivated by external factors doesn’t last for long.

Intrinsic motivation is long lasting

According to Daniel Pink, author of Drive: The Surprising Truth About What Motivates Us, the three elements that truly motivate us are autonomy, mastery and purpose. What will inspire you to forgo the fast food drive through and choose healthy eating consistently is the desire to direct your life (autonomy), the drive to get better and better at what matters to you (mastery) and the longing to be in service of something larger than yourself (purpose).

Focus on inner motivation and building autonomy, mastery and purpose and before you know it you’ll have forgotten your past struggles with food and will be able to stick with a healthy diet because it’s not a diet anymore… it’s how you, a healthy and happy person, want to eat. Eating right is no longer a goal… it’s who you are.

In part two of this series, I’ll provide three specific powerful, yet simple things you can do to increase your motivation to eat right.

Dr. Ellen Albertson, PhD, RDN, CD is a Psychologist, Registered Dietitian Nutritionist and Certified Wellcoach. Dr. Ellen is the founder of SmashYourScale.com and the author of The Diabetic and The Dietitian: How to Help Your Husband Defeat Diabetes…Without Losing Your Mind or Marriage! 

Feeling Stressed at the Holidays?

angry and stressedHow many times in the last few weeks has someone said to you “I’m totally stressed out.” They then proceed, in a jumble of words, with a recitation of all the things they have to do, all the things they think they have to do, and everything else that’s on their mind.

When you then throw breast cancer into the mix, you may find that you feel depressed, overwhelmed or at a loss for what to do in order to calm yourself and your emotions.

Everyone feels stress

Everyone feels stress at this time of year (and some feel it all year long.)

Some types of stress are “good”. Welcoming a new infant into your family. Getting a new job.

Other types of stress are “bad”. Losing a parent. Being diagnosed with a chronic and serious disease. Feeling like you are alone and don’t have a family or friends to support you.

What to do?

First, sit down with your morning cup of tea or coffee and think about your life and your feelings.

Second, make a list of everything you have to do. Prioritize the list. Eliminate things that are not essential. Make a plan for how your day will go.

Third, think about a happy time in your life. Close your eyes and bring up a picture in your mind of how you felt, where you were, who was with you, what is the memory you cherish the most

Fourth, take a brief walk outside and take a series of deep breaths. I know you have a lot to do, but you need to give yourself a break periodically throughout the day.

Fifth, make sure you get enough sleep. After a busy day, your body and your brain need time to recover.

Stress can impact your health

Stress is a risk factor with a documented impact on your neuro-endocrine and immune system. Numerous studies have shown a physical impact on your health.

Remember that you are strong and you can handle anything that comes your way.

To learn more, click here

 

Happy Holidays!

Gingerbread House

 

I hope you had a good Thanksgiving and were able to share your life with family and friends. Once the weekend is over and everyone goes back to their jobs and their regular life. It’ s time to put up the tree, get out the menorah, or whatever decorations and traditions you follow. It is typically a happy time of year to celebrate. You might make a gingerbread house, a snowman or snow fort if you are lucky enough to have an early snow fall. If you live near a hill, you might even get to do some sledding.

 

 

 

 

A small break with tradition

MINI CONTEST:

Guess who cooked Thanksgiving Dinner this year?

I. A professional chef we hired for the occasion

II. My husband, took over preparation of the entire meal

III. My mother, grandmother, aunt, sister, brother or other friend

IV. Fill in your best/wildest guess and receive recognition for your practice/business in a blog post that will announce the winners including one link to your home page, click here to send an email with your contest entry. Note: Decision of the judges will be final and other rules may apply.

Deadline to enter is Friday, December 21, 2018 by 12:00 Noon Eastern Time.

 

On to the rest of the holidays!

I hope you get some time off throughout the holiday season to enjoy the pleasure of spending time with your family and friends. With all the turmoil we face around the world, this is a good time to pause and think about all the good things that have happened this year.

 

Peace on Earth

Water is essential to life

Waterfall in India

When you are being treated for breast cancer, one challenge you may face is finding a way to stay hydrated at a time when plain water may not taste good to you.*

Water is essential to life

As adults our bodies are approximately 60% water. It is a major part of nearly everything in our body and we cannot survive for long if we are not getting enough water every day.

Water regulates our body temperature so we don’t get overheated. It helps metabolize and transport nutrients we get from our food throughout the bloodstream. It also flushes waste out of our system, primarily through urination.

Water lubricates our joints and helps protect them. It is a main component of saliva which keeps our mouth moist. Saliva, along with chewing, starts the process of breaking down the starches in our diet.

Most adult women need between 8-10 glasses under normal circumstances. The recommended adequate intake (AI) of water is about 9 cups per day for women and 13-15 cups per day for men.

*Be sure to check with your doctor first, to make sure there are no  restrictions on your fluid intake. 

Do you need another reason to eat fruit and veggies?

Many fruits and vegetables contain a lot of water and it has been estimated that many contain 70-90% water by weight. For example, the water content of raw baby carrots or cooked frozen carrots is 90%, a peeled apple is 63% and an unpeeled apple is 81%, by weight.

How do fruits and vegetable help?  In addition to all the vitamins, minerals and phytonutrients they provide, they also help you stay hydrated due to their high water content.

Here are some other beverage ideas to try

Homemade flavored waters such as water with lemon, water with oranges and mint (skip the mint if you have acid reflux), “green water” (water with parsley, cucumbers and other greens), basil and strawberry cooler, cranberry juice with seltzer, apple juice and seltzer.

Other choices to try include hot tea, decaffeinated hot tea, iced tea, decaffeinated iced tea, ginger tea, cardamom tea, herbal tea, green tea, decaffeinated green tea, low sodium broth, homemade soup, lowfat milk, whole milk (if you need to gain weight), almond milk, rice milk, cashew milk, and coconut water (can have a laxative effect).

If none of those beverages help, drink sodas, diet sodas, fruit juices such as apple juice. While these are not the healthiest choices due to their high sugar content and other artificial ingredients, you need to stay hydrated. These choices are better than allowing yourself to become dehydrated because you “don’t want to eat anything unhealthy.”

Caffeine can be a diuretic and often contributes to acid reflux and heartburn

You may have also noticed that I have not put coffee on the list of beverage ideas. That is because coffee often contributes to acid reflux and heartburn. Coffee may also have a diuretic effect (due to the caffeine, how much coffee you drink, and other factors in your diet).  As a result, drinking a lot of coffee will most likely be counterproductive to your efforts to stay hydrated.

 

 

Stop Drinks

Sometimes Drinks

My chemo t-shirt

My Chemo Shirt

I like to wear my chemo t-shirt every time I have some sort of treatment. I’ve had it for over 10 years and can’t even remember where it came from in the first place.

The thing that makes it so ideal for treatment days, is the comfort it provides to my body and soul. It’s not a pretty shirt, but it’s MY chemo shirt. It provides me with a small feeling of comfort whenever I put it on.

The cotton is soft from many years of frequent washing, and so far, the color has never faded. It’s a rather ugly green gray with silver and light green paint splatters across it’s front. It has a relatively low neckline which comes in handy when the nurse needs to access my port. My port has been proudly perched on my chest wall where it was installed a number of years ago. It’s been there so long that I can no longer remember when I got it, and I don’t even think about it anymore.

I don’t know how many days of treatment I’ve had at this point, but it’s definitely more than 30. I don’t really keep count anymore. I’ve done it so many times that it no longer unnerves me the way it used to. It’s just part of what I do.

When you have chronic breast cancer, your treatment and maintenance treatment never ends. unless you go so thoroughly into remission that you can’t remember what life felt like when you had active breast cancer.

I save my chemo t-shirt for chemo days

I NEVER wear my chemo t- shirt on days that I am not getting treatment. Being a creature of habit, it makes me happy whenever I wear it to my appointments. It reminds me how far I’ve come.

Comfort on chemo days and other treatment days is an important part of your self-care.   I dress casually, in my chemo t-shirt of course, and wear sneakers or other comfortable shoes with comfortable thick socks, Since infusion rooms, and hospitals are usually chilly, I always wear a sweater or polar fleece jacket with a front zipper that is easy to access and is in a dark color. That way I never have to worry about ruining my favorite white shirt in case something spills.

Things I always bring

Like many people, I am a creature of habit. I always wear my t-shirt, eat a good breakfast with some protein, order the same lunch, and bring some of my favorite healthy snacks that I rotate through my appointments.  Every time I have an appointment, I also park in the same place, bring something good to read or listen to, and prepare for a small nap during my treatment. I bring noise blocking headphones which I wear to shut out the noise in the room. I don’t usually bring eyeshades, but I’ve seen others bring them to shut out the light when they want to take a nap.

By following my routine, I am refreshed when it is time to head home. When I get home, I have a mild casserole ready to go in my refrigerator so I don’t have to cook. I just remove the foil and reheat. While it’s in the oven, I put my pjs on and turn on the evening news to see what I missed while I was away for the afternoon.

Flying with Breast Cancer

Barbara in Dubai with compression sleeve

At some point in your breast cancer journey, you will probably have the occasion to take a flight for business, vacation, family travel or some other reason. Your should discuss it with your doctor to make sure you are cleared for takeoff, and ask about your risk of developing lymphedema. I’m fortunate that I’ve never had a problem and have flown many times throughout my breast cancer journey.

If you’ve had lymph nodes removed from one of your arms during your breast surgery, you are at risk for developing lymphedema both on the ground and when you fly. Lymphedema is less common today than it was in the past,  but it is still a risk you need to consider.  Make sure you discuss it with your doctor.

What is lymphedema?

Lymphedema is an accumulation of fluid in your arm (or another part of your body) and causes edema, or swelling that can be very painful and uncomfortable. Your doctor may prescribe a lymphedema compression sleeve and glove, which helps keep the fluid from accumulating.

I’ve had a lymphedema sleeve and glove since my original surgery nearly 14 years ago.   When I first got them, I was extremely careful to use them each and every time I flew. Now, if it’s a short flight,  I often leave off the glove. When I go international, I wear both the sleeve and the glove. It’s just part of my equipment whenever I pack for a trip.

Ways to help prevent lymphedema

Another way you can help prevent developing lymphedema is to never allow anyone  to take blood or place a blood pressure cuff on your “at risk” arm.  If you have a week with a particularly large number of doctors visits and blood tests, this can cause discomfort in your arm where the lymph nodes are intact. It can also come into play if you need to have an imaging test such as an MRI or CT Scan with contrast. Contrast is often administered via an intravenous infusion (IV), which also goes through the same arm.

A healthy diet may help

I usually recommend a low sodium diet for breast cancer patients at risk of lymphedema, although there isn’t definitive research to support this recommendation. Following a lower sodium diet is generally part of a heart healthy eating plan, lymphedema notwithstanding. So unless your doctor tells you something to the contrary, try to reduce your salt intake by avoiding processed foods, commercially canned soups, salty deli meats and pickles.

Being overweight or obese puts you at higher risk

There is research that associates a higher risk of developing lymphedema if you are obese or overweight. Eating healthy, well balanced meals, participating in physical activity and following a sensible weight loss plan if you need to lose some pounds, will help you with your overall health. Maintaining a healthy body weight will also help reduce your risk of developing breast cancer, high blood pressure and can help if you have diabetes.

Other advice I’ve received in the past is to avoid heavy lifting with your “at risk” arm and always carry your handbag on the side where your lymph nodes are still intact. While an inconvenience when you are early in your post-surgical recovery, at this point I hardly ever think of lymphedema risk, unless I’m on a plane. I also have to admit, that I sometimes forget to wear my sleeve and glove when I’m on a short flight. Nobody’s perfect all the time!

Call your doctor if you start to develop symptoms

If you start to experience lymphedema symptoms, call your doctor immediately. Your doctor can help guide you with getting it under control. There are physical therapists and lymphedema therapists who are specially trained to help reduce lymphedema using massage, exercises and wrapping techniques. Don’t wait to get this started. Once you’ve had lymphedema for a few weeks or months, it becomes increasingly difficult to treat.

I’m lucky that I’ve not personally experienced lymphedema. At this point my doctors allow me to do all my normal activities with no limitations. Right after your surgery you have to be extra careful until your body has healed. It becomes less of a concern,  as the years go by, depending on how many lymph nodes were removed.

I’m still careful about needles and blood pressure cuffs on my “at risk” arm.  In the meantime, I’ll keep wearing my sleeve and glove on long plane rides, follow a healthy diet and exercise daily. I’d rather prevent a problem that I don’t currently have, then try to fix it later.  It’s just one more small part of my self-care plan to remain strong and resilient.

Don’t let breast cancer kill your dreams.  Life goes on, despite your diagnosis.

Resources

If you want additional information, click here to go to Breast Cancer: Treating Lymphedema from PubMed Health, a service provided by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).

If you are located in Australia or New Zealand, click here to go to the Australasian Lymphology Association.

Spinning through breast cancer

spin class

I just came home from spin class.*

I am so happy that my strength is back to the point where I can complete a full one hour spin class and still have energy left to continue on my daily routine without missing a beat. I will admit that I don’t do all the “jumps” and my pace is well below what the instructor is urging, but I’m there, and I’m managing to stay with it throughout the whole class.  Over time I know that I will continue to get stronger and will eventually work up to the full spin class experience. For now, I’m happy to be there at all and I do as much as I can at my own pace.

It wasn’t always like this

It wasn’t always like this. In fact, when I first had a recurrence of my breast cancer 3-4 years ago, I entered a downward spiral where things went from bad to worse. And just when I thought it couldn’t get any more complicated or scary, it did. More on that another day.

When my doctors realized that I had had a recurrence, I entered another long journey back into the world of breast cancer treatment, side effects and hopefully, someday, a “cure”. I put cure in quotation marks because when I first got re-diagnosed, my doctor said “there is no cure . . . at least not yet.”

My first time around I had been a “young” breast cancer patient. Generally women who get the disease before age 45 are considered young. This time around I was clearly out of the “young” category and have moved into the ranks of the “middle-aged.”

In any case things are fine now and I hesitate to write these words lest I jinx myself and have yet another problem. I’ve come to terms with the chronic nature of my disease, more or less, and always try to remember “words are just words” and they have no power over your diagnosis or cure.

Why I like spin class

When I go to spin, I am able to feel “normal” for an hour at a time. No one knows about my medical history. To others in the class, I’m just one more middle-aged woman trying to keep her weight gain at bay.

I do feel “normal” most of the time these days as I go about my business, cooking, writing, working, doing chores.  Spin, however, has a special effect on me because it is so all-encompassing. When you are on the spin bike, and the music is blasting and the instructor is constantly giving instructions and urging you on, you become totally enveloped in the experience and all your other thoughts and fears vanish. You are simply too busy spinning on the bike to let anything else get in the way.

I don’t feel middle-aged, but don’t know how else to say it

I hate describing myself as “middle aged.” In fact, I don’t think I’ve ever written those words before when trying to explain my station in life.  After I thought about it, I can’t come up with a better way to say it. Older woman? Woman? Woman of experience? Young woman? (Who am I kidding?). None of these phrases ring true, so I guess I’ll have to stick to “middle-aged.”

Why does age matter?

The reason it matters is that as you go through life your body changes and the type of breast cancer you are likely to get is different depending on your age. Many years ago, my grandmother had breast cancer at around age 80; so why did I get it in my mid-40s and again 10 years later?

Of course her breast cancer was probably at least 50 years ago. Breast cancer and its treatment today is so very different then it was back in the 60s.   Just think of all the medical advances that have taken place over the past 50 years. Now think where we will be in another 50 years…

There are some constants

One of the biggest constants that I have observed in the past few years is the amount of research which supports the importance of exercise as a way to help reduce your risk of recurrence, or even getting the disease in the first place. For example, One study published in 2016 reported an inverse relationship between increased levels of physical activity and reduction of the risk of developing breast cancer. The American Institute of Cancer Research (AICR.org), reported similar findings in 2017 from another article which appeared in Epidemiologic Reviews.

Scientific research supports the many benefits of physical activity

Want to know more? Read this factsheet from the National Institutes of Health, National Cancer Institute for more scientific evidence about the benefits of being physically active.

The bottom line for me, is that I’ll keep going to spin, taking long walks and doing as much yoga and strength training as my schedule will permit. I may not have control over my disease, but I certainly have control over my schedule and how I choose to eat, exercise and practice good lifestyle habits.

Please join me on this journey.

 

*NOTE:  Consult with your doctor before beginning spin class or another exercise program. This article is for information and entertainment only, and does not provide medical advice. 

 

Eating breakfast on chemo days

When you are undergoing treatment for breast cancer, it is important that you continue to eat well even if your appetite wanes.   Research shows that patients who maintain their weight during the course of treatment, often have better outcomes.

It makes sense. After all, when you are having breast cancer treatment, whether it is chemotherapy or radiation, your body will be working hard to fight the cancer. It may also need a little extra help to tolerate the treatments.  The way we provide the fuel for our bodies to heal and tolerate treatments is through our diet.

I sometimes get the question about whether it is ok to eat on days when you are having treatment. This often comes from people who don’t realize that they can, and should, eat on treatment days. Eating daily will help you stay healthier during treatment, unless your doctor has advised you not to eat due to a medical test or some other reason.

What should I eat for breakfast on treatment days?

Whenever I’m heading out for treatment, I always try to  start my day with a good breakfast that is a balanced meal. Ideally the meal will contain some protein, carbs, fruits, dairy and whole grains.

For example,  how about an egg white veggie scramble with a slice of whole grain toast, a small glass of skim milk and a handful of blueberries or other fruit?

Or, banana nut oatmeal with a green smoothie on the side?

Sometimes I’ll make a vegetable frittata in advance. Then, the morning of chemo I can just heat up a piece in the microwave which makes for a quick and nutritious breakfast when I’m on the run.  You can pair it with a slice of whole grain toast and a small glass of skim milk to round out the meal.

If I eat Greek yogurt or Skyr, I add some sliced fresh fruit or berries to balance the protein.  Skyr, is a traditional Icelandic yogurt made of skim milk with live active cultures. It is similar to Greek yogurt in nutritional values and consistency.  I will often also add a homemade low fat whole wheat blueberry muffin or other whole grain muffin to increase the calories in the meal.

By starting my day with a hearty breakfast, it helps me stay full throughout the morning. If later on I don’t feel like eating too much, at least I’ve had a good breakfast and can better make it through the day.

 

 

Makeup tips for when you’re not feeling your best

An Interview with Darlene Baldachino,
Hair Stylist and Makeup Expert*

Darlene Baldachino Hair Stylist and Makeup ArtistI recently spoke to Darlene Baldachino to get some makeup tips from her for women going through treatment for breast cancer. Darlene is the Creative Director of the SydneyAlbert SalonSpa in Princeton, NJ as well as a hair stylist and makeup expert.

When you aren’t feeling well, and all you want to do is get on your sweatpants and lie on the sofa watching old movies or napping, why am I suggesting that makeup is important?

 

Taking a shower, putting on clean clothes and some makeup will generally help you feel better

I originally got this advice from my mother when I was under the weather as a young teenager.  I don’t have any science to back the advice, and this is not a medical recommendation.  Anecdotally, however, I can tell you that for me, it usually helps. There’s something about pulling yourself together with a clean shirt, washed face, brushed teeth and hair, and a little makeup, that somehow makes you feel better.  Try it, and let me know if it helps.

Makeup makes you look healthier

Theresa E. DiDonato, PhD wrote: “Beyond any attractiveness measures, cosmetics may help women create certain favorable social perceptions. Indeed, a recent experiment revealed that women pictured wearing cosmetics were evaluated as healthier, more confident, and even having greater earning potential than the same women wearing no makeup (Nash, Fieldman, Hussey, Leveque, & Pineau, 2003).” (Source: Psychology Today).

Makeup can help you protect your privacy

You may not care if people know you are going through treatment for breast cancer. Everyone is different, and this is your journey.  If you want to keep your condition private, you will probably want to wear a wig (assuming you lose your hair), regular clothes (no sweatpants in public), and some makeup when you go out.  It’s up to you — this is your journey and you are in control of what you do, or don’t, reveal to co-workers or others.

I will tell you from personal experience, you will get a lot fewer intrusive questions if you look “normal,” and not like you spent the day lying around in messy pajamas.

*Disclosure: Darlene is my personal hair stylist. I neither gave or received any financial compensation for conducting and posting this interview.

Protein Needs During Breast Cancer

Grilled Salmon and Vegetables

Protein is a very important part of a healthy diet. Along with carbohydrates and fat, protein is essential for good health.  When you have breast cancer (or other types of cancer) it becomes even more important than usual to have enough protein every day. This is because you may have an increased need for protein as a result of your diagnosis.

Why is protein important?

Protein helps strengthen our immune system and can help us to fight infections. It is used by our bodies to build cells, bones, muscles and skin. When you have an injury, such as a cut or wound, it helps repair the damage and heal the tissue.  It is also used to build hormones, enzymes, and hemoglobin, the part of our red blood cells which carries oxygen throughout our system.

Protein supplies essential amino acids

Proteins are made of amino acids, which are joined together in large chains to form the many different proteins our bodies need.  There are certain amino acids which our body is not able to make. These are called the essential amino acids, which means we need to get them from our diet by eating foods which contain them.

Animal-based foods, such as fish, beef or chicken, contain all the essential amino acids, so they are considered to be complete proteins.  Most plant-based foods are missing one or more of the essential amino acids. So if you follow a vegetarian or vegan diet, you need to be careful to eat a broad range of foods to be sure that you are still getting all the amino acids you need from the foods you choose.  A plant-based diet can be perfectly healthy in this regard – it just takes a little planning.

How much protein do you need in a “regular” healthy diet?

The amount of protein you need varies based on factors such as your gender, age, health status and how physically active you are.  The general recommendation from the Institute of Medicine for adults over age 18 is for protein to make up between 10 and 35% of total daily calories.  For adult men, the recommendation is to consume around 56 grams per day; for adult women, the recommendation is to consume around 46 grams per day.

To put this in perspective,  the protein amount provided by one egg is around 6 grams. If you eat a 3 ounce serving of salmon you’ll get nearly 22 grams, while a cup of quinoa will provide around 8 grams. A cup of cooked spinach provides around 5 grams.

It is also possible to eat too much protein in your diet, which can cause other health problems if you are not careful, including weight gain.

What if you have breast cancer?

When you have breast cancer, your body often needs additional protein in order to help you fight off the disease and stay healthy and strong throughout your treatments.

How much additional protein you may need will depend on a number of factors.  Depending on your situation, you might need nearly double the amount of protein as what you would normally eat. For women, this means you may need to increase your protein to as much as 60-80 grams/day when you are undergoing treatment.  Please discuss this with your doctor or registered dietitian nutritionist since many factors go into determining how much protein you should be having each day.