Battling cancer is, without question, a life-altering experience — physically, mentally, and emotionally. And powerful treatments like chemotherapy can take a significant toll on the body, including changes in appearance, including to hair and skin. When this happens, there are often support and resources that hairstylists and estheticians can offer to help you feel more like yourself.

Nicole Roby, esthetician and senior spa leader at LifeSpa in Oakbrook, Ill., fully understands this experience: She experienced the effects of chemotherapy during her own battle with breast cancer.

“Hair loss was one of the most emotionally challenging parts of my chemotherapy journey,” she says. “It wasn’t just about losing my hair — it felt more like losing myself and my identity.”

Roby was diagnosed with stage 3 metastatic breast cancer in October 2021 and underwent two surgeries later that year. In early 2022, Roby began treatment that included 25 rounds of infusion chemotherapy treatment that went through June; she then underwent 30 rounds of radiation between July and September 2022. Today, she takes an oral chemo medication daily in addition to receiving quarterly infusions due to her stage three diagnosis.

“A majority of what I experienced with my hair and skin during my infusion and radiation treatments was a surprise,” Roby says. “They warn you about some things, but you can never be prepared for those changes fully. Especially as an esthetician, where my skin is my billboard, a big challenge I experienced was skin dehydration, dull and lackluster skin, and hyperpigmentation that wouldn’t budge.”

We asked Roby to share more of her experience around how chemotherapy affected her hair and skin and how she learned to best care for both during and after treatment.

Life Time | How did you feel when you learned your treatment would cause you to lose your hair? Tell us about your initial thoughts and actions.

Nicole Roby | When my oncologist confirmed in January 2022 that I would need to start chemo right away as a life-saving measure, I planned to cut my hair to a short pixie the week after my first chemo session. I felt that was the best way to not get overwhelmed with hair loss. I was told that I would begin to experience hair loss by the second treatment, and that was almost spot on.

When my hair started falling out after my initial “chemo cut,” I made the decision to shave my head, which was both heartbreaking and empowering. I chose to have one of my fellow stylists here at LifeSpa, Georgia Kolovitz, shave my head. She knew how to care for me during this sensitive process after helping her father during his cancer treatment. There is something powerful in facing the mirror bald and deciding you are still you.

I had complete hair loss by my third chemo session and remained bald until the end of my radiation treatments. What I was not prepared for was the physical pain that came with the hair loss. My scalp became extremely sensitive and dry.

LT | Tell us about the regrowth process after treatment — what was that like for you?

NR | I first began to see hair regrowth that October, after my chemo had ended. Regrowth was just as emotional as losing the hair to begin with because my hair came back in soft, fuzzy patches, like how a baby’s hair grows.

And the hair was stick straight! My first thought was, Where are my curls and will they ever come back? My focus during the regrowth period was to protect and care for my scalp so that my hair could continue to grow. Every little strand felt like a small victory. Watching my hair grow again was a reminder of what my body had been through, how resilient it truly is, and what was possible.

LT | What hair-care solutions can help someone dealing with hair regrowth after chemotherapy?

NR | Scalp care is crucial, especially right after chemo when your skin is sensitive. A healthy scalp will grant you healthy hair and how you care for it can determine your outcome during the regrowth process.

I recommend using lightweight shampoos and conditioners to not weigh the hair down; they also provide a great base for the early regrowth stages. Avoid shampoos with sulfates, which can add stress to the hair and scalp.

I massaged my scalp regularly with lightweight serums and oils like the Initialiste Scalp Concentrate and Genesis Serum Fortifiant from Kerastase, which is formulated to help weakened hair, promote growth, boost circulation, and nourish follicles. This also helps ease the tightness of the skin from how dry the scalp can be as a result of the treatments.

As your hair starts to grow back, it’s important to treat it delicately:

• Skip excessive heat styling, harsh brushing, and color services in the early stages to avoid damaging the new hair that’s coming in.
• Give the scalp lots of TLC! Red-light therapy can help stimulate growth and also decrease sensitivity.
• Use a satin or silk pillowcase to reduce friction and ease the, at times, painful growth process that is associated with hair loss. The hair follicles coming in are inflamed and there is cell damage from treatment. As the new hair pushes through an already sensitive scalp, it can result in a painful, tight feeling.

Understand everyone’s regrowth process is different, and that hair texture may change temporarily or permanently. My hair came back stick straight when it used to be curly. After about five months, my curls came back and flourished, and I felt more like myself.

If possible, I’d encourage finding a hairstylist who is experienced working with those who have lost hair during cancer treatment — they can offer support, resources, and suggestions specific to your unique needs.

LT | How did chemotherapy affect your skin? How did you care for it during this period?

NR | Chemotherapy targets rapidly dividing cells in the body, which means it can also affect healthy cells that multiply quickly, including skin cells. My chemo treatment took a major toll on my skin. It became extremely dry, sensitive, and at times, inflamed. I experienced dullness, hyperpigmentation, and a general loss of that “healthy glow,” both during and after treatment. My skin didn’t have its true glow back until six months after radiation.

Hydration became my No. 1 priority. Drinking water and consistently using moisturizing products were key. I collaborated with my doctor on safe skincare products to use.

I am also oncology-certified in esthetics, so I was well versed about how and what to use on my skin. I adopted a minimal, oncology-safe skincare routine with products from Eminence and isClinical. Nourishing ingredients like hyaluronic acid, squalane, and ceramides helped my skin feel and look better.

[My daily routine includes] a gentle cleanse twice a day with Stone Crop Gel Cleanser from Eminence in the morning and the Cleansing Complex from isClinical in the evening. [I also] add in the Pro-Heal and Hydra-Cool serums from isClinical.

I used the Zents body-care line. This became a primary hydrator for the skin on my body. I felt good about the ingredients and the Unzented option, which is dye-free and scent-free, as it was safe for my sensitive skin.

LT | What tips do you have for caring for the skin after chemotherapy?

NR | As your skin heals after chemo, it’s important to listen to your body as it will often tell you what it needs. For example, if it’s feeling dry, you might need to use products with soothing, hydrating ingredients.
Here are the top things I’d prioritize:

• Never skip SPF. As an esthetician, recommending SPF is my top priority for anyone. But after chemotherapy, I am even more diligent about sun protection. Chemo and post-care medications can make your skin more sensitive to sunlight, so I always wear SPF 30 or higher, even on cloudy days and when I’m indoors. My preference is a mineral SPF.
• Combat dryness as best as you can. Drink lots of water, consider using a humidifier, and avoid long, hot showers (lukewarm is best) as they can be drying for the skin. Apply your body moisturizer while the skin is still damp from the shower. A combination of a body oil followed by a moisturizing lotion or cream can help lock in hydration.
• Find an experienced esthetician or dermatologist who is well-versed in working with those who have gone through cancer treatment, if possible. They can offer support and resources based on your symptoms and individual skincare needs.

LT | How has going through this process helped you embrace the next phase in your recovery?

NR | This experience shifted the way I see beauty and healing. I’ve learned that recovery isn’t just physical but also emotional, mental, and deeply personal. I no longer have a strong attachment to my hair; I value health over everything.

My hair regrowth marked a turning point for me: It reminded me I was moving forward and healing. My glow also returned, and I enjoy even more the calm that comes with caring for my skin.

Also, cancer was just a part of me and doesn’t define who I am! I have always been a strong-willed person. I have a great family around me and my parents instilled in me that I can be both strong and vulnerable. Cancer doesn’t change who you are. I feel like I’ve lived a few lives, and this is just one big chapter that wasn’t so pretty. But it shows how will and determination can help you overcome the hardest challenges thrown your way.

LT | What advice would you give to someone just starting their post-chemotherapy recovery?

NR | Give yourself grace and know that your body has endured one of the worst types of traumas and it needs time to recover. Ask for help from those who’ve experienced chemo. Find local groups or take advantage of cancer center groups for community.

Don’t be afraid of self-care — you need it and deserve it. You may be uncomfortable in the beginning, but there is a long road ahead and a positive mindset will get you far.

In most cases your hair will grow back, and your skin will glow again. Embrace the now, and enjoy living in this new normal in the most positive way you can. It will keep you going!

When Peg Burgess was diagnosed with ovarian cancer in 2022, her treatment plan included an eight-hour surgery and multiple rounds of chemotherapy treatment. After several months of treatment, her body was at its weakest.

“When I got out of the hospital after each round of chemo, I couldn’t walk more than five steps,” Burgess, 70, recalls. “I wanted to do something to feel strong, and I decided I wasn’t going to let cancer run my life.”

In October 2024 — after hearing she was in remission and would likely be for at least 15 more months — she decided it was time to rebuild her strength, so she signed up for an Intro to Dynamic Personal Training session at Life Time MetroWest-Boston in Framingham, Mass. It’s made all the difference. Exercise has helped Burgess not only regain strength and continue to fight her disease, but it’s also lead her to a close friendship that’s a vital part of her support system.

Determination Makes the Difference

Burgess’s determination stood out to Ronald Drago, Dynamic Personal Trainer at Life Time MetroWest-Boston, who met Burgess in that introductory session. “Right off the bat, I noticed that even though she was unfamiliar with weight training, she was a high-effort performer,” he says. “She puts 100 percent into every single rep and set. I’ve never worked with someone who works quite as hard as Peg — and I’ve been doing this for over two decades.”

“Before my diagnosis, I had previously worked with a number of personal trainers, but I would go for a month and then stop,” Burgess explains. “But with Ron, I immediately felt comfortable during that first session. It had been so long since I last worked out, just moving my body felt amazing, and it got better every time.”

Burgess’s motivation was inspiring for Drago from the get-go, but as they worked together and he learned more about what she was dealing with, it became even more extraordinary. When her cancer returned in February 2025 and she had to begin treatment again, their partnership became even stronger.

“I decided to stay with it because it made such a difference in my life,” she says. “Every day I come into the club, and I can do something I couldn’t before on the workout floor. And over time, even everyday activities are just easier for me.”

Strength Found in Showing Up

Drago and Burgess continued training together three to four times a week. While their original goal was to build Burgess’s resilience to withstand treatment, she also discovered a love of strength training and developed a wonderful friendship with Drago.

“I get disappointed if I’m not sore after a workout,” she laughs. “It’s not work for me, it’s a delight. Ron and I have become very good friends. We have a lot of fun.”

Although there are plenty of times when Burgess doesn’t feel great, she never gives up. Immediately following an infusion is when patients often feel their sickest, and there are times when she can’t make it to the club. So Drago goes to her house, and they continue to work together until she feels strong enough to come back to Life Time.

“Peg has a unique quality in that she pushes every rep to the max,” says Drago. “Even if the volume needs to be adjusted, the level of intensity is always high, even when she’s not feeling great.”

As Burgess has continued with cancer treatment, she’s become a bright light for other members at Life Time MetroWest-Boston who are awestruck at her journey and success. “I’ve talked to other members who have undergone cancer treatment, and they’re in disbelief that Peg is able to work out four to five days a week while going through it,” Drago says.

Burgess admits that she’s not out of the woods yet, but the plan to strengthen her body is working — and so is her treatment. While there’s no end-date set for her infusions, she’s had positive visits with her doctors who are encouraged with her progress; they see a path to reducing the treatment load in the future.

She’s also feeling less sick after each chemo session and seeing muscle in places that she never has before. “You can definitely see how Peg’s muscle mass has increased, and every time she finds a new muscle, she’ll show it to you,” Drago laughs. “I was watching her train one day and I said to myself, She doesn’t appear to be someone who’s getting sicker. The good days outweigh the bad now.”

The Force of Friendship

Drago and Burgess’s friendship is clear to anyone who sees them training together, but especially to Mark Airoldi, personal training leader at Life Time MetroWest-Boston.

“Ron is a hard-nosed ex-Marine, and to see the degree of love and care he has for Peg is inspiring,” says Airoldi. “I’ve seen Ron transform as a person since they met. The fact that he has shown that degree of care has inspired our entire team. It puts into perspective what we do and why we do it. To say it’s been powerful wouldn’t do it justice.”

Burgess can attest. “Working with Ron and strength training has made such a difference in my life. I’ll never do strength training without Ron. He’s my absolute favorite, and I adore him. I feel like he’s saving my life.”

The adoration is mutual. “I feel that I’ve learned as much from Peg as she’s learned from me,” Ron says. “It’s helped me become a better trainer. We laugh a lot. We try to make the best out of the situation. I have someone who I feel will be in my life as long as we can.”

The recommendations for exercising during cancer treatment are not much different from those geared toward the general public, experts say. The American College of Sports Medicine (ACSM) recommends healthy adults should get a minimum 150 minutes of moderate-intensity aerobic exercise per week at least two days of which should include some resistance training.

1) Get started now.

The sooner you start moving, the better, says Spencer. “A lot of people think, I don’t need to work on this now, and so they wait until treatment is done. At that point, they may be tired and deconditioned, and side effects possibly could have been mitigated if they had started moving sooner.

It’s just about meeting [yourself] where you’re at.

“For the most part everyone can be moving more: It’s just about meeting [yourself] where you’re at. If you haven’t been active your entire life and now you’re going through treatment, you might be doing five minutes a day and building up from there,” she says.

 

2) Make a plan with your care team.

“Besides getting the initial clearance to work out, it’s important to find out if there are any issues you should be particularly concerned about,” says Champ. “Ask, ‘Based on the surgery I had, is there a decreased range of motion? Are there concerns because of chemo? Are there concerns because of [my] immune system?’ All those things come into play.”

Experts recommend working with an exercise professional who can communicate and collaborate with your care team. This helps ensure safety while also increasing the effectiveness of workouts. “Much like medical treatment, this should all be done in person, under expert personnel. But also it has to be dose-escalated,” says Champ. “If I give you a low dose of radiation, it’s not going to cause any side effects, but also it’s not going to work.”

Some of the most prominent cancer organizations, such as the Mayo Clinic and Memorial Sloan Kettering, promote exercise as an integral part of treatment plans. There are also trainers, physical therapists, and other movement professionals who have experience with cancer and may be a resource for clients.

“While there are certifications out there in the field, there isn’t a generally accepted approach saying [this] is ‘the right way,’” says Schneider. “The best option would be for the fitness professional to stay in contact with the oncology team to make sure they are clear on treatment and potential side effects, and the team is aware of exercise and recovery the patient is going through.”

 

3) Take it one day at a time.

Cancer treatment has a cyclical nature, explains Spencer. “The first one to five days after chemo, a patient may be feeling badly, but the closer they get to the next cycle, the more energy they’ll have. It’s important to reassure them it’s normal not to feel their best after treatment. Doing something at a lesser intensity is OK, as long as they’re still moving.” (Try this gentle, somatic workout designed to support you well-being.)

That said, not every day has to be an easy day. When a patient is feeling good, Spencer advises, the approach to exercise should look much the same as it does for someone without a cancer diagnosis: Progressively increase the load, intensity, and/or volume of their workouts to match their energy and fitness level.

Champ uses a red-, yellow-, and green-light system so that patients can let him and other trainers know how they’re feeling. Red indicates a light and easy day; yellow means they can push a little harder; and green shows they’re ready for a regular workout.

 

4) To maximize your benefits, maximize your efforts.

“Too often, people say, ‘This person has cancer; we’re not going to push them hard.’ But data shows that the more muscle mass and the less fat you have, the better the outcome [of overall treatment],” says Champ.

When patients come to Champ’s facility, they get a quick lesson in the principle of progressive overload: This means that to see results, you need to continue to put your body under additional stress.

“Whether you’re on nasty chemo or you’re not on chemo at all, we’re going to overload you. It’s just figuring out personally where you are and what that level of overload is,” says Champ. This approach helps ensure that patients aren’t just going through the motions — that the work they’re putting in is actually effective.

“If we think we’re going to put on muscle with exercise, it has to be exercise that’s going to cause you to put muscle mass on.”

Similarly, Almli urges cancer patients to challenge themselves with their cardio workouts. “A lot of people think, Well, I’m just going to walk. But you need to walk fast enough to get your heart rate up. If it took you 25 minutes to walk a mile on the treadmill, that’s probably not an effective cardio exercise. We’re human beings, we’re supposed to walk,” she says. “I love the idea of some sort of wearable technology so you can see what your heart rate is doing.”

 

5) Be aware of red flags that indicate you’re doing too much.

“I tell people it’s OK to be tired; it’s not OK to be hurting. If you want to stop because you’re tired, challenge yourself to do a little bit more,” says Almli.

“If you want to stop because you’re tired, challenge yourself to do a little bit more.”

To see if a client has pushed too far — or not enough — Schneider watches for changes in mental clarity or brain fogginess, windedness, strength gain or loss, pain, range of motion, and emotional states.

“The biggest tell will be if they can recover quickly,” he says. “The metric I use is: Work as hard as you can while being able to do it again tomorrow. Not necessarily the same routine but being able to maintain a similar intensity level.”

 

6) Find an accountability partner.

“It’s really hard to exercise on your own, especially if you don’t feel well,” says Almli. “But if you get a buddy and start slow, you have someone to hold you accountable.” You can make regular plans with a friend to meet for walks, join a group fitness class that you’re expected to attend, or work with a personal trainer.

She recommends scheduling exercise like you would an appointment. “When you’re going through cancer treatment, your calendar is so full of things you don’t want to do — labs, scans, doctor appointments, chemotherapy, radiation, etc. Add some exercise with a friend, so when you look at your calendar, it gives you something to look forward to.”

When you or someone you love is diagnosed with cancer, you may feel like the world just tilted on its axis. It is normal to feel this way, says integrative cancer-care expert Nalini Chilkov, LAc, OMD — cancer is a serious and scary prospect. Yet no matter how dire the report, you do have time to catch your breath and get your questions answered so that you can make informed decisions.

Integrative cancer experts offer this advice to help you prepare for the journey.

1) Take time to make a plan.

A cancer diagnosis is completely unsettling, and your first impulse may be to act quickly. That’s a good instinct — but acting quickly is different from acting immediately.

“When people are first diagnosed, the oncologist often says, ‘OK, we’ll start chemo next week, then we’ll do surgery, then more chemo, then some radiation, then we’ll do hormonal therapy,’” says Chilkov. “And the patient’s supposed to be ready for all that next week.” That’s a lot for many of us.

And while some cancers are aggressive, most develop slowly over time; they don’t appear in the body overnight. In these cases, treatment doesn’t have to start overnight either.

“Cancer is not an emergency — [your] hair isn’t on fire,” she notes. “There’s time to get a second or third opinion, to organize what needs to be organized, to get childcare covered, to be well prepared for the challenging treatments ahead.”

Taking a little extra time is also good for your mental health. “People can integrate what has just happened to them and get ready to do something difficult,” she adds.2

2) Get multiple opinions.

Finding the right care team is important. “A second and third opinion is always helpful,” says functional-medicine physician Elizabeth Boham, MD, MS, RD. This can be especially valuable if you live in an area without a reputable cancer-treatment center.

Even if you have good local resources, there’s value in getting additional perspectives. Oncology is practiced differently at different hospitals across the United States and in other parts of the world. And the best specialist for your specific diagnosis may be located elsewhere.

“You may not end up getting treatment [at a different cancer center], but they may introduce you to new options or reinforce what your local oncologist is recommending,” adds Boham.

And now there’s telemedicine. Many cancer experts, including integrative practitioners, are available for virtual consultations, so you need travel no farther than your laptop.

3) Think “both/and.”

Integrative cancer care can be powerfully supportive, but even its practitioners don’t view it as a replacement for chemotherapy, radiation, or immuno­therapy. “Most natural therapies don’t actually reduce tumor burden, and that’s the first job in any treatment protocol,” says Chilkov.

The best way to think about an integrative approach to cancer may be as a complement to tumor-reduction protocols. Cancer nutrition consultant Jeanne Wallace, PhD, CNC, describes her work this way: “It’s about how we can assess the terrain and match you up with the self-care strategies that are best for you.”

Vitamin C infusions are now a fairly popular adjunctive cancer treatment. In very high doses, vitamin C puts oxidative stress on cancer cells, making them more susceptible to conventional treatments like radiation and chemotherapy.

“It can be a really supportive treatment,” says functional-medicine physician Elizabeth Boham, MD, MS, RD. “But talk to your oncologist first.” As with diet, much depends on your particular cancer and internal terrain.

“If your terrain isn’t doing well, vitamin C infusions are a waste of time, energy, and money,” says functional-medicine physician Patrick Hanaway, MD. “The first thing you want to do is focus on the lifestyle aspects that improve internal terrain — nutrition, sleep, physical activity, stress management, and finding meaning and purpose in your life.”

If you do opt to pursue treatment, it matters where you receive it, adds Boham. “A lot of the IV centers where people go to fix their hangover can’t mix that amount of vitamin C.”

There’s a lot of debate about the “right” diet for cancer. Experts champion different diets: ketogenic, ancestral, paleo. Others say vegan is the only way to go. Or maybe a Mediterranean diet, the fasting-mimicking diet, or intermittent fasting. It can be dizzying to dive into the world of nutritional oncology.

So, what’s the best anticancer diet for you? It depends. There is no one right way to eat when you have cancer, says ­functional-medicine physician Patrick ­Hanaway, MD. The best approach will be tailored to your diagnosis and internal terrain.

“Some cancers, like glioblastoma multi­forme, are particularly insulin sensitive,” he says. “So, if we have someone with one of those cancers, then they may benefit greatly from a ketogenic approach,” which keeps insulin production low.

Depending on the cancer, this approach can even make treatments more potent, says Hanaway. Other insulin-sensitive cancers include breast, colorectal, pancreatic, and radiation-sensitive cancers, such as head and neck and anorectal.

Then there are the types with no apparent relationship to insulin sensitivity. “We can’t make a global statement,” he continues. “We can’t say all cancers are stimulated by sugar and all cancers should be treated with a ketogenic diet.”

If your terrain biomarkers suggest epigenetic changes are in play, “a plant-based diet might work well,” says cancer nutrition consultant Jeanne Wallace, PhD, CNC. Conversely, if blood tests indicate you have a problem with angiogenesis, a plant-based diet may not be the right choice for you. It can lower zinc and increase copper, and copper can fuel the angiogenesis that supports tumor growth.

A functional or integrative practitioner with expertise in nutritional oncology can help you understand your cancer biomarkers and develop the best approach.

  Explore this article:

• Building Anticancer Terrain: The Basics
• Building Anticancer Terrain: The Specifics
• If You Get a Cancer Diagnosis …
• What’s the Best Anti-Cancer Diet?
• What About High-Dose Vitamin C for Cancer?

Years ago, as a novice gardener, I found the weeds in my yard confounding. Not only did they spring up overnight, but they spread like wildfire. No sooner would I clear a space for dahlias than the dirt would fill in with dandelions.

Eventually I noticed that weeds showed up and spread every spring no matter what, but their distribution was erratic. They preferred certain spots in my yard over others. It was the same with plants I planted: They would thrive or languish depending on where I put them.

Today, as a more experienced gardener, I get it. Of course my plants flourished in spots with better soil and more sun. It wasn’t magic making the dahlias produce blooms the size of dinner plates in my sunny backyard, nor was it a curse causing them to wither anemically in the shady front. It was the growing conditions that made the difference.

The same principle applies inside of our bodies. The health of our cells and tissues depends on the health of their surrounding cells and tissues — and, like gardeners who add nutrients to the soil and water the plants, our food and lifestyle choices can make or break the whole system.

A healthy ecosystem, unsurprisingly, can make the body resistant to diseases of all kinds, including cancer.

This is what’s known in integrative medicine as the “terrain theory” of cancer. When we think of the body as a garden we tend with our food and lifestyle choices, we can think of cancer cells as weeds — uninvited guests trying to take over.

We can also use what we know about cancer’s preferred environment to make our bodies less hospitable to its growth and spread.

Conventional cancer treatment typically focuses on targeting and eliminating cancer cells from the body — and this is critical. But it’s not all we can do, experts say.

“We know that cancer cells are not an island unto themselves,” notes cancer nutrition consultant Jeanne M. Wallace, PhD, CNC, who founded Nutritional Solutions in 1997 to help cancer patients complement their conventional treatments with food, nutrients, herbs, and a healthy lifestyle. “Tending to the internal terrain is the missing link in oncology treatment.”

The terrain approach isn’t a replacement for conventional care, Wallace adds. It’s a holistic plan that centers nutrition and lifestyle, which can make radiation and chemo more effective, minimize their side effects, and offer up a road map for life after treatment. This can be important psychologically as well as physically.

“After a conventional oncologist has done what they can to reduce the tumor burden, they may feel that their work is done,” says Nalini Chilkov, LAc, OMD, an expert in collaborative integrative cancer care. “But the patient feels like they’ve been dropped off the edge of a cliff. [They] need ongoing support for their recovery and to rebuild and sustain their health.

“Every patient deserves to have a plan for their health and not just a plan for their disease.”

Current estimates suggest that one in two men and one in three women will receive some type of cancer diagnosis during their lifetime. And a recent World Health Organization report predicts a 77 percent increase in the number of cancer cases worldwide by 2050. So cultivating a healthy inner terrain matters for all of us, with or without cancer.

All the more reason to nurture your internal ecosystem, starting today.

Building Anticancer Terrain: The Basics

You don’t need a healthcare provider to begin cultivating an anticancer terrain. While everyone will need unique support during cancer treatment, these diet and lifestyle changes can help you build a healthier terrain right now.

1) Regulate blood sugar — and not just because cancer likes sugar. Many cancers do like sugar as a source of fuel, but its unhealthy effects are far broader and more damaging.

A high-glycemic diet fans the flames of insulin resistance, says Wallace. “This can foster tumor progression in several ways — it fuels inflammation, it fuels angiogenesis.” (Angiogenesis is the formation of new blood vessels; this normally helps the body heal but also helps tumors grow.)

Wallace adds that insulin resistance may also contribute to dysregulated immune function, impaired mitochondria, imbalanced hormones, and weakened autophagy — a process of cellular cleanup.

To keep blood sugar in check, focus on eating whole foods and complex carbohydrates, and skip ultraprocessed fare and refined carbohydrates. High-quality sleep, physical activity, and stress manage­ment all help keep blood sugar regulated too.

If you’re struggling to cut back on sugar, you’re not alone — it’s a highly addictive substance. Try increas­ing protein and healthy fats to keep your cravings in check. (For more on how to kick the sugar habit, visit “20 Tips to Curb Sugar Cravings and Kick the Addiction.”)

2) Control inflammation. The inflammatory response protects the body from acute injury and harmful substances. As a temporary measure, this is beneficial. But when the body is exposed to unremitting challenges from a nutrient-poor diet, environmental toxins, or life stressors, inflammation can become chronic. This can contribute to a host of problems, including tumor growth.

The best way to keep chronic inflammation at bay is to eat plenty of minimally processed whole foods, nourish your gut with plenty of fiber and probiotic-rich fermented foods, and take sleep and stress management seriously. This advice can feel so commonplace as to barely warrant mention, but it’s repeated so often because it matters so much. These practices are foundational for building an internal ecosystem that’s inhospitable to cancer — and for keeping the body healthy overall. (For more on chronic inflammation, visit “How Chronic Inflammation Affects Your Health.”)

3) Keep NF-kB in mind. NF-kB is a signaling pathway inside cells that regulates the immune system’s inflammatory response. It has been called cancer’s “master switch” because it lies upstream of many of the pathways that promote cancer.

“Right now, there’s a big push to develop drugs that target cancer-­promoting genes, known as ‘oncogenes.’ ‘Oh, here’s another gene that promotes cancer. Let’s block that,’” says Wallace. “I’m not a huge fan of that approach.”

Gene expression is plastic, she explains, and cancer genes are all part of a massive, interrelated web. “You hit one, and another pops up in its place — like a game of whack-a-mole.”

The more effective approach, she says, is to look upstream. For a great many of the genes involved in cancer growth, the controlling signal pathway is NF-kB. Keeping NF-kB dormant can help dial down the procancer signals in your body.

“NF-kB senses the environment, and it communicates what’s happen­ing to the cells, which are always trying to assess the broader ecosystem,” says Wallace. “When NF-kB senses stress, infections, or other problems, it triggers a state of alarm in the cell nucleus.”

One way to calm NF-kB is with some ordinary kitchen spices or herbs, says Wallace — think basil, cinnamon, cardamom, cumin, nutmeg, rosemary, thyme, and turmeric. Use them liberally. Opting for pasture-raised, pasture-finished meat can also help regulate NF-kB, she adds. (See this list of “40 Spices and Plant-Based Foods With Anti-Cancer Potential.”)

Wallace also suggests limiting exposure to tech-related electromagnetic fields (EMFs), because they may interfere with native electromagnetic signaling. “We know that too much non-native EMF triggers NF-kB.”

To help minimize EMF exposure, carry your cellphone in your bag rather than your pocket, leave it in the kitchen when you go to bed, and consider unplugging your Wi-Fi at night. (For more on EMFs and your health, visit “What You Need to Know About EMFs.”)

4) Care for your mitochondria. The tiny factories in our cells that turn the food we eat and the oxygen we breathe into energy, mitochondria play a big role in maintaining cell health and, by extension, the entire internal ecosystem. “They control the fate of the cell, deciding if the cell will undergo apoptosis [programmed cell death] or if the cell has enough energy to heal,” explains Wallace.

Mitochondria read the environment in a way that’s similar to NF-kB, she adds. “They have sensors for sunlight. They pick up on electromagnetic fields. They sense the bonds between protons and electrons in the food that you eat in order to understand the season.”

One easy way to support mitochondria is to live in harmony with nature — especially circadian and seasonal cycles. “Get some exposure to red light from the sun, red-light ­devices, or incandescent full-­spectrum light bulbs first thing in the morning, and don’t expose yourself to blue light from screens late in the day,” says Wallace. “Eat food in season and get some physical activity. If you’re doing these kinds of things, it leads mitochondria to signal that the fate of the cell is to be healthy.”

(For more on mitochondria and your health, visit “The Care and Feeding of Your Mitochondria.”)

5) Steer clear of toxins. Many environmental toxins are known carcinogens, so anything you can do to reduce your exposure can benefit your internal terrain. “Do you use a lot of cleaning supplies with toxins? Are you spraying pesticides on the lawn?” asks Wallace. “There are a lot of good nontoxic options.”

The same applies for cosmetics and body-care products, like lotion, deodorant, and toothpaste. Both NF-kB and mitochondria can be better regulated when harmful substances aren’t constantly in the vicinity, so start swapping in simpler, nontoxic formulations for the products you use every day. (For more on the benefits of non­toxic personal-care products, see “How the Ingredients in Personal-Care Products Can Affect Your Health” and try making your own deodorant with this simple three ingredient recipe.)

6) Sleep in complete darkness. Recent research has found that when levels of the sleep hormone melatonin are at their peak, some cancer cells revert their phenotype to healthy cells. This is a clinical way of saying some cells act as cancer cells only during the day and revert to healthier cells at night. Researchers have dubbed these “part-time” cancer cells.

Melatonin is triggered by darkness, so sleeping in a completely dark environment is critically important for producing healthy levels of the hormone. Light-blocking curtains keep ambient light from coming into the bedroom, and eliminating screens, power cords with illuminated buttons, and electric alarm clocks can also create a sanctuary of darkness.

Building Anticancer Terrain: The Specifics

As you tune in to your health, you’ll become better at discerning what your body requires — especially if you’re undergoing active cancer treatment. “Our terrain is as unique as our fingerprint,” says Wallace.

This means your needs will be different from anyone else’s. It’s why a dietary or supplement strategy that works for one person may be meaningless (or counterproductive) for someone else.

“It’s really important to personalize the work on your individual terrain,” says functional-medicine physician Elizabeth Boham, MD, MS, RD, herself a breast-cancer survivor. While most cancer patients will need to manage blood sugar, she says, “[some] will also need to focus more on rest and rejuvenation, while [others] may have to focus on their microbiome or another underlying source of inflammation.”

Though cancer development typically involves factors like inflammation and epigenetic changes, the degree to which each affects your situation can vary greatly. For one person, inflammation may be a big player, and yet “sometimes you’ll see someone with a really aggressive cancer but no inflammation,” says Wallace. Their problem might be with their mitochondria, or something else.

This is where lab testing comes in. Biomarkers can point to where your internal terrain needs extra support. Tests measuring blood sugar and inflammation are available direct to consumers, and a practitioner versed in integrative cancer care can help interpret the numbers — and offer more nuanced tests for personalized feedback. Wallace’s team uses a range of tests to identify specific vulnerabilities in a client’s terrain to address problems at their source.

Internal terrain isn’t static; it changes over time and with new treatments, so ongoing testing is important. “If we have a client and they are on two specific drugs and a month later the oncologist switches them to two different drugs, [our integrative plan] will be something completely different than it was before the switch,” says Wallace.

She recommends bloodwork during treatment and modifies the integrative-care plan accordingly.

Once treatment is complete, getting routine bloodwork can be valuable both physically and psychologically. It allows you to track your internal terrain and make sure your numbers are staying in the desired range — which is a comfort.

Such interventions can help you give your terrain what it needs most this season. And staying attuned to its changing needs gives your garden its best chance to produce award-winning blooms for years to come.

If You Get a Cancer Diagnosis …

When you or someone you love is diagnosed with cancer, you may feel like the world just tilted on its axis. It is normal to feel this way, says integrative cancer-care expert Nalini Chilkov, LAc, OMD — cancer is a serious and scary prospect. Yet no matter how dire the report, you do have time to catch your breath and get your questions answered so that you can make informed decisions.

Integrative cancer experts offer this advice to help you prepare for the journey.

1) Take time to make a plan.

A cancer diagnosis is completely unsettling, and your first impulse may be to act quickly. That’s a good instinct — but acting quickly is different from acting immediately.

“When people are first diagnosed, the oncologist often says, ‘OK, we’ll start chemo next week, then we’ll do surgery, then more chemo, then some radiation, then we’ll do hormonal therapy,’” says Chilkov. “And the patient’s supposed to be ready for all that next week.” That’s a lot for many of us.

And while some cancers are aggressive, most develop slowly over time; they don’t appear in the body overnight. In these cases, treatment doesn’t have to start overnight either.

“Cancer is not an emergency — [your] hair isn’t on fire,” she notes. “There’s time to get a second or third opinion, to organize what needs to be organized, to get childcare covered, to be well prepared for the challenging treatments ahead.”

Taking a little extra time is also good for your mental health. “People can integrate what has just happened to them and get ready to do something difficult,” she adds.2

2) Get multiple opinions.

Finding the right care team is important. “A second and third opinion is always helpful,” says functional-medicine physician Elizabeth Boham, MD, MS, RD. This can be especially valuable if you live in an area without a reputable cancer-treatment center.

Even if you have good local resources, there’s value in getting additional perspectives. Oncology is practiced differently at different hospitals across the United States and in other parts of the world. And the best specialist for your specific diagnosis may be located elsewhere.

“You may not end up getting treatment [at a different cancer center], but they may introduce you to new options or reinforce what your local oncologist is recommending,” adds Boham.

And now there’s telemedicine. Many cancer experts, including integrative practitioners, are available for virtual consultations, so you need travel no farther than your laptop.

3) Think “both/and.”

Integrative cancer care can be powerfully supportive, but even its practitioners don’t view it as a replacement for chemotherapy, radiation, or immuno­therapy. “Most natural therapies don’t actually reduce tumor burden, and that’s the first job in any treatment protocol,” says Chilkov.

The best way to think about an integrative approach to cancer may be as a complement to tumor-reduction protocols. Cancer nutrition consultant Jeanne Wallace, PhD, CNC, describes her work this way: “It’s about how we can assess the terrain and match you up with the self-care strategies that are best for you.”

What’s the Best Anti-Cancer Diet?

There’s a lot of debate about the “right” diet for cancer. Experts champion different diets: ketogenic, ancestral, paleo. Others say vegan is the only way to go. Or maybe a Mediterranean diet, the fasting-mimicking diet, or intermittent fasting. It can be dizzying to dive into the world of nutritional oncology.

So, what’s the best anticancer diet for you? It depends. There is no one right way to eat when you have cancer, says ­functional-medicine physician Patrick ­Hanaway, MD. The best approach will be tailored to your diagnosis and internal terrain.

“Some cancers, like glioblastoma multi­forme, are particularly insulin sensitive,” he says. “So, if we have someone with one of those cancers, then they may benefit greatly from a ketogenic approach,” which keeps insulin production low.

Depending on the cancer, this approach can even make treatments more potent, says Hanaway. Other insulin-sensitive cancers include breast, colorectal, pancreatic, and radiation-sensitive cancers, such as head and neck and anorectal.

Then there are the types with no apparent relationship to insulin sensitivity. “We can’t make a global statement,” he continues. “We can’t say all cancers are stimulated by sugar and all cancers should be treated with a ketogenic diet.”

If your terrain biomarkers suggest epigenetic changes are in play, “a plant-based diet might work well,” says cancer nutrition consultant Jeanne Wallace, PhD, CNC. Conversely, if blood tests indicate you have a problem with angiogenesis, a plant-based diet may not be the right choice for you. It can lower zinc and increase copper, and copper can fuel the angiogenesis that supports tumor growth.

A functional or integrative practitioner with expertise in nutritional oncology can help you understand your cancer biomarkers and develop the best approach.

What About High-Dose Vitamin C for Cancer?

Vitamin C infusions are now a fairly popular adjunctive cancer treatment. In very high doses, vitamin C puts oxidative stress on cancer cells, making them more susceptible to conventional treatments like radiation and chemotherapy.

“It can be a really supportive treatment,” says functional-medicine physician Elizabeth Boham, MD, MS, RD. “But talk to your oncologist first.” As with diet, much depends on your particular cancer and internal terrain.

“If your terrain isn’t doing well, vitamin C infusions are a waste of time, energy, and money,” says functional-medicine physician Patrick Hanaway, MD. “The first thing you want to do is focus on the lifestyle aspects that improve internal terrain — nutrition, sleep, physical activity, stress management, and finding meaning and purpose in your life.”

If you do opt to pursue treatment, it matters where you receive it, adds Boham. “A lot of the IV centers where people go to fix their hangover can’t mix that amount of vitamin C.”

Illustrations by: Sandra Dionisi