Interview with Alison Tierney, Cancer Dietitian

Alison: Pretty much the doctor said, we know what we're looking at here. We just need a biopsy to confirm it.

Essentially. The first thing that I did was go to this great grocery store that we have that has a wonderful salad bar and load up on broccoli sprouts and greens and legumes and all these things, That was within my control. obviously I knew that going to eat that delicious plate of amazing food, wasn't going to change the outcome of my.

my biopsy at that moment, right? But it was, this is full control. This is what I have control over. And this is what I can do when everything else is out of control. And nutrition is that thing, It is one thing we can control what we put in our mouth, how much we do it, how much we are physically active, et cetera.

Tina: I'm Dr. Tina Kazer. 

Leah: And I'm Dr. Leah Sherman. 

Tina: And we're two naturopathic doctors who practice integrative cancer care. 

Leah: But we're not your doctors. 

Tina: This is for education, entertainment, and informational purposes only. 

Leah: Do not apply any of this information without first speaking to your doctor. 

Tina: The views and opinions expressed on this podcast by the hosts and their guests are solely their own.

Leah: Welcome to the Cancer Pod.

Hi, Tina. Hi, Leah. So today we have a very special guest we have with us today Allison Tierney, so Allison Tierney is a Board certified oncology dietitian and cancer thriver who empowers those affected by cancer to conquer fears, take back control, and fully support their body before, during, and after cancer treatment.

In 2022, Allison was diagnosed with invasive ductal carcinoma at the age of 33. Her knowledge base of oncology nutrition supported her throughout surgery, chemotherapy, and immunotherapy. Today, she uses both her professional and personal experience to help cancer thrivers do the same. Using evidence based nutrition and lifestyle medicine, Allison guides her clients through recommendations to reduce treatment side effects, enhance quality of life, focus on recurrence risk reduction, and ultimately help cancer thrivers reclaim the control cancer tries to steal.

Her passion for cancer nutrition isn't just a passion or a profession, it's also personal. So welcome, 

Alison: Allison. Thank you so much for having me. I'm excited to be here. 

Tina: And I just have a question right out of the gates. Um, were you already doing cancer care before your diagnosis? 

Alison: Yes, that is correct.

Okay. Yeah, I've been doing oncology nutrition for about 10 years now. 

Tina: Okay. 

Leah: your, um, your experience with your diagnosis, you said, Um, Before we, before we started recording, you said that you were treated at the same cancer center that you were working. 

Alison: Yeah, absolutely. I actually had left that cancer center at the end of 2018, but was still very well connected with everybody there.

So I knew about probably 85 percent of the staff when I went back for my own diagnosis and treatment. 

Leah: Okay. And were there any experiences, as you were there as a patient that kind of changed the way that you managed patients once you completed treatment? Was there anything that kind of stood out in terms of how you were, you know, you were treated by the staff or, anything like that?

Alison: Yeah. Well, I was actually treated incredibly well by the staff and like, You know, and it was interesting because I had been gone for, gosh, about three years at that point, where, because I had left to work in my own private practice, which I do now today still. And I was still, you know, introduced to some people like, Oh, this is our oncology dietician.

And then they would remind themselves like, Oh, wait. She's not a dietitian anymore. Um, so, but I was really well connected to those individuals still. Um, so many friendships that were made during the course of working there. And what was really interesting is the day of my I'll it diagnosis, but it was really when I had the ultrasound mammogram and biopsy.

I was coming to the breast center to have an ultrasound because there was a suspicious lump and I had messaged my friend who is a nurse navigator at the cancer center and said, Hey, I'm coming to the cancer center today. Didn't tell them why. And I said, Hey, when I'm done with my appointment, maybe I can come up.

And we called it the clubhouse, which is where all of our desks were. So it was the nurse navigator, social workers, dietitian, et cetera. And I could come up and say hi to everyone. And at the end, when we knew that it was no longer, you know, benign or, you know, it was suspicious. Now I ended up texting that friend and said, Hey, I'm actually at the breast center and I'm here for a biopsy now.

And it's concerning. Will you come down? And so it was actually where I had that experience. She was my friend. And I do remember her saying, do you want me to be your oncology navigator, or do you want me to be your friend? And I said, Both. And then I do remember her very specifically asking as well. Are you sure that you want to be treated here?

Um, because I think she was so well informed, like, you know, everybody here, right? This is going to be a very personal, emotional, vulnerable thing. Do you want to be treated here? And I said, absolutely. Yes. And the reason I said yes, is because, you know, I worked there for many years, and I knew the ins and outs, and I knew how they treated their patients, and that's what I wanted, and I received amazing care, and this sounds kind of weird, but I knew before I was ever diagnosed with cancer who I would want for my oncologist, so I pretty much was able to kind of hand select that team knowing exactly who they were, what they were about, other patients that they'd had.

So I had a really good experience from that perspective. I think the hard part for me that I experienced about being treated at the same cancer center that I used to work at was that I had a hard time letting my guard down. And what I mean by that is something that I actually worked through with my counselor was really, and the counselor that I chose that didn't work there when I was there.

So that was a specific choice to work with someone that didn't already know me, and I remember very specifically one time during chemo. And I remember just being so like fatigued and just drained and emotional and, you know, not really being myself. Right. And I remember as soon as the nurse came in the room, I kind of popped up and I was the normal Alison, right?

This nurse I worked with for so many years and she was a great friend. And from that standpoint, and then when she'd leave the room, I'd kind of silk back down and I was back to being that way. And I remember on my way home from the cancer center that day, telling my husband, I'm really sorry that you're not getting the best version of me.

And they are, but it's so much easier to. To pretend with them and I can be real with you and then, you know, thinking about that, I don't think pretend was the right word. It was just where I was sending my energy at that time, but I very much learned that I had a hard time putting my guard down in that vulnerable state, right?

Which was probably what my nurse navigator friend was talking to me about. Like, are you sure you want to be treated here? And it was really that concept that I used to walk in those doors every day as a professional and now I'm walking in these doors. several times a week as a patient. And I had a hard time letting that guard down.

But once I was able to work through that a little bit more, I was able to do that more so as time went on. And as my treatment progressed, 

Leah: Yeah, I definitely, recognize that same, situation in what, you know, what I went through in terms of when I was treated, I was Dr. Sherman, every, you know, the nurses, everyone, you know, they, they referred to me as Dr.

Sherman. So it was like, you know, and the, plus the fact that you might run into patients in the hall or, you know, like somewhere, so it was like always kind of putting on a face. I definitely, recognize that and that is kind of hard. 

Alison: Yeah, and I think cancer itself often means, putting on a different face, right?

Then maybe the outward appearance doesn't match the inward appearance or how you're feeling inward, right? And so, um, That's a, you're, you're constantly feeling like you're putting this face on. And I think that can be so mentally and emotionally draining for, I mean, the cancer journey itself is already a mentally and emotionally draining, but never really being able to put your guard down the way that might be healing and restorative can just add this other layer of difficulty in the whole process.

Tina: hmm. Yeah, absolutely. Do you think that's, there's an added layer obviously being seen at an institution that knows your professional self that adds a whole layer of having to put a facade, on as a patient, but do you think that women in general don't want to put other people out? So there's some concern about, Oh, I don't want to, I want to be my best self cause I don't want to ruin your day.

I don't want to bring you down. I don't want to, lay that on you. So yeah, there's a little self sacrifice layered in there. 

Alison: Absolutely. And I also see that from the standpoint of when patients are talking to me or just people that I'm conversing with in social media or whatnot, whatever it might be, when they might ask a question or they're, you know, for example, um, so we were talking about soy and someone said their oncologist told them to avoid soy.

 And I said, well, do you know what their reasoning was? And they said, well, I of didn't ask them them. I did. Right. And I think there's a couple of pieces to that. They didn't want to impose further. So. Some of it could also be that, you know, you're hearing one thing and sometimes going out the other.

There's so much going on in an oncologist appointment, but I think sometimes it's, I don't want to feel like a burden. I don't want to be that person that's asking further questions, or I don't want to be the person that questions my oncologist and thinks and challenges it. Right. And I think that happens a lot for women is that we don't want to be the person that challenges Even when it doesn't feel right.

Um, so I think that's part of my story too, is like advocating for yourself when something doesn't feel right, ask more questions, be willing to keep asking more questions until you get an answer, you know, and I think about from my own journey, had I not acted upon the lump that I felt and asked for more answers, I don't know where I'd be today, to be honest, 

Leah: Oh, because of your age, because of people probably, were you, were you dismissed at all, or was it like, oh, you're too young for this to be suspicious, or?

Alison: Not necessarily for myself. I know that that's the case for a lot of young women. It's like, oh, you're too young, it's probably nothing, right? Um, my situation was more so, The reason why I got into oncology nutrition is because my mom is a breast cancer survivor, my grandmother is a breast cancer survivor, my grandfather passed away from liver cancer, my other grandmother passed away from lung cancer, and my godmother is a breast cancer survivor, right?

There was so much cancer in my family that I was, you Very interested and curious about how nutrition could play a role. I was already interested in nutrition because I was an athlete and wanted to know how my sports performance could be enhanced through the nutrition. But then all these diagnoses happened and I wanted to know how could nutrition play a role?

Could it help reduce our risk of recurrence? Could it help during the course of treatment and could it help into survivorship? And I don't think I'd be here talking today if we didn't find out that yes, nutrition can play a role in all of these areas. So that interest in oncology came from that, and therefore that strong family history of cancer didn't necessarily, um, dismiss me.

My OBGYN is the same OBGYN that my mom was diagnosed with breast cancer with, and so she knew my history very well. And I was only 10 days post breastfeeding my second child and I went in for an annual exam. She did breast exam. We found a lump and honestly the lump itself was kind of dismissed because I had just finished breastfeeding like, you know, breast changed so much.

It could have been a clogged up, et cetera. And I remember just shooting the breeze with her being like, Oh yeah. Okay. Whatever. And then I remember going home and feeling it. over and over and I believe my role as an oncology dietitian and working with a lot of young breast cancer survivors is actually part of my story in early detection from the standpoint of those individuals that came before me and sure, the knowledge base that I had, but it was really that that said, I'm not too young to have breast cancer.

I have an extensive family history of it. I need more answers. I need peace of mind. so a few weeks later, I messaged my doc and said, Hey, I need some peace of mind. I actually just read the MyChart message the other day going back to it and saying, I just want some peace of mind. What do we do next?

And that's where the ultrasound was scheduled. Um, ultrasound came back. Hmm, and there was already concern, mammogram, concern. We need to get a biopsy. And that's kind of how it all happened. 

Tina: So, am I hearing you right? You self advocated for the follow up imaging. It wasn't your OB GYN that said, let's check this out and make sure it's okay?

Alison: Correct. Yes. And, from that standpoint, you know, I've thought about this a lot, I was preparing for a lifestyle medicine conference where I was the main breast cancer speaker and I had prepared, was preparing for and came across some research about breast cancer, during pregnancy, postpartum and with breastfeeding.

And although yes, it's rare, but it does happen. And I knew that already, but it was like just showing up on the screen that I was like, Hmm. Every time I felt that lump, I felt really anxious and I was like, okay, this is a sign that's telling me that I need to dig further. And that's when I reached out to my OBGYN.

Um, I had had a lump between my pregnancies that we ultrasounded. They went, it went away after a cycle. Um, so this time it was like, man, it hasn't changed. I've had a cycle. It didn't go away. Um, and I remember talking to my husband about it and he wasn't concerned at all. Even looking back, he was like, I didn't think anything of it.

And he said, I think most women at this point, they would have waited a whole nother year to go back to their OBGYN, have another breast exam. And then maybe something he's like, I am so grateful that you trusted your intuition and kept an eye on it. And so, you know, that's where I try to advocate for women is like, if there's something That doesn't feel right.

I was just talking to somebody in social media just the other day, and she wanted to know my story and she had a lump that they did say you're too young. And I said, have they had it checked out? And she said, no. And I said, you know, I feel like a lump is, you know, it's guilty until proven innocent, you know, no matter how old you are.

Right. And so my hope is that even if there is some question there, people will get more answers, and make sure that it's nothing. Cause again, In a year from that original, you know, feeling of the lump, what, where would my cancer have been a year later without doing anything about it? I don't 

Tina: know.

Right. Exactly. and looking at your website, that whole idea of controlling the controllables, I think that's, that's part of it. I mean, you had the self agency to actually communicate with medical practitioners. And I think that's a bigger hurdle for people who are outside medicine.

So, With all due respect to folks who are like, I tried to do that. My doctor didn't listen to me. That's, that's a hard place to be. And I've heard people's stories where they try to self advocate and they get, blocked. And so reminding people that their intuition is something they should not allow other people to talk them out of is probably top of mind.

In my, thoughts. 

Alison: Yeah, definitely. And I think it easier said than done from this point. Point two is that if, if you're up against that blockade, where somebody is not listening to you, we need to find a different medical provider that's going to help you get those answers or that peace of mind or a diagnosis, God forbid.

Tina: Totally. 

Leah: As you were going through treatment, did you have a dietitian that worked with you? Did you have someone you could, you know, bounce ideas off with, or were you kind of like, was that your thing? You're like, no, no, no. I got this. 

Alison: That's interesting. Um, and I'm smiling because, um, I did have one and it was an interesting experience.

 We'll just say that. Um, but I did have some colleagues that I knew really well that I did bounce some ideas off of and that wasn't a formal, Experience that I had with them. But and of course, you know, I always told them like, I'm not taking this as medical advice by any means, but I was fortunate enough to have some oncology dietitians to be able to bounce some ideas off as well.

and I also believe that, you know, different dietitians, just like different people, we provide a different things and different ideas. And that was why I was very open to having a dietitian on my team, because they probably have ideas that I could never think of. Right. And I think we all bring something different to the table.

And I was totally open to experiencing that. Um, I do feel very lucky to have had the knowledge and resources that I had going into it. And I did play off so much of my previous experience to help me through treatment. 

Leah: Was there anything that maybe it was a recommendation that you typically made? as they were going through treatment that when you actually experienced maybe that side effect or something that Suddenly you're like, Oh, wow, that really works.

Or maybe I'm going to change my recommendations from now on. 

Alison: That's a really great question. I haven't actually been asked that before. So, um, I would say that there wasn't anything where I was like, Oh wow, this doesn't work, I need to change my recommendation. But what I will say is that it really.

brought just obviously a different level of awareness and actually helped me come up with more ideas. And an example that I'll give is, you know, when I was really struggling to get enough intake in, I just, I didn't have an appetite. I was really struggling with that. You know, when we talk about eating small, frequent meals.

Um, but one thing that I did different was really communicate to my husband and said, I was really well aware that I was like, unless you're putting the food in front of me, I'm not going to eat. Right. But if you put it in front of me, I will make a commitment to eating that. And that kind of changed that game when I was really struggling and I was noticing, you know, that.

more weight loss. And I was like, I can't keep up with this else. And what is going to be something that's going to help you get more of the calories and nutrition that you need? And to me, it was being able to verbalize that I'm not going to eat this unless it's put in front of me. And it also takes away some of that.

I don't have to decide what to eat. And I also don't have to put the energy into making it so that can really break down some of the barriers that are there when it comes to getting adequate nutrition. So from that perspective, that experience gave me so much more insight about possibilities that could work for people if they're experiencing similar symptoms or things that I've experienced.

Leah: Yeah. Something that you talk about on your website, which think, I experienced it myself that like when you go through treatment, there's like the logical brain. And then there's the emotional brain, right? I mean, it's just like having worked in cancer, you know, in cancer centers, like I knew logically, What was going on and what to expect.

And it didn't matter once I started going through treatment, like the kind of irrational thoughts would come in. And I, not during treatment, but after treatment, I started to experience a little bit of like fear of foods. Um, and you talk about that on your website, how you help patients to dispel those, those fears around food.

 what are some of the more common fears that you see with patients? 

Alison: Absolutely. Yeah. I love how you describe that, that you know, like the fact, but you also know, like, what's irrational, even though, like, you know, the background, you know, the information you're like, this is irrational, but yet I still continue to think it and believe it.

 Right. So that's so true. But when it comes to fear, right, there's so much fear around cancer itself. Right. And a lot of people come to me, which I totally understand because the moment. That I. believe that I had breast cancer, right? Pretty much the doctor said, we know what we're looking at here. We just need a biopsy to confirm it.

Essentially. The first thing that I did was go to this great grocery store that we have that has a wonderful salad bar and load up on broccoli sprouts and greens and legumes and all these things, That was within my control. obviously I knew that by going to eat that delicious plate of amazing food, wasn't going to change the outcome of my.

my biopsy at that moment, right? But it was, this is full control. This is what I have control over. And this is what I can do when everything else is out of control. And nutrition is that thing, It is one thing we can control what we put in our mouth, how much we do it, how much we are physically active, et cetera.

 but I would say the biggest things that patients come to me with in terms of fear is number one, they're like, I don't know what to eat. And I don't know what not to eat. because of so much misinformation out there. And the biggest fears definitely come from sugar and even the sugar from the, in the form of fruit, right?

Can I eat fruit again? Um, soy, especially as breast cancer survivors, people are saying, well, I thought I wasn't supposed to eat soy. And here's this information that it actually can help reduce the risk of recurrence. Is this something that I should be doing? Um, carbohydrates themselves and trying to really break down that Fact that we need carbohydrates, we just need the right types of carbohydrates and that's what's going to fuel us.

 so those are probably the biggest ones, but you know, I was talking to a client who is a three time breast cancer survivor. and she was telling me, you know, we've been working together, dispelling myths, set some goals. And the best thing she told me last week was, she goes, I'm not afraid anymore.

I'm not afraid of the food because I know that what I'm putting in my body is nourishing me. And that's everything. If we can help reduce the fear, and I'm never going to say that the fear is going to be completely gone, because I think that's what's So many cancer patients can relate. There's always this level of fear, right?

 but if we can help take away some of the fear, especially the fear away from food, that can be so beneficial for us, that's going to be really empowering for us as cancer patients. And also when we're empowered, to me, it's more than just about food. It's about Our mental health, our emotional health, when we aren't scared, when we can live the life that we want to live, because we have the energy to do it, right?

It goes so much farther beyond food and nutrition. It goes down, in my opinion, to living a high quality life.

 Yeah, for sure. 

So can we talk specifics about some of the things within the dietary realm that you might advise people? 

Sure. Absolutely. 

All right. So our most popular episode that we've ever done is called sugar. Does it feed cancer? And so what is your kind of elevator speech about sugar and cancer? Can people eat it?

Is it our desserts completely off the docket? how do you explain it to people and, and how can they live a, A good, rounded, high quality life and still manage their relationship with this whole like idea of sugar and cancer. 

I think that one of the biggest things to help reduce fear is to truly understand the underlying why.

Okay. So I love to teach the why because I think if we can teach the why that can help reduce the fear and lead to empowerment rather than just saying each sugar or don't eat sugar. let me start by saying this, when we eat carbohydrates, it turns into glucose or sugar.

Okay. No matter if we're eating skittles, which are literally just pure sugar all the way to broccoli that contains carbohydrates. Those carbohydrates are going to be broken down into glucose in our body. Glucose is the primary fuel source. of every single cell in our body. So we need glucose in order to have energy.

And what a lot of people aren't familiar with is that if we don't have glucose, our body knows how to make it. Okay. Our liver can produce glucose and we can create glucose from protein, et cetera. So our body is going to get glucose. Now, when it comes to cancer itself, Does cancer feed of sugar?

Yeah, it certainly can. It requires a heck of a lot of energy to be cancer to grow and divide and everything. But cancer also feeds off of fatty acids and, amino acids and so forth. So if we're taking away the entire fuel source of glucose, yes, we're going to be taking away a fuel source from cancer, but the cancer is going to get the fuel source it needs.

At the same time, if we take away glucose from our bodies, We're also going to be depriving our healthy cells from the fuel that it needs in order to thrive. so what I think is really difficult and frustrating when it comes to the information space about sugar feeding cancer is there's almost two complete extremes, right?

Don't eat a any sugar, not even the form of, of fruit all the way to sugar doesn't feed cancer. Here's your Snickers bar. It doesn't matter. I don't think either of them are true. Okay. And research really shows that it doesn't necessarily have to do with sugar itself. self, but sugar's relationship to insulin resistance and how insulin resistance plays a role in increasing insulin or causing hyperinsulinemia, high levels of insulin that really can lead to the growth development or proliferation of cancer cells.

So all that to say. we actually want to eat foods that have carbohydrates. In fact, the primary recommendation internationally, cancer recommendations, the American Institute for Cancer Research, the World Cancer Research Fund, the American Cancer Society go on and on and on is that we want to eat a diet that's rich in fruits, vegetables, whole grains and legumes and nuts and seeds and make that a part of your usual diet, right?

All of these foods, except for nuts and seeds, they have small amounts of it, but fruits, vegetables, whole grains and legumes are all rich in carbohydrates. But the key pieces, there's so many different parts of it, but one of the big key pieces of it is that these carbohydrates contain fiber and fiber is going to help naturally regulate our blood sugars help reduce insulin resistance and make sure that we're insulin sensitive 

Does that help make more sense about where I lie in sugar feeding cancer? It's not on either extreme, but kind of in the middle. And we do need carbohydrates. We just want to focus on whole, intact carbohydrate rich foods.

Tina: Yeah, that's that's basically in line with what I have always recommended to patients too, which is it's about your blood sugar What is your glucose doing and we use that as our guide as to how they should be treating sugars in their diet So if somebody already has some level of insulin resistance, they may have to be more controlling about their intake than somebody who's very fit active and just choose up that glucose as fast as they eat the carbohydrates.

They, you know, chew up that glucose because their muscles are active all the time. And so it's, it's very individualized in some ways. 

Alison: Yeah, absolutely. And also keeping in point, like if there's that insulin resistance, they're making sure that we're making efforts and goals towards reducing that insulin supply.

resistance and becoming more insulin sensitive, right? So I think there's a lot of misunderstanding about insulin sensitivity and insulin resistance. and that we also need to remember that high blood sugars are a result of insulin resistance. So if we're just focused on purely looking at blood glucose and not necessarily focused on insulin resistance, we're focused on the symptom, not the root cause.

Right. So there's this image that I always like to show my patients or, um, create this image for people is okay. There's a sink and it's overflowing with water. Okay. The sink, the faucet is still turned on. The water is running and the sink is overflowing and there's to physicians.

Um, and they're mopping up the water on the floor. Okay. But if they were to turn off the sink, stop the water from running, They could mop up the floor easier and stop the problem from happening. So it's really about, okay, we can't just put a bandaid on something we need to focus. Yes. The symptoms matter, right?

High blood sugars are not a good thing, especially in the long chronic case, but we need to turn the faucet off so that we can really focus on solving the root problem. 

Leah: A lot of what's been coming out in the last couple of years, in you know, the oncology, research circles is the effect of alcohol.

And the risk of cancer. So are you seeing a lot of that with your, your patients or clients? Are they asking you, you know, what, can I still drink? I mean, how, you know, how do you talk to your patients about alcohol? 

Alison: Yeah, absolutely. That is a super common one and really truly alcohol itself is a carcinogen, If we look at the list of cancer causing substances, um, group one, a group one carcinogen is By definition, known to cause cancer in humans. Okay, we have enough data and research to support that it increases cancer risk. Alcohol is on that group one carcinogen list. Also on that group one carcinogen list is processed meats.

So these are two that we either want to eliminate or really try to reduce as much as possible. And I think that when it comes to alcohol, that's a lot harder for people because it's, you So much more social, right? It can be something that is more of a treat for people at the end of the day.

It's been a stressful day. That's how they might unwind. but in 2015, the world health organization declared that no amount of alcohol was safe for breast cancer survivors. So usually how I counsel patient is number one, if you don't drink, don't start, you know, the benefits of resveratrol that you would get from red wine can be gotten from purple grapes, right?

Or some other areas of the diet. And the other component is. As I'm usually digging in with a patient to help understand why do they want to drink, right? Some people, when you really talk to them about it, they really only are interested in drinking because That's what they do when they're social, but they might not even actually like it, right?

So are there other opportunities that we can help someone feel comfortable in their social situation and whether that's having a mocktail or something like that? So it also comes down in my opinion, not just saying don't drink, but also digging a little bit deeper into understanding. Why do you drink?

What do you enjoy about it? And. Trying to work with that individual and making an individual recommendation to help reduce their risk of recurrence based on also where they find joy. So it's that balancing act of those things. Does that make sense? Oh, absolutely. Yeah. 

Leah: I think that's a component that are afraid to face themselves as to like, why, why not?

Why do I drink like, oh, you know, I only have a drink every once in a while, you know, whether it's social or to relax, it's, it's not always easy to face that, you know, because it is so socially acceptable. 

Alison: Yeah, absolutely. I mean, I live in Wisconsin, right? kind of this, the, uh, capital of beer, cheese and sausage, right?

Some of these, you know, really unfortunate, not healthy things for us, right? Um, you know, I've actually grown up. I've never drank alcohol. It's something that I just chose myself. I don't actually really enjoy it. So I've been in a lot of positions that have really helped me. socially where people are uncomfortable because I'm not drinking, right?

 I'm not uncomfortable because I'm so used to it. But they're uncomfortable because I'm not drinking. And so I think that's another really interesting part is You shouldn't have to worry about making other people comfortable, You should make a choice that's good for you.

And for me, a choice that's good for me is not drinking. Um, and you know, it doesn't mean that I don't go to events where there's drinking or anything, but it's more of a, this is just the choice that I'm making when I'm at these events. And for lack of better term, I don't care what someone else chooses to do.

I'm reflecting on what's best choice for me. 

Leah: Okay. So you brought 

up the, um, the Wisconsin diet, which I am very familiar with. And I had to kind of educate Tina a little bit about, uh, drinking and Wisconsinably, but having worked in the Midwest, it's a lot different. I think it's a lot more like what Americans eat as opposed to living on the coast, where, especially in Oregon, people are a little bit more aware of, diet and vegetables and that sort of thing.

So what tools do you give to your patients who maybe they never really, you know, Eight vegetables. Um, I know that when I have been to, restaurants or bars in Wisconsin, they have vegetables and they're all deep fried and I'm not picking on Wisconsin in any way. It's like one of my favorite places to be, but I just mean, in terms of working with people who they may never have received any sort of education as to what a healthier diet would look like, or a plant based diet.

Because that's, that's your, That's your whole thing. And so how do you introduce plants? To somebody who they may not really be familiar with a lot of plant foods. 

Alison: So often I joke that if I can do it in Wisconsin, you can do it anywhere, right? If I can live a plant based lifestyle, you can do it anywhere.

Um, but I also, I have clients that are live very rurally in different states and they can be, you can still be successful. So the first part that I, again, I like to teach the benefits of plants, right? If I were to tell a heavy meat and dairy eater, Like, nope, you got to stop. Now it's time to eat plants.

They're going to look at me and be like, who are you? Like what, you know? So it's really kind of digging down into who are they And where does that come from? and I really like focusing on the perspective of adding before subtracting. And what I mean by that is by not necessarily telling someone, okay, no more sausage, no more, deli meat.

it's more of, okay, let's saythey're going to eat a deli meat sandwich. Can we add lettuce? Can we add tomatoes? Can we add onions? Can we add more of these whole plant based foods to their diet? before we worry about subtracting. And I think that can be so beneficial because depending on the individual, you're meeting them where they are.

And that's super important is to meet them where they are and give them small little wins that show them that they can do it And that when they make these small, sustainable changes, it doesn't have to happen overnight. It doesn't have to be 180 degree. change. But adding these small little changes can really lead to really impactful, long lasting results, I like to kind of pick on my brother and my brother is one of these guys who I thought would never in his whole life ever consider not eating meat or eating less meat, for example. And my brother, turned to me one time and said, I think I'm going to be a vegetarian for a little while and just try it out.

And I looked at him and I was like, who are you? And what have you done with my brother? Because I don't even understand where this is coming from. And he, he did that. He became a vegetarian and now he's plant based, completely plant based, no longer eats meat or dairy or anything like that. And kind of in the middle of this, I said, you know, Nate, I'm kind of curious Where did this come from?

I didn't say, Oh, you really need to do this. Right. And he's like, well, of course I've been watching you over the years and I noticed how impactful it was on your health and the energy you had and your skin cleared up. all these things. And he goes, you know what really did it though? He said, one time you told me I said, I don't think.

You understand how bad you feel because you've never felt good. And he said that really stuck with me. So when I started adopting some more of these things and I started noticing that I felt better and better and better, and then I wanted to dive into more of it, I dove in and I've never turned back because I feel so good.

That I'm never going to go back to that because I remember how bad I felt once I felt good. So it's kind of working with those. Obviously, I can be a lot more blunt with my brother, right? But it's really taking that person from where they are, um, and making those small little changes. I was just talking to a patient before we got on this call, that grew up as a dairy farmer.

They grew up on a dairy farm. Dairy was a huge part of it. This individual was just diagnosed with type 2 diabetes and we were talking about milk and he's like, Well, I just don't know if this is something that I can change and I said, I don't think you need to get rid of it completely, but can we dial it back and can we add more of these things?

And he was totally agreeable to that because I think honestly, if I told him absolutely no dairy ever again. He probably would have hung up on the call, right? So it's about making those changes that, can help the patient really see some powerful impact. That's going to help them lead even more in that direction.

Tina: Yeah. That, that is always the case where people don't know how bad they feel because you can talk to people and they're like, I don't really have any pain or, they are convinced that they don't feel anything, but once the diet gets really cleaned up and then they go off and eat, you know, Something from Subway and a Coca Cola or something like,

 they feel the consequences. It's, it's interesting how the human is hooked up in our brains to not really notice because it's such a slow process. Absolutely. 

Leah: Yeah. Or you've just, yeah, you've experienced it your whole life. And so it's, it's normal, it's, it's a normal thing like on how you feel and then yeah, you make those changes and yeah, seeing that in patients, um, when they have that shift, it's yeah, it's everything.

um, do you have a lot of patients that ask you about fasting because that's another, another area where, I think there's still is a little controversy around that, um, in the oncology world. do you find that patients ask you about whether fasting. during treatment or, after treatment while they're in survivorship?

Alison: Absolutely. This, I see an awful lot and I also think that, since I share my story and I'm very open about sharing my story, patients come specifically often to me to talk about it because I did fast forward. for chemotherapy. Um, so that was something that I employed in my own journey. And, when I decided that I was going to do it, uh, that was where I bounced ideas off of my oncology dietician colleagues was really because I had 12 weeks of weekly chemotherapy, right?

I had 12 weeks. counseled patients before on fasting for every two week or every three week type treatment protocols, but I had never counseled someone through weekly chemotherapy. And I really thought to myself, Oh my gosh, is this going to be sustainable? Right. Am I going to be able to do it? And I was kind of scouring the research to find more, more see if there was, you know, the same protocol that I had and what was the results of it.

So, um, I had some feedback from the dietitians that I worked with telling them what I wanted to do, asking their suggestions, but also brought the research available to my oncologist. And it, this is kind of where that working with, you know, your oncologist is your past colleague is really interesting because I brought all the research in and I knew what I wanted to do.

And I was like, okay, about this. And he goes, Alison. I trust you. You know what you're doing. Go ahead. And I think obviously that's a very unique experience with the oncologist, but he had worked with me before he knew who I was, what I did, how I practiced, et cetera. so I did go ahead with fasting for myself.

 I did have to kind of, you know, alter my fasting protocol a little bit because I was losing weight just a little bit too quickly, more than I wanted to. And I was thought to myself, this is not going to be sustainable for another, I think it was maybe had eight cycles left or something. Once I adjusted it a little bit, then I was able to maintain my weight the rest of the treatment.

And, I had never tried a cycle without fasting, so I can't tell you what it would have been like if I didn't fast. But my main reasoning for fasting was to aim to try to reduce the side effects of chemotherapy. Um, especially like the nausea, peripheral neuropathy that comes through it. and bowel changes, et cetera.

 And I tolerated treatment very well. And I personally believe that played a role in how well I did. And 

Tina: when you did fasting, because weekly is, It's very challenging. Did you do it for three day spans and did you just do a massive caloric restriction vegan type diet? How did you, not details, but just how did you in general approach that?

Cause that would be challenging. 

Alison: Yeah. Thanks for saying that. Especially not necessarily details. And the reason I, I also, I, definitely share a little bit because I always want to make sure that people don't just take what I did and do it because it might not be right for them because fasting isn't right for everybody.

Um, and there's definitely considerations to be made. you know, I was coming in, thankfully to chemotherapy, very healthy, very strong. and so I, um, ended up starting. So my first few fasts were about six months. 65 hours, I think. so it wasn't a full three days, um, but that's where it started and I was finding that was just a little bit too long and not sustainable.

so I ended up, shortening to about closer to like 56 hours with the intention of it to be 48 hours, but just the way chemo falls. And when it starts, I found the first day was the hardest. The next day was always chemotherapy for me. And I think there's so many things that are going on.

you get a big dose of Benadryl. So you're super tired. And so you just kind of don't notice it as much. and then the third day, which I was really only fasting for a few hours during that day to make it a full 20, 48 hours, I found was the easiest. I felt great. And that probably had something to do with the steroids that I was given during the quarantine.

course of treatment, for premeds. But also, I always say that I don't know if it was necessarily like this effect of me knowing like, Oh, I'm going to eat later today. So this is no big deal. Um, so I'm not sure if it was really, did I feel that good? And was the third day the easiest or was it, I know I'm going to eat and so I'm going to feel good.

 it was very challenging. I've looked back and think to myself, how did I do that for 12 weeks? I don't even know, but honestly, I. think just looking back, I reminded myself of the research. I reminded myself of why I was doing it, why it was important to me. And I say it, Oftentimes that, sure, I did treatment and everything that I've done for cancer for myself, but I also did it for my family, right?

I did it for my husband. I did it for my kids because they deserve to have a mom that's here for a long time and that's healthy. And so I also reminded myself of my why and my why was my family.

 Yeah. So with that being said, I do get a fair amount of people that come to me because they, they hear about me fasting. They know that I've coached people through it. Um, I do talk my one on one clients because I do have that one on one care with them. I can provide that recommendation and that information if it's something that they want to.

Um, so that's where we talk about it. And then intermittent fasting comes up quite a bit and intermittent fasting. There's so many different types of intermittent fasting, right? You can do 13 hour fast overnight. You can do a 16 eight when you know where you fast for 16 hours and have an eight hour eating window.

You can have a 24 hour There's so many different ones. And that's where, again, I think it depends on the individual. I think the research. It's pretty promising where it's at. I think we're going to continue to see more research come out about this and also help us understand who it's appropriate for and who might it not be appropriate for, um, and how to do it the right way.

So I think there's more to come in that area, but I do think it's pretty promising and pretty awesome. 

Tina: And it is one of the controllables, I suppose, to an extent. 

Alison: Yes, absolutely. It is one of the controllables. 

Tina: I really liked the idea of, understanding that controlling the controllables and, you know, we're naturopaths.

You're a dietitian. We all talk about diet and supplements and exercise and all these great things. And I want to just refer back to what you said in the beginning, which is also stress levels, our nervous system. 

 controlling the controllables it's so much more than diet, like you mentioned. So, I appreciate 

Alison: the work you're doing.

Yeah, I tell people all the time, like, I'm a dietitian. Of course I'm going to talk to you about nutrition. Like, I'm a nerd. That's totally what I'm going to talk about, right? But that's not to say the other things don't matter, And I think when it comes to my own journey, that was probably the biggest eye opening experience for myself was sure.

Before I was diagnosed, I followed a plant based diet. I wasn't doing everything perfect by any means. I was also postpartum with two kids, right? So, you know, my sleep probably wasn't great, you know. But how I managed stress? How I worked through my emotions or didn't work through my emotions was not okay.

And, you know, I think of myself, I'm a very different person than I was pre cancer. And I actually think for the better. I think of a better version of myself. And did I change diet and nutrition? I didn't overhaul, but I honed in on different things in my diet, nutrition, and changed things from my pre cancer to my post cancer self.

My physical activity has always been on pretty par levels. I was a college athlete, and that's always been a huge part of me. But when it comes to, those other aspects, not having boundaries and not holding them, um, not working through the emotions, not managing stress well, those things were huge. It was a huge kick in the pants to change that.

And I'm not perfect at it now, but I have come a long way. And, um, I was talking to my cancer counselor and we were talking, I told her like, I have a new motto for myself. She's like, yeah. And I said, I don't do overwhelm. And she's like, That's a really great motto, Allison. She's like, I love it for you, but you're going to have to add something else to it.

And I was like, what's that? She goes, I don't do overwhelm. And sometimes that will feel uncomfortable because we're so used to always doing all, you know, I'm a type a high achieving perfectionist type personality. It's hard to try not to do something perfect or try, you know, aim for that. And that's going to feel uncomfortable.

but honestly, that uncomfortable work has been where I've made some of my biggest progress over the last two years since my diagnosis. And not to say that I'm thankful for cancer. But I don't know that I would have learned those lessons if it weren't for cancer. And for that, I'm grateful. I wish something not life threatening would have taught me that, but I'm not sure that something less would have been enough.

So my hope is that by not only sharing nutrition and the empowerment that comes from that and controlling the controllables, but sharing my journey about Changing my mental health, my emotional health, how I handle those things can be an eye opening experience for somebody else that hopefully doesn't have to wait until they may or may not experience a life threatening diagnosis to make those changes.

Tina: I love it. I 

Alison: love it. 

Tina: So, is there anything else you wanted to talk about, Leah? 

Leah: Uh, no, but I do, uh, well, yes, um, and hopefully, Allison, you'll want to talk about it too. it's the. The program that you offer for people, you have a website, which it's great website. I signed up for your newsletter. I got your, um, your download, the, the 10 high protein plant based snacks.

yeah. So can you go more into the program that you offer for, for clients? 

Alison: Yeah, absolutely. Thank you for asking about that. Um, so I know I'm always biased. So from the standpoint of like, it's a great program, right? I have so much fun with it. And that's cause I feel like I'm so privileged to work with just some of the best people there is.

Um, so my main program is called the wholesome journey and it's really talks about, you know, My business is called wholesome, really not only from wholesome nutrition, but again, from that whole person health perspective, So the group program is my main program, and it's primarily cancer survivors or individuals that have high risk for cancer, but anybody is welcome.

That is just interested in using more of a plant predominant nutrition approach to help reduce their risk of cancer and its recurrence. And in that program, I have online curriculum where it's basically a lot of that teaching. I can't talk a lot about the why, right? And I like to really dive into some of those teachings to really motivate people to incorporate the things that I recommend.

So there's this online curriculum, there's group community, and there's also group Q and A sessions. They can ask any questions they want with me, but also what a great way to connect with individuals from literally not only just around the country, but a lot around the world that are going through a similar experience.

And I always tell people, you know, we don't have the exact same experience, right? Leah, you and I, we have, we're both cancer survivors, but we don't have the same exact journey, but we have some shared experiences, right? And so how we can connect with other survivors or other individuals that are going through a similar journey.

That is transformative. And that's probably my favorite part of the group program. and I also offer one on one coaching that, um, has the group coaching, but also that one on one. If someone's looking for more of that individual attention, really focusing on that. And that's where I work also with a lot of patients that are going through active treatment so we can help manage their side effects with nutrition and make changes as they go through treatment.

Um, so yeah, those are the primary programs. Um, if anybody's interested in learning more, they can definitely reach out to me. Visit my website. I'd be happy to chat more about it. 

Leah: And your website is wholesome LLC. com. 

Alison: That is correct. Yep. Okay. 

Leah: Just so everyone, you don't have to go to show notes. I just told you right now.

Absolutely. 

Yep. 

Alison: Wholesome LLC. com. And I'm most active on social media On Instagram and that's at wholesome dot cancer dot nutrition. 

Leah: Yeah, and I love I love everything that you're doing on Instagram, too so if If our listeners aren't following Allison, you, you need to, 

 she's great. 

Alison: Thank you so much.

I appreciate that. 

Tina: All right. Well, thank you so much for joining us today. This has been a great conversation. I hope our listeners gained a little knowledge. And of course, as always, they can write to us, at our email, thecancerpod at gmail. com and go over to Instagram as you're following wholesome, wait, wholesome.

cancer. cancerpod. 

com. 

Alison: Yep. At Instagram, it's wholesome. cancer. nutrition. Awesome. Okay. 

Leah: So you can follow us too, right? You can probably type in wholesome and I'll pop out. But, um, yeah, no, this has been great. Um, I'm so glad that we talk, you know, in person. 

Alison: Likewise. Thank you so much for having me, Tina and Leigh.

I really appreciate it. Anytime. 

Leah: Thanks for listening to the Cancer Pod. Remember to subscribe, review, and rate us wherever you get your podcasts. Follow us on social media for updates, and as always, this is not medical advice. These are our opinions. Talk to your doctor before changing anything related to your treatment plan.

The Cancer Pod is hosted by me, Dr. Leah Sherman, and by Dr. Tina Kazer. Music is by Kevin MacLeod. See you next time!