Episode 22: Sleep and the Big C: Managing Sleep and Cancer

Show notes:

As we all unfortunately know, cancer is a major disruption for everyone in its wake. But whether we’re dealing with our own diagnosis or that of a loved one, there are tools and methods for improving our quality of sleep and our quality of life, from the initial diagnosis to the treatments we choose to pursue and beyond. 

To learn more, we’ve invited Dr. Eleonora Teplinsky, medical oncologist, professor, and fellow podcast host. The head of breast and gynecological medical oncology at Valley Mount Sinai Comprehensive Care Center, Dr. Eleonora focuses on young women with breast cancer, survivorship, exercise oncology, and the use of social media in oncology. As the host of the INTERLUDE Podcast, where she shares stories and experiences of those effected by cancer, she aims to empower patients to truly understand their diagnosis, providing support, inspiration, and strength to many.

Episode-related links:

A Survivor’s Guide to Chemotherapy and Sleep
Tempur-Pedic Helps Fulfill The Bucket List of a Man Fighting Cancer
Why Sleeping While Sick Is So Important

Transcript:

Dr. Shelby Harris: How are you sleeping? Are you sleeping? I’m Dr. Shelby Harris, Director of Sleep Health at Sleepopolis, where we dive deep into all things sleep. If you like sleep talking with Dr. Shelby, you’re in the right place. Take a second right now to like this video on YouTube or give us a five star rating through Spotify or Apple Podcasts.

It seems simple, I know, but it helps us reach a lot more people to get them the rest they deserve. And if you’re tired of hitting the snooze button, hit that subscribe button instead. A new episode of science-backed sleep tips is available every other Wednesday. 

As we all unfortunately know, cancer is a major disruption for everyone in its wake. But whether we’re dealing with our own diagnosis or that of a loved one, there are tools and methods for improving our quality of sleep and our quality of life, from the initial diagnosis to the treatments we choose to pursue and beyond. 

To learn more, we’ve invited Dr. Eleonora Teplinsky, medical oncologist, professor, and fellow podcast host. The head of breast and gynecological medical oncology at Valley Mount Sinai Comprehensive Care Center, Dr. Eleonora focuses on young women with breast cancer, survivorship, exercise oncology, and the use of social media in oncology. As the host of the INTERLUDE Podcast, where she shares stories and experiences of those effected by cancer, she aims to empower patients to truly understand their diagnosis, providing support, inspiration, and strength to many.

Dr. Eleonora, we are so glad you could join us today to empower our listeners to better understand this important far reaching topic. So thank you for being here and welcome to Sleep Talking with Dr. Shelby. 

Dr. Eleanora Teplinsky: Thank you for having me. It’s great to be here. 

DS: So we really want this episode to be a resource for anyone dealing with a cancer diagnosis; the patients themselves, but also their loved ones, those in their support system. And while some of our listeners might be all too familiar with the effects cancer can have on our lives, there’s also people out there facing this diagnosis for the first time. 

So for everyone out there, can we start by going over the common ways that cancer can affect your sleep quality? Let’s say the pain, for example, how does the pain associated with cancer interfere with sleep? And what are some strategies that some people might use to help them get better rest that you’ve learned throughout your time? 

DE: Such an important topic. I mean, I will tell you that the majority of patients that I see on a daily basis are all struggling with some sort of sleep disturbance. And there’s so many ways that cancer, even a diagnosis of cancer, let alone the treatment, can impact sleep.

So just to go through some of them, I mean, the biggest one is the impact of cancer on mental health, you know, the anxiety. The grief, the depression, the fear of cancer recurrence, I mean, all of these things, you know, really, really impact someone’s mental health and then that impacts their sleep. 

They are having a hard time falling asleep. They are waking up in the middle of the night. They’re not getting restorative sleep. So they’re sleeping, but they’re waking up still feeling exhausted and fatigued. 

I talk a lot to my patients about social media scrolling that happens at night. And, you know, there’s a lot of good on social media, but there’s a lot of also triggering content and information that then impacts their sleep. So, you know mental health by far the big one 

DS: Yeah. 

DE: Another thing that we see of course is pain. Some cancers cause a lot more pain than others. It depends on the type of cancer on the stage and where the disease is located but obviously if you’re experiencing pain anywhere in your body and can’t get comfortable that’s going to impact sleep. 

Another thing that we see, and I see this often in my world, is early onset menopause, premature menopause, and the medications that we put people on to that low estrogen state. You know, people are just not finding that their sleep is restorative, they’re having trouble falling asleep, and a lot of my women are waking up multiple times a night to go to the bathroom, and then they, can’t fall back asleep. So we see urinary problems play a role as well. 

So what we always try to do is go to the root cause, right? So if it’s mental health, how do we manage that anxiety? You know, things like journaling and meditation. 

DS: Okay. 

DE: And we can dive into all of those, seeing a therapist, but obviously there’s also sleep supportive medications that some of the patients need to be on, but we really try to figure out what’s the root cause of the sleep disturbances before we just throw medications at them.

DS: What about just the thing that I see a lot is fatigue. So a lot of patients with cancer are just reporting just extreme fatigue and then dozing a lot during the day or even just not even feeling like they can do much. So then their battery isn’t being charged essentially, or they’re not using their battery to need to charge it as much at night. So how do you manage the fatigue in a lot of patients? 

DE: Yeah. Fatigue is a big one. So if you’re undergoing chemotherapy, fatigue is the most common side effect. 

DS: Yeah. 

DE: So I try to tell patients -they always feel like it’s counterproductive -but I tell them to exercise and we know that movement really helps manage some of that fatigue and it does help them with better sleep.

So we always try to talk about, can you get out for a 10 minute walk, you know, and it can be, I’m going to walk to the end of the street and back. And if I feel better, maybe I’ll do a little bit more. Sometimes it requires a dose reduction or treatment interruption, you know, depending on their fatigue. 

The way, the two questions that I asked to try to really get a sense of what their fatigue is, like, is number one, at the end of the day, do you feel just so exhausted and drained? You know, that thought of I just sat down on the couch and I cannot get up. So more than what would be kind of a normal day, like I’m busy, I have a lot to do. And then when they wake up in the morning, do they feel rested? So a lot of my patients will spend eight hours in bed, but they wake up and they just don’t feel rested. So that kind of tells us that the fatigue is at a point where we really want to intervene. 

Anemia, a lot of our patients have low blood counts, and that’s going to cause fatigue and that’s going to impact their sleep. Other, you know, electrolyte, liver abnormalities, all those things also can cause fatigue.

And then a lot of the medications also can do it. It’s like a perfect storm. And I’m sure you’ve seen and talked about this all the time, you know, you’re anemic, you’re fatigued. You took a nap during the day, then you were anxious at night and you were seeing something and then it’s like, you know, it all comes together.

DS: Right. So there’s a balance of needing to rest during the day. But at the same point, like you said, if you can’t get off the couch, if you can’t move, if your sleep isn’t restorative, then it might be a sign that something needs to be adjusted. And when you say adjusted, like, are you talking mostly about chemotherapy or something else?

DE: It’s typically that, you know, if we think that it is a medication, whether it’s chemotherapy or targeted therapy, but if we think it’s that your fatigue is coming from medications, then sometimes we can lower the dose of that medication and see. 

You know, this is where it’s really important for patients to be really honest with their oncologist. I think sometimes people downplay the symptoms a little bit. And so you’re not getting a full picture, but we definitely can adjust the treatment. Sometimes we’ll take a break from the treatments for a week or two, just to let people kind of recover. And obviously, you know, it depends, the stage of your cancer and where you are in the treatment process really impact it.

You know, someone coming to the end of their chemotherapy is going to be more fatigued. 

DS: Yeah. 

DE: Someone with stage 4 disease who’s going to be on treatment indefinitely, you know, the fatigue becomes a huge issue, especially with where the disease is in their body. So there’s so many factors. 

DS: Do you find radiation to be a cause of fatigue in a lot of people? I’ve had some people report that, but I don’t think people talk about that enough. 

DE: Absolutely. And I think the part that we don’t talk about often enough is that it often comes after all these other treatments. 

DS: Yeah. 

DE: So breast cancer, typically you’ve had chemotherapy, you’ve had surgery, and now you’re adding radiation to it. So it’s building on this tidal wave already that’s been happening. And so it kind of just further exacerbates it. You know, people always think, well, radiation’s just a one part of my body, but it has systemic impacts as well. 

DS: Tell me a little bit more about your area of specialty within oncology. So how do the patients kind of present to you a lot of the times and like you were talking about with the medications, what medications do you think are the things that really do impact sleep the most for patients?

DE: So I treat breast and GYN cancers. Breast cancer, mostly, majority of people are picked up on a mammogram. So you go for your routine mammogram and something is picked up and a portion of patients feel a mass and then they go for a mammogram. A handful of patients are diagnosed already with stage 4 disease and that’s sometimes they’re coming in with new pain or shortness of breath or, you know, things like that, that prompt a workup. But for the majority of people, it’s being diagnosed on a mammogram. And then treatment is, you know, a combination, for early stage, stage 1 through 3 breast cancer is a combination of surgery.

And then sometimes people need chemotherapy. Sometimes they need radiation. All breast cancers are different. But when we talk about the most common medications we give for breast cancer, about 80 percent of breast cancers are hormonally driven. So they’re estrogen or progesterone receptor positive. And we want to essentially block estrogen from getting to a breast cancer cell. And those are the kind of classes of endocrine therapy, or some people call it hormone therapy; tamoxifen, aromatase inhibitors, that’s anastrozole, letrozole, exemestene. 

The two classes of medications work in a little bit of a different way. With the aromatase inhibitors, you’re putting people into a lower estrogen state. So they have to be in menopause to be on these medications. 

DS: Okay. 

DE: And then what these meds do is they block estrogen production in the body. 

DS: Okay. 

DE: So, mostly we usually don’t recommend hormone replacement therapy because these are hormonally driven cancers. 

DS: Okay. 

DE: You know, so a lot of people are getting night sweats, right? They’re waking up multiple times a night. 

DS: Yeah. 

DE: Changing their clothes. They’re drenched in sweat. So that obviously impacts your sleep. The medications can cause fatigue on their own. They can cause joint pain. People are feeling aching. They wake up in the morning and they feel very stiff. You know the genitourinary syndrome of menopause. So sometimes it can be frequent urination and they’re waking up at night So everything all kind of plays together. 

And insomnia just on their own, you know, not even from one of these things we see sometimes that changing the time of day that people take these medications can actually help them with better sleep.

DS: Interesting. So what? To change it from what? Evening to morning, or when do people typically take them? 

DE: It depends. You have to kind of play around with the side effects. 

DS: Okay. 

DE: It’s a daily medication, but it takes several hours to kind of peak onset of the medication. So sometimes people feel, they take it in the early afternoon, and by the time it’s at its peak they’re ready to go to bed and they’re not sleeping. So I have some people who actually like to take it, like at night It helps them, because it helps them fall asleep, because it’s not hitting kind of until later. 

So it’s a little bit of trial and error, but what I find is that these women are not getting good sleep so then they wake up and they’re achy and now that’s impacted their mood and maybe they’re now, they are tired, so they’re not exercising, you know, and then again, it’s a spiral, so- 

DS: Totally. 

DE: And some people do really well with these medications. And I always tell patients that if you’re experiencing these side effects, it’s not your fault. You know, it’s not anything that you’re not doing or doing. Everyone just handles them, their body reacts in different ways. 

DS: What sort of treatments would you use for patients kind of in this realm who are coming to you, other than changing the medication time? You had mentioned medication. Are there other things that you might recommend when it’s more, it seems to be kind of hormonally driven? Yes, there are other things that play in, and they can’t take any sort of hormone replacement. So what would you suggest? 

DE: So yeah, I think that, you know, there’s a number of things that we can try to do. There are some great medications for hot flashes and night sweats. So Veozah is a newer one on the market, but that’s really shown really good responses. So I had people I’m seeing sleeping better because I’m not waking up, you know, with night sweats multiple times a night. 

Tart cherry is a supplement that I love to use because it is actually, there’s data showing, that it can help with the joint pain from the aromatase inhibitors, but also it can increase melatonin levels.

So we usually, I tell people if you’re gonna take melatonin, you can combine it with tart cherry and sometimes that helps. I find that magnesium glycinate is something that can help . So, you know, trying to do more non prescription medications, a little bit more natural. Those things can help. Now, the other thing is we do vaginal estrogen often for our patients.

DS: Okay. 

DE: It’s not absorbed into the body and that can help with some of those frequent nighttime urination symptoms. So again, trying to figure out, trying to address each thing, you know, and there are of course, prescription sleep medications that you know much better than I do and you know, I try to get my patients away from taking the anti-anxiety medications at night.

DS: Yeah. 

DE: Because I find that -some people need them- but I find that if we can try to approach it from a more natural, okay, let’s talk about therapy and journaling and meditation, because then it becomes hard, at least from what I’ve seen, to wean off the medications. 

DS: Right. They’re addictive. They just are. So, and you just kind of get used to the dose. So, we even in sleep medicine don’t like to use many of the anti-anxiety and the benzos, the more common benzos. But I think, you know, other things like CBT for insomnia or ACT therapy, there’s like so many different, non-medication approaches that do have evidence behind them. And I think sometimes people just accept that they’re not going to sleep, but it sounds like there are ways to try and, it might not be perfect, but ways to try and mitigate it as best you can. 

DE: Exactly. And, you know, even if – an acupuncture, you know, is another great thing that we do. I always tell people, you may not get it perfect, you may not be back to where you were, but if we can even improve it by 10 to 15%, sometimes that’s great.

And that’s enough to get people feeling a little bit better during the daytime. 

DS: Now, I’d asked my followers, I know you saw it like on Instagram, I’d asked, what questions do you have? A lot of them were about the meds for breast cancer. But then I got a number of questions of people saying that they were really concerned about sleep loss leading to cancer. And can you talk a little bit about that? Because at the beginning of the episode, you mentioned recurrence and anxiety about recurrence. So then if you’re not sleeping, that can add into it. So how do you manage that or talk with patients about that? 

DE: That’s a great question. So not sleeping on its own is not going to cause someone’s cancer to come back. 

DS: Okay. 

DE: But it all plays a role in, again, we find that when people are not sleeping well, then it makes it harder to exercise. It makes it harder to take care of your body, nourish it in the ways that we need to. So it all kind of plays a role. But I always want to stress that if people are struggling with insomnia that is not going to increase the chance of their cancer coming back on its own.

But a fear of cancer recurrence is very real, and studies show that over 50 percent of cancer survivors experience it. Everyone I talk to says that there’s no way it’s only 50%, you know, they feel that the number is much higher than that. And, you know, I think about, for some people, it can be very paralyzing. It drives their thoughts, it really impacts their day to day functioning, and that’s where we really need to get support from specialists and mental health professionals. 

Some people, they recognize that they have a fear, it sometimes flares up, maybe during a treatment anniversary or when someone else is diagnosed, but they’re able to, you know, kind of manage it.

DS: Yeah. 

DE: So it’s a matter of, you know, the severity and and really seeking help. But yes, it plays a role when you’re not sleeping. And if you’re having a hard time sleeping, and that’s often at night is where all of those thoughts creep in. And if you’re already struggling with insomnia, and then you’re worried and you’re nervous and you’re anxious, it’s just going to make it worse. 

DS: Right. So I think what’s interesting is that you essentially said that sleep is not in a vacuum. When you’re not sleeping, it does impact so many other things that we know can increase the risk of cancer in general, even just cancer occurrence, not even reoccurrence. So I think people get so fixated on, I’m not sleeping.

And then it’s like, what are all the other things that you’re doing that could be improved that maybe would help to mitigate some of that? 

DE: We don’t have enough research on it to, like, it’s hard to measure. 

DS: Yeah. 

DE: We know that when you don’t sleep, right, your body’s reacting in a different kind of fight or flight, like, way. And so how does that play a role? We just don’t know. 

I always tell people that it’s not always going to be all perfect, right? 

DS: Yeah. 

DE: Most of us are not having the days where we got eight hours of sleep and we exercised for 40 minutes and we made three nutritious meals, right? Like, no one’s perfect. But even to not get discouraged, okay, well I didn’t sleep, that means the rest of the day is shot or, you know, I didn’t work out today, so that’s it. It’s all done. 

Pick, you know, small changes and small habits that you can do. So maybe, yeah, you didn’t work out today, but maybe you’re going to really drink a lot of water, right? Or you’re going to eat a healthier lunch. It doesn’t have to be an all or nothing thing. And I think that’s where we struggle in the survivorship world is it’s really hard for patients.

They have a new body, these new medications, they don’t know what’s normal, all the hormonal changes and it’s a lot. And then we tell them, don’t drink alcohol. 

DS: Yeah. 

DE: You know, don’t work out. I mean, it’s like everything. And on that note, let’s talk about alcohol maybe. 

DS: Please. I was just going to get there. So talk to me about that.

DE: Well, all the guidelines say there’s no safe amount of alcohol when it comes to cancer. 

DS: Okay. 

DE: Alcohol is a WHO class one carcinogen. It increases the risk of many cancers and it does so through many different mechanisms. It can impact hormone levels, it can increase exposure to other carcinogens. I mean, there’s so many different ways that it can do it.

What I tell my patients is if you enjoy alcohol, you know, we try to limit to about three drinks per week on average. So I want people to get away from, I need my glass of wine with dinner. I need my glass of wine to sleep. 

DS: Yes, that’s the big one. 

DE: When I see my patients who are struggling with survivorship and being on, on these anti hormonal medications, the first thing I tell them is to stop drinking alcohol.

DS: Okay. 

DE: You know, or to have maybe one drink on a Saturday, but most people who’ve given it up really say their sleep is better. 

DS: Yeah, the hot flashes, I would think, are improving a lot too, yeah. 

DE: And, you know, people say, but I need alcohol to help me sleep. And, you know, I always tell them, it’s worse sleep with alcohol.

DS: I know. But I mean, there’s that idea too of like, I have to have alcohol to unwind, to de-stress. Because I’m feeling anxious, I need to help kind of manage it with that. 

So talking about the anxiety and I mean, depression, mood issues, mental health. What point do you recommend people maybe see a therapist? Talk to me about like just even resources for people who are survivors who kind of want to talk with others to kind of process a bit. Like where do you refer people to? 

DE: So there’s a lot of really great resources and there’s so many that we don’t even know about. I mean, there’s so many people, you know, trying to help others in this space, which is wonderful.

I really think most people people would benefit from seeing a therapist who’ve been impacted by cancer and that’s not just the patient, it’s caregivers. 

DS: Mm hmm. 

DE: We don’t talk a lot about caregivers, but they really can benefit as well. The problem is that there is a shortage of therapists. 

DS: Yeah. 

DE: It’s often not covered by insurance. People don’t know, they meet one and that wasn’t a good fit and ,well, how do you find another one? So that’s I think a big, big part of it. 

In the New York, New Jersey area, there is a company, Cancer Care, and they actually offer 10 free therapy sessions to all patients impacted by cancer. 

DS: That is unbelievable. 

DE: Huge. I’m sure now everyone’s gonna go there and they’re gonna be like, why did we get this influx? 

DS: That’s wonderful.

DE: Yeah. 

DS: I’m totally gonna refer people to – it’s crazy. I’m a therapist in New York and had no idea about that. So okay, that’s a great resource. What about like groups? 

DE: Yeah. 

DS: Yeah. 

DE: So there’s so many I mean, you know, I think social media, one of the good things about social media is that it’s really revolutionized, you know, what support groups used to be, you know, support groups used to be in person and, you know, once a week or whatever, and those still exist and they’re wonderful, but you can find your own people in whatever you’re struggling with online. So Facebook has a number of, you know, closed patient groups and depending on which disease type, you know, for triple negative, they have a great, TNBC thrivers.

DS: Wonderful. 

DE: For the Breast of Us is a great one. The Breasties. I mean, there’s so many out there that I, you know, it takes a little bit of time to figure out which community someone’s going to feel good in. You know, what are their people, right? But there’s a lot of really great people out there. And what I love about survivors and thrivers is that they’re the nicest people.

They want to share, they want to help, they want to reach out. So it’s sometimes hard for people to open up and be vulnerable about what they’re going through. But when they do, there’s a group of people waiting to take them in. 

DS: Especially people who’ve been there, who get it. That’s the key. 

DE: Yeah. It’s the lived experience.

DS: Exactly. 

DE: And I will say my patients get so much information from these groups. For chemotherapy, you know, we offer scalp cooling to try to preserve some hair loss. There’s a scalp cooling Facebook group. And they go and they get these amazing tips. I had a patient who said to me last year, oh, this medication was newly approved. And she said, you know, everyone in the group is saying that when they had a longer infusion, they tolerated it better. Now I would have never known that, you know, and so we did it and she felt better. And so there are all these things that just by talking to other people, it can help and it can help manage some of that anxiety because knowing that you’re not alone, that other people are struggling with the same things. I think that helps. 

DS: Yeah, I think social media, I agree. I think it’s really revolutionized a lot of the field. I think it was very doctors, doctors, doctors. I mean, we are the experts for sure in how to treat and do what we need to do, but I think that patients can have a very valuable voice in helping and problem solving.

Like I know with your podcast, and I know at least in sleep medicine, just narcolepsy, hypersomnia groups, apnea, right? So you’ll have all these physicians putting people on PAP therapy and then patients are having issues, but now there are other patients, there are podcasts, there are groups online of how to problem solve with how to use things and what to get the most out of their treatment. So I agree. I think it’s really revolutionized a lot of the field. Tell us about your Instagram account a little bit. 

DE: Yeah. So it’s @drteplinsky, super easy. I started it several years ago, mostly just because I felt like there was so much misinformation and people were 

DS: -Yep. 

DE: not getting like good quality information. And I also found like there was so much I wanted to talk about with my patients, but you have 15 minutes, not enough time to do that. So I said, I’m just going to put it online. And it helps me a lot because I’ve really started to understand a little bit more about what people go through and what they want to know and I think it’s made me a better doctor If you’ve been doing it for a while, right, you realize like oh back in the day I used to post this right and now I don’t really talk about that anymore. Like I used to post like more inspirational quotes and- 

DS: Yeah. 

DE: I don’t really do that anymore right? But like it’s funny to look back and see like kind of the iterations of the social media. But I try to post things to share people’s stories, which is what I do in the podcast and to post education, science, the data, because there’s so much misinformation.

People are talking about, you know, mammograms cause cancer and they don’t. You know, that’s a big one. And there’s big accounts, right? There’s the latest one, the influencers are saying that you don’t need sunscreen, that sunscreen causes skin cancer. I mean, I don’t even know where we got that one. 

DS: It’s mind-numbing. 

DE: But you see someone with a million followers, right? And you think, well, they must know what they’re talking about. Like, they have a million followers. And, you know, in my little corner, that’s what I try to do is to combat some of that misinformation. 

DS: Which is exactly where I started mine, too. It’s really, it’s hard. It’s really hard to combat it, especially when people have a million followers, like you were saying. Like, I get asked all the time. Do women really need one to two hours more sleep than men and an extra hour when they’re menstruating? I’m like, no, no, they need a little bit more, but not two hours more.

It’s not going to happen. It’s a big one. And I’m hearing it more and more. And then if someone’s struggling with sleep already and they’re like, I’m not getting an hour more than most men. And when I menstruate, why am I not getting an extra hour on top of that? Like, it’s just going to make their sleep worse.

DE: Who has time? Who has time for two more hours of sleep? 

DS: I know. That’s, that’s what I often say. I’m like, where is that going to happen? 

DE: I know. Oh my gosh. 

DS: Changing gears just a tiny bit, I’m always interested in having worked at Montefiore in the hospital environment. And I think it’s a big thing in sleep medicine as well, is that we’re trying to work towards having hospital stays, inpatient stays, be a bit more sleep friendly and having treatments kind of timed circadian-wise.

Do you notice this when you have patients who are hospitalized? Like, how are you seeing that and are there any adjustments being made in the hospital environment? 

DE: So I love that idea. I will say no. I mean, a majority of my patients don’t spend much time in the hospital. People are going home the same day, the next day after the surgeries, but you know, people get admitted and when they get admitted, it’s often for symptoms.

So now already like they’re not feeling great. Something’s going on, maybe they have an infection and oh no, like they’re still getting woken up at 5am for their blood work and everyone’s coming in. 

I will say the one thing is we just built a new hospital. And so the way they’re designed is that the nurses don’t have to like basically interrupt everything in the room to give medications, so they can kind of silently walk in and, like, give the meds.

DS: Smart. 

DE: So if you’re needing something at 3 a. m, you know, the lighting is a little bit better. So it is in that sense, but I find that patients, they want to go home. The first like, sleep in the hospital is – 

DS: Horrible. 

DE: It’s horrible. 

DS: It’s horrible. 

DE: It’s horrible. And then if you want to take a nap, everyone comes in and like interrupts you.

DS: Yeah. Yeah. Good luck with that. 

DE: Yeah. 

DS: There are some hospitals that are thinking more about it and how to really make sleep happen in the hospital because it’s restorative. It helps people recover. So, and I love that your hospital is thinking about that stuff a bit more. It’s not perfect, but you’re getting there.

DE: Getting there, right? Baby steps. 

DS: What myths do you think you’d like to, I mean, we were just talking about myth busting and things that you’re seeing online, but other than the mammogram causing cancer, are there any other like, big myths that you see going around when it comes to cancer and cancer treatment, anything you think people misunderstand?

DE: There’s a lot out there. I think a lot of the myths are about radiation dosing and how that, you know, with scans in general, it’s a lot of misinformation about screening and the benefits of screening and, you know, mammograms and pap smears and colonoscopies and CAT scans for smokers, or people with smoking histories, like all of those are really important.

Periodically, there’s a lot of misinformation about the HPV vaccine, which we know essentially reduces and eliminates cervical cancer as well as other HPV associated cancer, but there’s so much misinformation. 

DS: Like, what are people saying? 

DE: Well, it’s just vaccines in general. 

DS: Oh, I see. 

DE: The HPV vaccine causes cancer, don’t get the HPV vaccine.

DS: Yeah. 

DE: And it’s challenging because it’s recommended to be given in childhood, you know, but it really works. So those are some of the big ones. And then, you know, things surface all the time that this, if you do this, you won’t get cancer. This magic supplement, you know. If it sounds too good to be true, it is.

DS: Okay. 

DE: And I think, yeah, I mean, there’s just a lot of, you know, people will say, I’ve taken this supplement and my cancer didn’t come back, a lot of holistic treatments. And I think holistic treatments have a big role as a complementary treatment, together with the medicines that we prescribe. 

DS: We talked about alcohol. Can you just briefly touch upon diet and how that might play in, if we’re thinking about cancer and recurrence, like, how do you counsel people on that? 

DE: So we know that eating more plants is the best thing you can do for your body. 

DS: Okay. 

DE: You know, people don’t need to become vegan, they don’t need to be fully plant-based, but a plant forward or plant predominant diet is going to be the best.

And then also limiting red meat and processed meat. Processed meat is on that same class 1 carcinogen as alcohol, and so that’s the bacon and the deli meats and the sausages and, you know, especially in the summer, right? A lot of grilling and so you don’t have to eliminate it. But again, what I want people to get away from is, okay, I’m going to have a burger with a beer every night.

DS: Yeah. 

DE: Those are special occasion things. So red meat, limiting that. ‘Cause all these things contribute. And that’s where there’s a lot of controversy, especially on social media. People will show them eating more of a ketogenic diet and that has been shown to not be as effective as a plant predominant Mediterranean style way of eating.

DS: Okay. So really Mediterranean or plant forward and they can go together. Okay. It makes a lot of sense. 

We’d like to end every episode with a segment that we call Something to Sleep On. So it’s one last piece of advice for anyone looking to improve their sleep habits. So thinking of all the things that we discussed today, and we did touch on a lot of topics, do you have any final thoughts for our listeners, maybe something to sleep on? 

DE: I think the best advice that I can give is one, recognizing that sleep and fatigue and insomnia are very much, you know, significant side effects from a cancer diagnosis and treatment. And so recognizing that it is normal is really important, but there are things that we can do starting with healthier lifestyle choices.

Like we talked about limiting alcohol use, exercising, diet, mental health management, and then addressing the underlying reasons that are causing the fatigue. 

DS: So don’t ignore it. 

DE: Don’t ignore it. 

DS: Don’t suck it up. Just do what you can and try and make it even a tiny bit better by working with your physician.

DE: Exactly. 

DS: Thank you so much. So Dr. Eleonora, thank you for being here. Thank you again for all the amazing, incredible work you’re doing. Your Instagram is immensely helpful and informative. I learned so much from it. And thank you for letting our listeners know that they’re really not alone in this diagnosis. So thank you.

DE: Thank you for having me such an important topic and I’m happy to be here. 

DS: Thanks for listening to Sleep Talking with Dr. Shelby, a Sleepopolis original podcast. Remember, if you’re tired of hitting that snooze button, make sure to hit that subscribe button right now in YouTube, Apple Podcasts, Spotify, or wherever you are listening.

And for even more sleep tips, visit sleepopolis.com and my Instagram page @sleepdocshelby. Today’s episode was produced and edited by Ready Freddie Media. Our Senior Director of Content is Alanna Nuñez. Our Head of Content is Molly Stout. And I’m Dr. Shelby Harris. 

Until next time, sleep well.