Alternative supports when HRT isn't an option after breast cancer with Dr Chandrika Gibson

Sarah McLachlan: 0:03

Hey there, I'm Sarah McLachlan. Thanks for joining me on the Chaos to Calm podcast, a podcast designed for women over 40 who think that changing hormones might be messing with their mood, metabolism and energy and want to change that in a healthy, sustainable and permanent way. Each episode will explore topics related to health and wellness for women in their 40s, like what the heck is happening to your hormones, what to do about it with nutrition, lifestyle and stress management, and inspiring conversations with guests sharing their insights and tips on how to live your best life in your 40s and beyond. So if you're feeling like you're in the midst of a hormonal storm and don't want perimenopause to be horrific, then join me on Chaos to Calm, as I share with you how to make it to menopause without it wrecking your relationships and life. Hello and welcome to episode number 27 of Chaos to Calm podcast.

Sarah McLachlan: 1:04

I'm your host, Sarah McLachlan, the perimenopause naturopath, and today I'm super excited to be welcoming Chandrika Gibson to the show. And Dr Chandrika Gibson has been a naturopath since 2000. Became a yoga teacher and yogi therapist in 2005 and has worked extensively with people diagnosed with cancer since 2006 in her private practice, suraya Health, and she has done a Masters of Wellness and she also has a PhD, and her research investigated the psychosocial education and support needs of people diagnosed with head and neck cancer and their health professionals who care for them. So her research findings covered off the health professionals, compassion, fatigue and burnout, body image distress for the cancer sufferers and the communication in health settings, and it's been published widely in Peer Reviewed journals. And she is such an expert in this area. I'm so excited to have her on today.

Sarah McLachlan: 2:15

We're going to be talking about sudden, medically induced menopause and why HRT may not be the right decision for you in those situations, particularly for breast cancer survivors, and we're going to talk some about the things that are proven food is medicine and lifestyle changes that can help you. So, without further ado, let's dive in and welcome Dr Chandrika Gibson with us today. So thank you for joining us today, chandrika. It's really exciting to have you here and be talking more about how younger women might find themselves suddenly in menopause and how that might feel and things that they can do if HRT is off the table with them. So perhaps we might just start today with getting to know you and how you found yourself. You've got a PhD, a Masters of Wellness. You've got like so much experience and knowledge there, how did you come to be where you are today?

Chandrika Gibson: 3:16

Well, thanks for having me on your podcast, sarah. I love the name of your podcast Chaos to Calm. It's really, you know, it really evokes what we hope we can do for people when they're experiencing any kind of health issue. And yeah, so my background, my story is, you know, I started out pretty passionate as a young naturopath, and when my dad was dying with lung cancer, I tried to throw my naturopathic knowledge his way, and I quickly learned that in the space of cancer, there's a lot of things that we might think as naturopaths are logical and sensible, but that don't necessarily interact really well with conventional treatment. And so that kind of started me on this long and winding road of the last 30 years to try to understand how can we really practice integrative oncology. And that journey has led me, yes, through higher degrees, including a PhD, and so I'm trying to use the term doctor now more Dr Chandriki Gibson.

Chandrika Gibson: 4:20

But I don't want to ever pretend that I am a medical professional, because I'm not.

Chandrika Gibson: 4:26

In fact, I'm much more interested in the psychosocial, in the mind, body, in the things we can do from a natural health perspective that don't interfere with conventional treatment, and that has brought me to this space of working with people with breast cancer. So I am employed by a charity by Breast Cancer Care WA. They are the most fantastic holistic organization I've ever worked for and I've worked for a lot of places. They have a team of breast care nurses who are specialized in oncology care, including one who specialized in metastatic breast cancer. So that's advanced breast cancer or I know the patients or the clients themselves wouldn't like to term it this way, but that is life limiting breast cancer and they also have a team of counselors who are working in that more psycho oncology space and so I kind of work across both sides of the team and I work to give them up to date research information, but also really pursuing my passion of trying to work more closely with all of the health professionals that surround people when they have a cancer diagnosis.

Sarah McLachlan: 5:38

And that's what your PhD was about, wasn't it? It was delving into those psychosocial parameters and how the carers and the patients were travelling through that whole experience of cancer treatment.

Chandrika Gibson: 5:53

Yeah, that's right. So that was focused. My PhD was focused on education and support in head and neck cancer and you know it's not so dissimilar, although head and neck cancer is less common. And obviously, when we're thinking about perimenopause and menopause, that's going to be more relevant to most people with breast cancer, who are largely women, although there are some men and obviously non-binary people and trans people can have breast cancers as well.

Chandrika Gibson: 6:21

So, yes, the menopause story is more specific to the breast cancer population, but I found that a lot of the issues are across both cohorts because, you know, head and neck cancer visibly changes your appearance because your face and your neck and your throat and your mouth are treated, and so that is something that I wrote about was the body image distress that can occur, and it's the same in breast cancer, and a lot of people think well, yes, of course, if you have to have a lumpectomy or a mastectomy, and particularly a radical mastectomy that changes your appearance, you lose your breast. Some people have them reconstructed, some people choose to stay flat, but there's also other elements to appearance change and some of that is what looks like very rapid aging and that's the medically induced menopause. You know, for most of us, if we're mostly. Well, it changes gradually, you know we notice our cycles change.

Chandrika Gibson: 7:14

we notice those, you know, night sweats and hot flashes and all of those symptoms, but they're quite gradual for most people, Whereas when you have medically induced menopause, then it's extremely sudden and it can happen at a much younger age than would typically be expected as well, which means your peers aren't necessarily going through it at the same time, which makes it more difficult to seek support. You don't necessarily feel as well understood by the people around you.

Sarah McLachlan: 7:42

Yeah, and I think part of that too is that we tend to, or our society tends to, associate menopause as being an old woman, and the reality is like you could start perimenopause in your mid 30s or you may be thrust into that menopause with for those medical reasons you just mentioned. So we kind of have to unravel that aspect and that the two aren't related. Yeah.

Chandrika Gibson: 8:10

Yeah.

Sarah McLachlan: 8:11

Then they're not mutually exclusive or not trying. I'm not getting it out very well today, but it's. I think that's. Part of the problem is that we tend to think oh well, that's what happens to Nana and grandma. Not that I could be in my 40s. I am in my 40s and I am menopausal, but most of my peers are not. And, yeah, it can be really lonely for people if you don't have. You know, maybe mum never talked to you about it. I know my mum didn't, her mum didn't talk to her about it.

Chandrika Gibson: 8:43

Yeah, it's one of those taboos, isn't it? And in the workplace it can be quite taboo.

Sarah McLachlan: 8:48

I think there's a sense of shame around it, would you agree? Or maybe shame's not quite the right word, but we feel embarrassed, maybe, yeah, yeah.

Chandrika Gibson: 8:59

I mean, I think there's a real renaissance happening. I think that the next generations of younger people having their menstrual cycle celebrated is really beautiful and I see much more kind of what we know as naturopathic practitioners, this kind of attunement with your cycle and understanding the phases of it that is becoming much more in the mainstream and in the kind of zeitgeist. But I still think there is taboo and especially, you know I notice myself, you know I'm still having a menstrual cycle and I'll tuck a tampon or a cup up my sleeve. I won't necessarily be obvious about it and you know I work mostly with women. There's nothing to hide, there's no shame and even if I was surrounded by men there's no shame. But there is this sort of sneaky like oh, it's private, it's a bit I don't know, maybe we've been a bit dirty.

Chandrika Gibson: 9:50

Yeah, we've absorbed that kind of cultural weirdness around. It's unhygienic, even though obviously it's not Exactly yeah.

Sarah McLachlan: 9:58

Yeah, Very clean process. I think that is part I remember like as a teen, just inheriting that kind of. I think perhaps the shame is around that, that it's, you know, dirty or we're unclean and and that kind of continues, doesn't it? But all these conversations that we're having, like you know us here today, but also you know the wider community, I've noticed much more conversation around perimenopause and menopause and so, yeah, I agree, the next generation, they're going to start reaping the benefits of that. But even us and women in their late 30s and 40s will have a totally different experience. To say, when I started perimenopause eight years ago or so, yeah.

Sarah McLachlan: 10:39

I think so, but still, if you're not in that space or you're not feeling like, oh okay, maybe perimenopause is happening for me and this is what's going on, if you're thrust suddenly into getting a diagnosis around breast cancer and then these things happening like that's a lot to process, it's quite shocking, it really is a lot of time.

Chandrika Gibson: 11:00

Yeah, and I think you know this is partly why I'm so interested in the psychosocial aspects, because everything to do with the disease gets a lot of airtime. Every health professional wants to talk to these patients or clients about the disease and about the conventional treatments, but they don't necessarily want to hear about the impact on the rest of their life, and the menopausal impacts are pretty intense and have a wide ranging effect on people's lives. So it affects around about 16,000, mostly women with breast cancer, but also with ovarian cancer and uterine cancers in Australia. The reason why they can't take HRT to kind of remedy their menopausal symptoms is because up to 80% of those cancers well, between 60 and 80% actually there's different cell biology, but quite a large percentage of cancers are driven by hormones, meaning their hormone receptor positive. So if you have circulating estrogen, progesterone and herceptin, these can feed tumor cells, and so the concern is, if you've had a breast cancer, you need to block those receptors so that you don't have circulating hormones that can feed cancer cells.

Chandrika Gibson: 12:17

And so it happens really suddenly. It happens either through surgical removal of the ovaries and or combined with chemotherapy, radiation and then these hormone blocking drugs, which are a relatively long term treatment. You might have heard of tamoxifen. There's also other drugs that are in the aromatase inhibitors class and they greatly reduce the risk of cancer regression sorry, recurrence or progression. So it is important that people who had a diagnosis of a hormone receptor positive cancer do take those hormone blocking drugs. But a lot of people can't maintain compliance, don't want to take them long term because the side effects are so intense.

Sarah McLachlan: 13:01

That's right. And you know, like, perimenopause is there for a reason. Like I say to my kids, this is, you know, a different kind of analogy, but that one of them, my youngest, was saying she was worried about getting older and becoming an adult. And you know, all people say to me oh, how do you have four kids? And I say, well, I didn't have them all at once and they weren't. You know, I got one at a time and we started with a baby and now I have a 19 year old as my eldest.

Sarah McLachlan: 13:27

So it's always progressive and a bit gentler. You get used to the idea, and the same with perimenopause. We get to get used to the idea, don't we? But there's just so many things going on for these women and you know, like when you might have your scan or your biopsy, you might get a phone call, you know really quickly, and be booked in for treatment or surgery within a week, so it's not a very long time to get your head around what's happening. And then your body is just totally thrust into a hormone absent space, which is different to the 10 years that you might have.

Sarah McLachlan: 14:03

Your body might have had to get used to it in a regular perimenopause experience for people. So you told me a really interesting stat when we were talking last time as well about because also perimenopause breast cancer when I was younger it was a more mature woman, say in their 50s or so, they were more likely to have breast cancer. But you were telling me some interesting stats around actually how young women are getting diagnosed.

Chandrika Gibson: 14:36

Yeah, I mean all cancer risk increases the older we get. But yes, breast cancer particularly can happen quite young. About a quarter of diagnosis are in people under 50 years of age.

Chandrika Gibson: 14:49

And so the new messaging is you know, check your breasts at 40, from 40 on, and yet we see. You know, at breast cancer KWA we have support groups, are segregated in terms of age. We have young women's support groups because we have so many people under 45, people dealing with young children, school age children, careers, that were, you know, just hitting their stride really when they were diagnosed, and so their issues are quite different from the older cohort of people with breast cancer who also go through, you know, a huge rigmarole and it's a big deal, but yeah, that's a lot of people. Actually, almost 25% of diagnosis are under 50.

Sarah McLachlan: 15:31

Yeah. Do you know if it's always been that way, or is this a newer trend, or there isn't the data to make that?

Chandrika Gibson: 15:39

There is the data. Actually the cancer registries are pretty amazing. If you ever want to look up those stats, listeners, you can hop on the Australian Institute of Health and Wellbeing, or Wellbeing or Welfare, the AIHW site anyway, and they have all of the cancer stats. You can break them down by age, you can break them down by tumor streams, type of cancer and state, and so it's really well recorded data. And so, yes, breast cancer is being detected earlier, and so the question is you know, does that mean it was always happening earlier and we just didn't pick it up till later? That's entirely possible because our public health messaging is better and people are, in general, more health literate, maybe thanks to the internet, and so they're getting screened sooner. They're more inclined, if they find their own lump, to go and get it checked out, or if their GP does other health checks, to notice some kind of irregularity. That causes people to get a diagnosis sooner, and that is a good thing, although there is there's a bit of nuance there, because there is a sense that there might be some kind of over-treatment of some particular types, like the noninvasive breast cancers that are called ductal carcinoma in tissues. They're just in the milk ducts and they haven't spread into other tissues, and this still gets classed as breast cancer. It still gets treated with surgery and radiation, not necessarily chemotherapy. In fact that's kind of off the table usually with DCIS.

Chandrika Gibson: 17:12

However, there is a kind of sense that perhaps this is too medicalised for something that is not likely to spread and not likely to be life threatening. But it doesn't matter. For the person who gets the diagnosis it doesn't make that much difference. You know they still get the whole experience of oh my goodness, this is a cancer diagnosis, my life is potentially under threat, even though the survival rates are fantastic. We're up to I think we're close to 98% of people with a breast cancer diagnosis are still alive five years post-diagnosis, to tell the tale. So that is a massive amount of survivors. But in those survivors, those people a lot of them who've had these hormone receptor positive types of breast cancer are then on hormone blocking drugs for five to 10 years. Recent research indicates that it might be safe to stop sooner.

Chandrika Gibson: 18:05

But, the reason that I explained before is that it lowers the risk of recurrence or, if you've got metastatic disease, it lowers the risk of progression, or flow is progression, and it also has some other benefits. So because obviously you don't have your circulating hormones that would normally protect your bone mineral density, then the tamoxifen actually protects your bone mineral density.

Chandrika Gibson: 18:26

The other class of drugs decreases your bone mineral density the aromatase inhibitors. So that's problematic because then you've got your osteopenia, your osteoporosis, your risk of bone fractures etc goes up. So, like you said before, it's kind of like very rapid aging. You're dealing with the bones of a much older person if you're on those aromatase inhibitors. But yeah, so taking tamoxifen is important, it's a good thing to do and so I think, to be integrative, we have to look at those strengths of what the conventional system does well.

Chandrika Gibson: 18:59

It does really well at keeping people alive, it does really well at preventing risk of recurrence in that fairly kind of crude, mechanistic way. But then what we can bring to it from a naturopathic and a complementary therapies kind of perspective is to help alleviate some of those symptoms. You know, to use our remedies and our therapies and our presence as well. I think you know being compassionate listeners is powerful medicine. Yes, absolutely.

Sarah McLachlan: 19:28

Yeah, I was just going to say I think that's something that we do really well is teaching people how to eat you know what food can do for them and also focusing on those lifestyle, you know that holistic view, and really caring for yourself, and I feel like that is something that a lot of people are not used to doing or not as connected with them, with their food, but also with themselves and what their body needs, and I know that's that's. I've always been passionate about it. That's why I started studying naturopathies. I just wanted to teach people how to eat and how to put their plate together and look after themselves, but I think that's what we're really good at doing. Would you agree with that?

Chandrika Gibson: 20:15

Yeah, I definitely think so, and I think that I know some people don't like the term coach and that health coaches might encourage on our turf a little bit. But I think we do a really good job as kind of motivational interviewers, coaching people to do what most people do know what a healthy diet looks like. But then when we get into the cancer space, oh my goodness, people are just bombarded with really non evidence based information that's very conflicting and very confusing and they get tied up in knots about. You know, thinking kind of magical thinking like if I can get my diet perfect yes, I have this clean diet If I live the perfect lifestyle, if I don't ever get stressed, then my cancer won't come back.

Chandrika Gibson: 20:58

And we know that that's not possible.

Sarah McLachlan: 21:01

And I can totally understand and empathize why they'd be feeling that way. But it falls into my observation. There is that that all or nothing that you know, we have that grown up bank thinking of that diet mindset and seeing all the women around us, you know, and diets at different times are either on it or they're not. And it falls into that for us as well, doesn't that? When it's with things like that, I noticed for many people that they, you know, even with weight loss and the things that I do, it's so confusing.

Sarah McLachlan: 21:30

The internet is fantastic, except it's information overload and how do you even know what actually is going to work for you or not? And that's again where that evidence based food as medicine is really valuable, but it's less hit and miss. Then, if you're guided by someone who knows and who does research so you can talk us through, because there's a lot of myths and things like I saw, it comes to mind. I imagine how many times you get asked about it. Oh, yes, yeah, because I do want to talk us through some of the things that you know, because if we know HRT is off the table for a lot of breast cancer survivors, what things that they can do that is evidence based, to support themselves and try and help their body adjust to that withdrawal of estrogen.

Chandrika Gibson: 22:19

Yeah, so nutritionally you really. It sounds boring, but a very diet is really important. Not starving yourself is very important. So people often think, if I can starve the cancer? Then it'll respond better to treatment or you know. I'll survive, and they put themselves on incredibly extreme, restricted diets. However, that's really the opposite of what you need you need some strength, some resilience.

Chandrika Gibson: 22:48

You want to have adequate amounts of protein so that your immune system functions, so that you can heal post surgery. So adequate amounts of protein, mostly from either lean meats or plant based proteins, and basically it's like a varied Mediterranean diet. You want to have lots of leafy vegetables. Things like your cruciferous vegetables are known to move excess hormones out of the system, so the sulfurophane in cabbage and broccoli and cauliflower, that's a really helpful thing to do. You can also think about, you know, feeding your gut microbiome with all of those starchy vegetables, your root vegetables, carrots and beetroots. And again, lots of fiber, lots of variety, keeping some good fats.

Chandrika Gibson: 23:33

You don't want to go super duper low fat, although you know low saturated fat is probably a good idea, because one of the other side effects of treatment is cardio toxicity. So you do want to think about cardiovascular well being and that's where the kind of olive oil and nuts and seeds and avocado kind of focus in a Mediterranean eating style has its place. So, you know, not lots of red meat, not lots of trans fats. In fact, try to avoid trans fats. If you're going to be extreme in anything, that's the one I'd say.

Sarah McLachlan: 24:03

Yes, that's okay to be extreme in and I always say it's always okay to be extreme in things like avoiding canola oil or things like that, those really crap vegetable oils. You just mentioned cardio toxicity Now some people might not know what that is. Can you tell us a bit more about that?

Chandrika Gibson: 24:21

I sure can. So if you have a left sided breast cancer and you go in for radiation therapy, which is one of the, you know, very commonly experienced treatments, the way that radiation is dosed is a small dose every day for five, six, seven weeks, and people have different regimes. But it's a long term treatment and well, relatively long term. And so if it's, if your breast cancer is left sided, what used to happen is the radiation beams would go through the left side breast and hit the heart and damage the heart muscle and never recover from that.

Chandrika Gibson: 24:57

But in recent years there's been advances in a technique called deep inspirational breath holding. And so now women going in for treatment on left sided breast cancer they get a snorkel and they get some instruction from the radiation therapist in how to hold their breath and they also get a little button to press so they take a deep breath in. And when you do that you can feel it yourself. Your chest moves away from your chest wall, moves away from your rib cage, and now the breast can be radiated without the radiation beams hitting the heart. So just by holding your breath in you can protect your heart. But then you have to push the buzzer when you need to take a breath, and so they stop giving you the radiation so you can take another breath and then take another deep in breath and hold it in.

Chandrika Gibson: 25:40

So protecting the heart is very cool and very, to me, very yogic, very natural. Let's learn to manage our breath and that helps manage your anxiety and the radiation bunker as well, because it's not a very pleasant environment. So that's one aspect of what can damage the heart and because we know that survival rates are so great it's not like you know, you get a damaged heart but you're going to die in a couple of years anyway. This is like something that you might happen to you in your 30s, 40s, 50s and you want to live another good 20, 30, 40 years. Yeah, that's right. So we need to protect the heart.

Chandrika Gibson: 26:17

Chemotherapy can also damage the heart. Chemotherapy has, you know, systemic effects. It is toxic and I understand you know. Sometimes in naturopathic world people say stay away from it. However, you always have to do your risk versus benefit kind of analysis and in most cases it's a really good thing to do. Perhaps not at the end of life, you know. If your time is limited and you want quality over quantity, that's absolutely a reasonable choice. But if you have a treatable breast cancer, you really should say yes to the radiation therapy and the chemotherapy because they are proven to save your life and give you a long time to get your health back on track. Yeah, so managing your heart health through your diet and through your exercise and through your stress management, that's you can do to kind of counter those not so great effects, the side effects of the chemo. And the radiation therapy.

Sarah McLachlan: 27:10

And it's interesting because I often hear and from the few people I've known, that go through cancer treatment, often they will lose their appetite or find it hard to keep down. Oh, is that, is that similar with breast cancer treatment? Do you know, do they?

Chandrika Gibson: 27:26

find that impact.

Chandrika Gibson: 27:27

Yeah, yeah definitely, I mean chemotherapy. It strips the mechism membranes of your, your mouth, your whole gut is affected. Nausea, your liver's processing all kinds of stuff, yeah, yeah, it's really normal to feel queasy. A lot of people don't actually vomit, but they do feel like food doesn't taste the same, and yeah, and so that's another reason why I think naturopaths need to be really careful about not being so prescriptive about you must eat only these foods, and blah, blah, blah, because during active treatment it's actually the statistics show the best outcomes come from maintaining your weight.

Chandrika Gibson: 28:05

Yes, so you don't want to lose dramatic amounts of weight during treatment even if you started out a bit overweight, and that obviously does increase your risk for many types of cancer. Once you're in active treatment, the best outcomes come from staying the same weight, which means you need to eat whatever you can tolerate, whatever you can stomach, and sometimes, you know, things like smoothies can be nice because you know they're easier to get down to if your mouth is really sore. But, yeah, not avoiding things because really you actually do need calories. And again, you know we have this different mindset. Like in the conventional system, if someone can't eat, they might be given a Sustigen or an Amishbua, and if we look at the list of ingredients, as naturopaths we go oh my goodness, that is terrible, don't do that to your health, but from a kind of biomechanical medicine perspective that's got the ingredients that's going to keep someone alive.

Chandrika Gibson: 29:00

But we can do it better.

Sarah McLachlan: 29:02

I was going to say can't we replicate that with some soups and or, you know, smoothies and things like that? For Absolutely yeah, yeah.

Chandrika Gibson: 29:12

And where you have clients that are, you know, willing to make a little bit more effort. You absolutely can. So you can use things like pea protein. You can use soy milk and nut milks and make beautiful fruit and vegetable based smoothies and definitely your soups, your kind of watery lentil soup to give you lots of protein and you know things that are iron rich as well. So getting all of your you know green leafy vegetables in. Yeah, and let me speak to the soy thing. I know that we're going to be cutting our time.

Sarah McLachlan: 29:41

Yeah, I was really curious. I was actually just thinking with the, with the foods. I was like if you know someone going through treatment, the best thing you could do for them is A, b there as a friend, but also take them some delicious, really nourishing soups, smoothies or, you know, try and support them in that way, Cause I imagine they probably may not have the focus or energy for thinking about cooking, shopping, all that sort of stuff as well.

Sarah McLachlan: 30:07

But yes, let's dive into soy, cause I'm super interested. I want to know like soy and also those cause. You mentioned lentils and they are phytoestrogenic from my perspective, so hit me with it.

Chandrika Gibson: 30:20

All right. Well, it used to be a controversial take, but it's really not controversial and if you want the references, I can give you all the citations. Well, that's a bit dull.

Sarah McLachlan: 30:28

It's not controversial. But yeah, that's good, that's good Cause I think it has lots of benefits. I generally tell women in perimenopause and menopause it's a lovely, beneficial food to include. With caveats I will say but yeah, go on, Please go on.

Chandrika Gibson: 30:46

Yes, with caveats about how processed it is in all of that? Yes, yes, so they're not going to cause cancer cells to grow in the way that full strength estrogen will, because they're so incredibly weak. For one thing, they're very, very weak tiny doses of estrogens or estrogen like molecules they're not even the same as our estrogen but also because they kind of fit the same receptors. That is going to stop your uptake from any circulating estrogen. So some things that can happen, like if you do have excess weight, is that your fat tissue can generate its own form of estrogen, and so that can be problematic.

Chandrika Gibson: 31:27

Your phytoestrogens will fill those estrogen receptors and prevent that naturally occurring estrogen from causing any growth of cancer cells. So they're really good foods to protect you from the adverse effects of estrogen. But also because they fill the receptors, they do to some extent moderate some of those menopausal symptoms. So it's perfect medicine, it's a tonic. It's exactly what we, as naturopaths, love to do is to give something that's not dramatically raising or lowering a level, but actually gives the body a tonic that helps you find homeostasis for yourself.

Sarah McLachlan: 32:04

It's so good. I love food as medicine. It's just so powerful when we know you know what works for us in our current situation, so I guess that's a another caveat there as well. As please do work with someone who's experienced in the cancer that you're going through or the treatment that you're having and how to support you with that with the right foods for you and your situation or scenario.

Sarah McLachlan: 32:30

Yeah, yeah that's so, so informative. Thank you, chandrika, and I've really enjoyed our conversation today. I think we could probably keep talking for a long time.

Chandrika Gibson: 32:42

I'm going to hear about CBT mindfulness day, cbt yes, we have to come back another time and that's right.

Sarah McLachlan: 32:50

All the lifestyle things we didn't get to go through there as well, and that's there is so many isn't there that are researched or have that research behind them. It's awesome that way.

Chandrika Gibson: 33:01

A lot that people can do so, in terms of empowering people, don't be scared of cancer. But instead of thinking I'm going to treat the cancer, think now I'm going to support the person to be as well as they possibly can and let oncologists do the treatment of the cancer.

Sarah McLachlan: 33:17

Yeah, I think that's the greatest advice is to think about supporting and nourishing your body and your mind through this significant life event and whether that's you going through the cancer or someone you know going through that, thinking always that yeah, about supporting and nourishing and holding that space for them to to work their way and adjust.

Chandrika Gibson: 33:42

Yeah, and post traumatic growth and thriving is entirely possible. Yes, so yes, we can help. That's an important role we play.

Sarah McLachlan: 33:50

Yeah, absolutely, and yeah, I think it's. It's always good to think about what you can do as well as you know. When you're taking medications or you're having treatment, you need to think about what you can't do as well, of course, but thinking about what we can do to help look after ourselves or to teach people how to look after themselves, so that they can do that in the long term.

Chandrika Gibson: 34:13

Yeah.

Sarah McLachlan: 34:13

I think that's really valuable. So thank you again. Thank you so much for taking the time to talk with us and and through yes, so much information in this episode. Now, it's really valuable and I love having it from that perspective. We kind of straddle both worlds and I think that that taught us so much about what we need to think about or what's important when going through this treatment and checking our breasts regularly as well. So thank you so much and thank you to everyone for listening in today and this episode of chaos to come.

Chandrika Gibson: 34:47

Thanks for having me, sarah.

Sarah McLachlan: 34:49

So welcome. Wow, what a information dense episode that was with Dr Chandrika Gibson. I'm so appreciative for her coming and sharing her knowledge with us. And we've covered off. You know how it might feel being suddenly put into menopause from necessary surgery or medications and why. You know HRT isn't the solution in those situations and you know things, different things to consider there. And also we've talked about some foods that you can use and the great soy question is it or isn't it an option? So lots for you to digest there. And don't forget to check out the show notes if you want to find out more about Chandrika and all that we've talked about today at wwwchaustacarmpodcastcom.

Sarah McLachlan: 35:45

And once again, thank you so much for sharing your time with me today and I hope you found this episode as invaluable as I have. Stay tuned for our next episode where I will actually be talking with a nutritionist, angelica, who is also going through breast cancer treatment at this time. So I will speak to you in our next episode. It's really common for women over 40 to experience the chaos of changing hormones, mood, metabolism and energy. But I hope you know now that common doesn't have to equal normal for you or them. You can help others understand they aren't alone in feeling this way and that Perimenopause doesn't have to be horrific by subscribing, leaving a review and sharing this podcast with other women in their 40s and beyond. Thanks so much for listening and sharing your time with me today in this Chaos to Calm conversation.