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- Diet and Nutrition (https://her2support.org/vbulletin/forumdisplay.php?f=55)

- - Fluids (https://her2support.org/vbulletin/showthread.php?t=50256)

I've been diligently trying to choke down two liters of non-caffeinated beverages per day, but I have indigestion from the Taxol and all that liquid is undoubtedly making it worse. It also interrupts my sleep.

I know my body needs water, but is there any special reason for the 8 cups/2 liters figure in cancer treatment? I remember reading that somebody just threw that out as a talking point and it morphed into holy writ, with no science behind it. Has anybody actually researched this?

No one answered this when I posted it. One of the bits of information I got actually said to drink up to 3 quarts of water a day. I get a lot of water in my food--fruits and vegetables, cooked grains, etc. I really couldn't do the "8 X 8," and I finally decided to let thirst be my guide.

Today a facebook friend posted this article from Scientific American about fluid intake. It's quite reassuring:

http://www.scientificamerican.com/ar...-water-per-day

Hi Mtngrl,

I like you let thirst be my guide but this herceptin sure makes me thirsty! I also suffer through the night my husband works odd hours and he normally wakes me to go so I don't lie there wishing I didn't need to!

Sorry haven't got any solid info for you but I don't think you can go too far wrong trusting your body?

Jenny

BTW when I was on chemo I drank LOADS the first 3 days

I follow the "let the thirst guide you" too. If I'm not thristy I have to gag down water, don't like doing that.

I think a lot of the information is out of date or not evidence-based. The article says that the beliefs that many people are chronically dehydrated, that you might not know you're dehydrated, and that you might think you're hungry when you're actually thirsty are all unfounded. I thought I remembered reading something that said the "8 glasses of water a day" "rule" was just pulled out of the air.

The only caution is that the article refers to "healthy people." I'm not sure I qualify, since I have Stage IV breast cancer (with liver metastasis) and am undergoing chemo. When I posted the question I was hoping someone knew whether there's something specific to chemo in all the booklets that repeat the advice.

It stands to reason that there can't be a "one size fits all" rule. How much you weigh, how much you sweat, how active you are, and how much fluid you get from other sources all influence the answer to the question.

I'm very confident in my medical team, but some of the printed information they gave me is out of date. For example, in the section on how breast cancer progresses it assumes a steady, uninterrupted rate of growth. That may be true of some breast cancers, but certainly not all.

Hi there. I'm definitely not an expert in this field, but do extensive reading when it comes to things such as nutrition, water consumption, exercise, etc. One thing I have learned over and over is that yes, the 8x8 theory might be overrated and out of date, but there has been significant research done as to exactly why we should consume water (beyond the "feeling thirsty" stage). Firstly, when you feel thirsty, that is the sign that you are already dehydrated - and also means that toxins have been building up, hindering liver function, nutrients haven't been moving properly throughout the body and we might be lacking in some due to this, and that proper water consumption is imperative for functioning kidneys and liver - if toxins build up (as they do without adequate water consumption), this hinders how the liver functions. I hear you - I hate drinking water myself and wish I didn't have to. But now I've just incorporated it into my lifestyle - loads of fruits and vegetables, reduced red meat and dairy, adequate exercise and adequate water consumption. And, my oncology nurse told me to drink extra while I was going through chemo, and now on Herceptin - it flushes waste out of your body and you are getting lots of bad things through your treatment so she said it is best to be on top of it ensuring that it is getting flushed out as much as possible. But I still can't stand water ;-)

I remember drinking a lot of Gatorade, cranberry juice, apple juice, and a Chinese herbal soup/tea during chemo. Water seemed to be too tasteless. Whatever I was drinking or eating, there's always a possibility that I would throw up. So I learned to sip them very slowly.

Another good way to get more fluid is to cook some plain rice soup. Rice is basically starch which can be dissolved by the enzymes in our mouth water. I'd gradually stir in an egg, add some finely chopped chicken or fish, and vegetables.

The Chemocare site has detailed information on the subject:

http://www.chemocare.com/managing/dehydration.asp

This Mayo Clinic link provides clear and easy tips:

http://www.mayoclinic.com/health/water/NU00283

I recall while doing the chemo how even plain water tasted awful if not bland. Diet drinks were sickeningly sweet. But I found that drinking straight club soda (carbonated water with potassium bicarbonate and potassium citrate added) helped with the taste and the bubbly fizz from the carbonation seemed to refresh my palate which had lost almost all of its ability to provide me with any pleasure in eating or drinking fluids. Later after the scourge of the "chemo taste" had subsided, I have continued drinking the club soda when just plain water seems too bland. I've found adding a twist of lemon or lime perks it up a little more at times.---bird

Amy,

Go to a compounding pharmacy or even a GNC, someplace where they sell probiotics that are kept in a refrigerator. Purchase a jar of probiotic powder and use it. It will end your indigestion from the chemo in less than a month. Do not use the caps as the powder is preferable and it must be the type that needs to be refrigerated.

Good luck!

It's nice to finally get some "traffic" on this thread. Thank you to everyone who chimed in.

I don't mind drinking water, it's just that forcing myself to drink beyond what my thirst says invariably leads to acid reflux (and too many trips to the bathroom.) It was that way for me before I started chemo. I also like sparkling water, herb tea, water with lemon, etc. But too much is too much.

My original post was shortly after I started chemo. After settling in a bit I've been lucky not to have much indigestion from chemo. If it starts I take an over-the-counter acid reducer, and that does the trick. I also haven't had trouble with foods smelling or tasting bad. Since I was switched to Abraxane because of an allergic reaction to Taxol I'm having even fewer symptoms. I get chemo weekly (or three on, one off, now that I'm getting Abraxane.) That might be why it's not too awful for me. But thanks for the suggestions. Someday I may be on a chemo regimen that is harder to handle.

I make my own yogurt and eat a lot of it. That does seem to soothe the GI tract and help the gut.

If you were to follow the link I posted and read the article, you would find that according to Scientific American there's no research to substantiate the oft-repeated claim that you can't tell how much fluid you need just by thirst. I thought that was very revealing, and interesting. It's why I posted it.

That being said, if someone on the forum knows of a scientific study that backs up the 8 (or 12!) glasses of water a day recommendation for people on chemo, I'd love to see a copy of it. That was what I was looking for when I started the thread.

Special thanks to Jackie07 for the two links. I appreciate having those resources.

Obviously dehydration is an issue if there's nausea, vomiting or diarrhea. The link gives great information for managing that kind of dehydration.

And the Mayo Clinic admits there's no scientific evidence for the "8 X 8" rule. but kind of says you might want to follow it anyway. I had heard that if you're peeing regularly, and your urine is clear or pale yellow, then you're hydrated well enough. Mayo says that too.

Still nothing specific for how much water you need simply because you're on chemotherapy, in the absence of nausea, vomiting or diarrhea. I suspect the booklets and pamphlets are just giving general advice about nutrition and hydration that the readers might not know.

The abstract below shows why 'thirst' might not be a good guide to our fulid intake during chemotherapy:

Front Neurosci. 2011;5:88. Epub 2011 Jul 14.
Behavioral Patterns Associated with Chemotherapy-Induced Emesis: A Potential Signature for Nausea in Musk Shrews.

Horn CC, Henry S, Meyers K, Magnusson MS.
Source

Biobehavioral Medicine in Oncology Program, University of Pittsburgh Cancer Institute Pittsburgh, PA, USA.

Abstract

Nausea and vomiting are common symptoms in patients with many diseases, including cancer and its treatments. Although the neurological basis of vomiting is reasonably well known, an understanding of the physiology of nausea is lacking. The primary barrier to mechanistic research on the nausea system is the lack of an animal model. Indeed investigating the effects of anti-nausea drugs in pre-clinical models is difficult because the primary readout is often emesis.

It is known that animals show a behavioral profile of sickness, associated with reduced feeding and movement, and possibly these general measures are signs of nausea. Studies attempting to relate the occurrence of additional behaviors to emesis have produced mixed results.

Here we applied a statistical method, temporal pattern (t-pattern) analysis, to determine patterns of behavior associated with emesis. Musk shrews were injected with the chemotherapy agent cisplatin (a gold standard in emesis research) to induce acute (<24 h) and delayed (>24 h) emesis. Emesis and other behaviors were coded and tracked from video files. T-pattern analysis revealed hundreds of non-random patterns of behavior associated with emesis, including sniffing, changes in body contraction, and locomotion.

There was little evidence that locomotion was inhibited by the occurrence of emesis. Eating, drinking, and other larger body movements including rearing, grooming, and body rotation, were significantly less common in emesis-related behavioral patterns in real versus randomized data.

These results lend preliminary evidence for the expression of emesis-related behavioral patterns, including reduced ingestive behavior, grooming, and exploratory behaviors.

In summary, this statistical approach to behavioral analysis in a pre-clinical emesis research model could be used to assess the more global effects and limitations of drugs used to control nausea and its potential correlates, including reduced feeding and activity levels.

******
ps. This is the Ice Cream Month and today is Watermelon Day:

http://en.wikipedia.org/wiki/National_Ice_Cream_Month
http://www.examiner.com/family-holidays-in-buffalo/national-watermelon-day-2011

Water facts from 'Eatingwell'

NCI says to Ask your doctors and nurses

The National Cancer Institute's advice on water intake during chemotherapy makes sense:

http://www.cancer.gov/cancertopics/c...ects/urination