Accompanying assistance

For a long time, rest was considered the right approach. That has now reversed. Those who remain active, even during and after treatment, are less exhausted, sleep better, maintain their weight more easily, and return to their daily routines more quickly. The German S3 guideline on complementary medicine recommends exercise with grade A – "should" – to combat fatigue and improve quality of life.

Fatigue is that debilitating tiredness that doesn't go away even after sleep. It's the most common side effect of all medications, and surprisingly, exercise is the best remedy. That sounds counterintuitive, but it's well-researched.

How to start when nothing seems to work

• Ten minutes already count. Once around the block, slowly. This is not a compromise, this is the beginning.
• Better often than for a long time. Three times ten minutes are better than one time thirty if you lack the strength.
• Don't overstay your welcome on good days. Otherwise, the day after tomorrow will cost more than the good day brought.
• Strength and endurance combined The best way to do this is by walking plus a few simple exercises using your own body weight.

When you should first ask

In cases of bone metastases, very low blood counts, recent surgery, a port, or severe dizziness, it's essential to consult the treatment team beforehand. This isn't because exercise is forbidden, but because the physical condition changes.

Cancer alters metabolism. The body breaks down muscle, even if there's plenty of food on the plate – and treatment often further reduces appetite. Those who lose muscle mass tolerate therapy less well and recover more slowly. Cancer medications are usually dosed according to height and weight, not muscle mass. Two people of the same weight will receive the same dose, even though one has significantly more muscle mass to handle it.

Therefore, at this time it's not about kilos, but about Protein and exercise. European nutritional guidelines recommend 1.0 to 1.5 grams of protein per kilogram of body weight per day - significantly more than is usually recommended.

And what if I'm overweight?

Then your idea is correct - only the timing matters.

The correct answer is: Being overweight is a proven risk factor. Fat tissue is not a static cushion; it is active: it sustains low-grade inflammation and produces hormones. And after completing treatment, weight loss is expressly recommended – the guidelines for cancer patients advise it.

The catch lies in the in-between: While undergoing treatment, the body, under calorie restriction, preferentially breaks down muscle, not fat. So you lose exactly what it needs, and the fat remains. Therefore, an ongoing treatment is the wrong time for a weight-loss diet.

The path that brings both together: Not eating less, but eating differently. Those who cut out refined sugar and processed foods and instead fill their plates with protein, vegetables, and healthy fats usually lose excess weight on their own—and maintain their muscle mass. This isn't a compromise; it's the better way.

Sugar and tumors: how it really works

The statement "sugar feeds the tumor" is true—just not in the way it sounds. Eliminating sugar doesn't deprive the cancer cell of anything, because blood sugar remains: the liver produces it, if necessary from muscle tissue. The proven pathway runs via the insulinSugar drives up insulin levels; insulin is a growth signal, and tumor cells have receptors for it. Several types of cancer have been shown to be more severe when insulin levels are elevated.

The honest statement is therefore: Your sugar levels drive the hormone that tells the tumor to grow. That's why refined sugar should be eliminated – and that's why vegetables, legumes, fruit, and whole grains should still be on your plate. This is explained in detail in the chapter "Sugar and Tumors" on the [website/publication name]. Nutrition page of this section.

The study did not examine the long fasting itself, but rather the... Fasting-mimickingA five-day, highly restricted, plant-based diet surrounding each chemotherapy treatment, developed by Valter Longo. In the Dutch DIRECT study, 131 women with breast cancer received either this diet or their usual diet.

The honest result: The main metric – severe side effects – was not Better. Secondary measurements showed more favorable results: response to chemotherapy was more frequently good, and less damage was observed in the genetic material of immune cells. The authors themselves write that these secondary results must be interpreted with caution.

And a figure that is rarely seen: Four out of five participants completed the first cycle. Only one in five managed to complete all cycles. The real problem was perseverance.

What follows from this?

Fasting-mimicking diets during chemotherapy are a serious approach for anyone choosing this path – and a topic for discussion with your doctor. It is not standard practice, and it is not a treatment.

Regarding autophagy, which is always mentioned in this context: Yoshinori Ohsumi received the Nobel Prize in 2016 for describing, How Cells clean themselves up. This is basic research on yeast cells – not proof that fasting helps with cancer. Anyone who quotes him that way is misquoting him.

Mistletoe therapy has been a part of German medicine for a hundred years; it is administered by many doctors as a complementary treatment, and many patients report that it improves their well-being. This should be taken seriously.

At the same time, the body of research is thinner than the prevalence would suggest. The German S3 guideline states: One can Applying mistletoe extract under the skin to improve quality of life – with explicitly limited evidence. She offers no recommendation on whether mistletoe slows tumor growth or prolongs life.

This is not a judgment against mistletoe. It is precise information about what it can and cannot do – and therefore more than most sources say about it.

If you think about it

• Medical supervision required. The dose and preparation are adjusted; it is not a tea and not a self-treatment.
• Tell your oncologist. Not because he will forbid it, but because he needs to know.
• Expect quality of life, nothing more. Anyone who starts with different expectations will be disappointed.

Acupuncture is one of the few procedures from traditional medicine that has made it into a German S3 guideline - however, not across the board, but for two clearly defined situations.

The two documented cases

• Joint pain while taking aromatase inhibitors. This side effect often leads women to discontinue the medication. The recommendation here is "should".
• Delayed nausea following platinum-based chemotherapy. In addition to, not instead of, the usual medications. The recommendation here is "may".

The guidelines don't recommend this for other conditions. If someone offers you acupuncture specifically for the tumor itself, that's the point at which you should leave.

Before addressing the fatigue itself, it's worth looking at what can be treated. Anemia, an underactive thyroid, nighttime pain, and certain medications can worsen fatigue and are treatable. Ask about these conditions – they aren't always checked automatically.

Which carries the rhythm again

• Out into the light in the morning. Twenty minutes of daylight will regulate your internal clock more reliably than any pill.
• Keep naps short. Twenty to thirty minutes, no later than early afternoon - otherwise he'll take the night with him.
• Fixed times, even on bad days. Getting up at the same time is more helpful than going to bed at the same time.
• Divide the day into portions. Schedule the most important tasks for the hours when experience has shown that you have the strength to do them.

If falling asleep is difficult for weeks, there's a specific, well-researched talk therapy for this. Ask about it at the cancer support center – it's more effective than sleeping pills and doesn't leave a hangover.

A cancer diagnosis doesn't just turn the body upside down. It calls into question the order of one's entire life, often overnight. Those who accept support demonstrably make more calm decisions and get through this time better.

It costs nothing and requires no referral. Simply mention it to the treatment team or call your nearest cancer support center. Partners, children, and parents are also welcome – they are a source of support, and they are rarely asked how they are doing.

What many also found beneficial

• Time outdoors. Forest, garden, water. No substitute for therapy, but the recovery is measurable.
• Something with the hands. Cooking, plants, music - anything that takes your mind out for a while.
• A group. Meeting others who are going through the same thing takes away the feeling of being alone.
• Write down. Questions, side effects, good days. It helps with the next appointment and with keeping track of things yourself.

Chemotherapy and radiation therapy work in part by inducing oxidative stress in tumor cells. High doses of antioxidants can mitigate this effect. What sounds like protection in advertising can then weaken the treatment.

What you should wait to do until your team agrees

• High doses of antioxidants - Vitamin C in gram doses, vitamin E, beta-carotene, selenium.
• St. John's wort. It accelerates the breakdown of many medications in the liver. This can cause the drug levels to drop too low.
• grapefruit In every form - it works in the opposite direction and can cause mirrors to rise dangerously.
• Turmeric, green tea extract, ginger in capsule form. As a spice in food, they are harmless. As a highly concentrated extract, they interfere with the same metabolic pathway.
• Everything that is sold "for detoxification" - During ongoing treatment, this is not a good time for it.

Vitamin D is a special case: A proven deficiency is corrected, that much is undisputed. The data isn't sufficient to explain anything beyond correction. Therefore, get it tested instead of estimating.

None of this means: keep your hands off plants. It means: During the treatment, the team makes decisions together, afterwards it's your turn again.

• „"should"“ - Strong recommendation, good body of research. In this guideline, only exercise achieves this in terms of accompanying measures.
• „"should"“ - Medium recommendation. Example: Acupuncture for joint pain during antihormone therapy.
• „"can"“ - Weak recommendation, limited data, justifiable in individual cases. This is where the mistletoe stands.

And there is the opposite direction: „"should not"“ and „"should not"“. There, the ketogenic diet and high-dose antioxidants are used during irradiation.

How to recognize a dubious offer

• It promises healing or speaks of "eliminating the cause".
• It advises against medical treatment. - overtly or between the lines.
• It costs money and the supplier is also the source.
• It cites cell experiments. and calls it effect.
• It's urgent. Reputable medicine does not rush.