Post-Surgery Healing Protocol

1. Coordinate with oncologist: All interventions should be discussed with treating oncologist - timing matters (some antioxidants during chemo controversial, generally safe between cycles) | 2. Nausea management: Ginger 1-2g daily (multiple RCTs show reduces chemo nausea), vitamin B6 75-150mg, acupuncture or acupressure (P6 point - wrist bands), ondansetron or other antiemetics as prescribed, eat small frequent meals, avoid strong smells | 3. Glutamine: 10-30g daily in divided doses (prevents/treats chemo-induced mucositis and neuropathy, improves gut healing) - take away from chemo by 12+ hours per some oncologists | 4. Vitamin D: Optimize 50-80 ng/ml (immune support, emerging evidence for cancer outcomes) | 5. Omega-3: 2-3g EPA/DHA (anti-inflammatory, reduces cachexia, improves outcomes in some cancers) | 6. Probiotics: High-dose 50-100 billion CFU (gut support, reduces diarrhea from chemo, immune function) | 7. Mushroom extracts: Turkey tail (PSK/PSP) 3g daily, reishi, maitake, cordyceps (immune support - PSK studied extensively in Asia as chemo adjunct, improves survival in gastric/colorectal cancer) | 8. Curcumin: 1-2g daily between chemo cycles (anti-inflammatory, may enhance chemo effects - controversial during chemo, safer between cycles) | 9. Green tea extract: EGCG 400-800mg (antioxidant, may enhance chemo - coordinate timing with oncologist) | 10. CoQ10: 200-400mg ubiquinol (cardioprotection especially with anthracyclines like doxorubicin, mitochondrial support) | 11. Alpha-lipoic acid: 600mg daily (neuropathy prevention, antioxidant) - especially with platinum agents (cisplatin, oxaliplatin) | 12. Vitamin E: 400 IU (neuropathy prevention) - take away from chemo | 13. Milk thistle: 300mg 3x/day (liver protection, safe with most chemos - check drug interactions) | 14. NAC: 600-1200mg 2x/day (glutathione support, liver protection) - take 24+ hours away from chemo | 15. Vitamin C IV: 25-75g IV infusions 2-3x/week (controversial - high-dose IV vitamin C may enhance chemo, protects healthy cells. Growing evidence but not mainstream. Oral vitamin C different - low dose 500-1000mg safe) - coordinate with integrative oncologist | 16. Melatonin: 20-40mg nightly (immune support, may enhance chemo effects and reduce toxicity - multiple studies by Lissoni, improves outcomes) | 17. Vitamin B12, folate: Methylated forms (energy, prevent anemia, nerve health) - but folic acid contraindicated during methotrexate or 5-FU chemo | 18. Hydration: 3+ liters fluid daily (flushes chemo, prevents kidney damage, reduces nausea) | 19. Exercise: Moderate exercise during chemo (walking 30 min 5x/week, yoga, tai chi) - improves fatigue, quality of life, possibly outcomes (don't overtrain - exhaustion is real) | 20. Cold cap: For hair preservation (scalp cooling during infusion - reduces hair loss 50-80% depending on regimen) - expensive, uncomfortable, doesn't work for all chemos | 21. Neuropathy prevention: Icing hands/feet during chemo infusion (especially taxanes, platinum agents) - reduces neuropathy risk 30-50%. Compression gloves/socks | 22. Mouthwash: For mucositis - glutamine swish and swallow, "magic mouthwash" (lidocaine/diphenhydramine/Maalox), avoid alcohol-based mouthwash | 23. Avoid: Alcohol (stresses liver, interacts with chemo), smoking (impairs healing, increases complications), grapefruit juice (affects drug metabolism), St. John's wort (drug interactions), high-dose antioxidants during chemo (controversial - may protect cancer cells, timing and dose matter - discuss with oncologist) | 24. Diet: High protein 1.5-2g/kg (prevent muscle wasting), adequate calories (cancer cachexia is real - maintain weight), emphasize vegetables, avoid processed foods, sugar in moderation (sugar doesn't "feed cancer" but metabolic health matters) | 25. Monitor: CBC weekly (watch for neutropenia <1000 - infection risk, may need Neulasta), liver/kidney function, electrolytes, weight (prevent cachexia) | 26. Acupuncture: Reduces chemo-induced nausea, pain, neuropathy, fatigue (multiple RCTs, now offered at many cancer centers) | 27. Mind-body: Meditation, guided imagery, support groups (reduce anxiety, improve quality of life, may improve outcomes)