by Jen Besten
Cancer no longer feels rare or distant. It used to be “one in eight”; now it is closer to “one in four,” and nearly everyone knows a friend, parent, sibling, coworker, or neighbor who has heard the words, “You have cancer.” It is no longer an abstract threat – it is personal, immediate, and woven into everyday life. One size does not fit all when navigating cancer and menopause.
When I was diagnosed, everything stopped. I had just run the New York City Marathon and was training for Boston, convinced I was healthy and strong. Like so many women, I blamed my new aches, fatigue, and sleepless nights on perimenopause, aging, or stress – and every doctor I saw agreed. My blood work looked “normal,” and I was told, “This is just what happens in your mid-40s.” In reality, I was unknowingly growing cancer & feeling the effects of perimenopause at the same time.
Those first weeks after my diagnosis became a blur of appointments, more blood work, and medical jargon. I felt like a passenger on a fast-moving train, carried along by rigid protocols and tightly-scheduled treatments. I trusted the system, followed my oncologist’s recommendations, and handed over my agency in exchange for poison, cutting, burning, and promises.
Even though science is meant to be scrutinized, I stopped questioning and stopped looking for alternatives. That is, until the red flags started to pop up. I was being told one thing, but my intuition was telling me something different. My cancer treatment was being prescribed with a one-size-fits-all approach. They were not looking at me as a healthy woman coming in for treatment. I had the same protocol as a bedridden 80-year-old with cancer. This did not work for me.
I knew I would follow conventional treatment – but I also knew that could not be my only plan. Researching online was overwhelming at first. There was definitely junk there, but I also found like-minded people who took control of their own treatment after realizing traditional medicine could only go so far. The more I dug, the more I found. Before I knew it, I had a war board on my wall, and I was researching up to 20 supplements or therapies a day. Luckily, I have a great general practitioner who listens and a wonderful husband who supports me no matter what crazy ideas I have. I was lucky that his job afforded us insurance and that he would have spent just about anything out-of-pocket to “save” me. This makes me feel grateful, but it also reminds me that there are people without the support system or income to do these therapies. That, I believe, needs to be rectified. At the same time, chemo sent me smack dab into menopause overnight. The perimenopause was now full-blown menopause with all of its wonderful symptoms. It was hard to tell what was chemo brain and what was brain fog brought on by menopausal hormonal issues.
Menopause is something that is not discussed with younger cancer patients because it is thought of as “not as important”. But I wanted to thrive, not just survive. I needed to figure out where my symptoms were stemming from, which started with fixing my immune system and digging into the root causes.
I was fortunate to benefit from all the menopause information that is now being shared. In the past, women avoided talking about “the change,” but our generation is different. We are fortunate enough to be Gen Xers. A generation that was never told there was anything we couldn’t do or that women were the weaker sex. Our mothers and grandmothers may not have shared their journey, but they empowered us to live loudly. We were the young women who benefited from Title 9. The generation before us did the work, and we reap the benefits. It is now our turn to give back. I truly believe this is why we are finally paying attention to this part of women’s health. It just does not make sense that women live 50% of their lives with symptoms that could be helped. We shouldn’t just have to deal with it.
Discovering Functional Medicine
It was time to find power in my own healing. Like I said, I did not just want to get through treatment; I wanted to thrive. That desire led me to a functional medicine doctor, someone who looks at the body as an integrated system rather than a collection of isolated parts. Instead of focusing only on attacking cancer directly, functional and integrative medicine emphasize strengthening the immune system, reducing inflammation, and creating an internal environment where cancer is less likely to thrive. That broader personal and systems-based approach is critical.
With my functional doctor, I began IV therapy twice a week. As my circulating tumor cell counts dropped, we gradually reduced visits to weekly, then every other week, with the goal of eventually going once a month. The purpose of these therapies is multi layered: improving immune function, unmasking cancer’s defenses, reducing inflammation, disrupting cancer cell metabolism, and protecting healthy cells. There is no single “magic bullet,” but cancer is not a one lane road – it is a highway with many entrances and exits. I want to close every exit to improve my chance of survival.
Adding this layer of care felt like a practical decision rather than a radical one. If it helped, wonderful; if it did not, there was little downside. I felt more energized, my skin improved, and, most importantly, I felt proactive during the hardest time of my life. This was never about rejecting conventional care in favor of something “natural”; it was about combining both approaches, integrating them thoughtfully, and personalizing my recovery. And most importantly, empowering myself.
Navigating Menopause in Cancer Treatment
Luckily for a lot of women, hormone replacement therapy, or HRT, is becoming a lot more prevalent. Unfortunately, decades of women were not given this opportunity because of a flawed study from the 1990s. Also, unfortunately for me, I cannot partake in HRT because of my hormone-driven cancer. This is another reason why the functional approach is so important for cancer patients going through menopause. When my oncologist could not give me any ideas on how to help my menopause symptoms, my functional doctor turned me onto a supplement from the rhubarb plant called Rhubestryn. This drastically helped my night sweats and hot flashes. I tried a bunch of different remedies on my own, but this is the one that worked.
My functional doctor – someone who understands cancer, immunity, metabolism, nutrition, and how all of those pieces interact – became my copilot for navigating the compounding challenges of cancer and menopause. Together, we built a flexible treatment map, constantly adjusting it based on lab results and feedback from my body. That map has included IV therapies, an extensive supplement routine, intentional nutrition, sleep, emotional healing, exercise, off label medications, and detox support.
Redefining Exercise
My relationship with exercise has changed as well. Before diagnosis, I pushed hard: long runs, intense cross training, minimal recovery. Now I still run, lift weights, and practice yoga, but I am much more mindful of how my body responds. I pay particular attention to lactic acid because emerging research suggests that chronically elevated lactate may help fuel cancer growth by acidifying the tumor environment and influencing cancer cell behavior. At the same time, regular, moderate movement helps the body clear lactate efficiently, improves mitochondrial function, supports immune health, and stabilizes metabolism. Not only does this approach help keep cancer from growing, but it also minimizes the menopause/perimenopause symptoms from exacerbating.
How women exercise needs to change at different stages of life. What women can do in their teens and 20s is different than what they can do in their 30s. Then, when perimenopause hits, their routine again needs to change in their 40s and 50s. Another shift will take place in post-menopausal women. Currently, my lifting routine is heavy and slow. I may only get through five exercises a session, but they are all combination movements, and I prioritize fewer reps with more sets. Strength is the goal, not the bikini.
The lesson for me has been that more is not always better. When you are under significant emotional or physical stress, relentless high intensity training can keep your body in fight or flight mode, driving up inflammation and wearing down immunity. Now, I schedule rest days on purpose, train smarter instead of harder, and treat movement as medicine that only works when it is paired with real recovery. If your workouts are leaving you drained rather than restored, it may be time to step back and listen more closely to your body.
Reframing Remission
None of this has been simple. I have had to advocate for myself, ask more of my doctors, and sift through information that is sometimes incomplete, conflicting, or not fully evidence-based. Some days, my choices are grounded in solid data; other days, they lean more on faith, intuition, or what some people might dismiss. My plan is not flawless or universal, but it is mine. Across all the medications, infusions, workouts, supplements, and therapies, there is one constant: none of it matters without self compassion and the courage to keep going. There is no universal playbook for surviving cancer or attacking menopause. Healing is less about discovering a single miracle and more about assembling every tool, insight, and fragment of hope you can find. Some days, you may devour research articles; other days, your only goal may be to make it to bedtime. Both ways of coping are valid. What matters is that you stay curious, ask hard questions, and build a circle of people who allow you to be tired and tough all at once.
I do not believe in the word “remission”. In fact, none of my healthcare providers even use that word with me. I did have one physician’s assistant use the word “cured” in the past couple of years. I politely nodded and knew in my head there’s no such thing. Once you have cancer, you have cancer. It’s just how much cancer do you have? Is it winning or are you winning?
There is a power in this. Traditional medicine only knows if something has “returned” with scans. By this time, it’s too late. If something is found on a scan, the cancer is there and often full-blown. With my integrative doctor, I undergo different blood tests and therapies. Even after being “cured” of cancer, my blood tests found circulating tumor cells, indicating the kind of cells and the percentages of each still present in my body. The results showed that something was still lingering, ready to attack. Luckily, with these tests, we have seen the numbers go in a positive direction. But it has been work. Just because my circulating tumor cell numbers have gone down does not mean it’s time to let up, have a party, and stop exercising, watching my diet, or doing my therapies. When you see positive change, that’s exactly the time to hone in and realize what is working. I needed to beat it back then, and I still do now.
So… no to the word “remission”. I believe it’s a made-up word. It’s there to comfort you if you need it. Some people need it, and I understand that. But I need to be an attack dog. I need to stay battle-ready to make sure this does not return. So the words “cured” and “remission” stay out of my vocabulary.
If there is one message to carry forward, let it be this: your story matters, your questions matter, and your instincts matter. There is a way ahead – not in one grand gesture, but in small, layered choices and healthy actions, taken one day at a time. The real goal is not only to kill cancer and defy menopause, but to create a body where cancer struggles to thrive, a mind that feels calmer, a life that feels fulfilling, and a routine that feels sustainable.
Jen Besten is a breast cancer fighter and Premier Personal Trainer at Hockessin Athletic Club. Inspired to transform the well-being of herself and others experiencing menopause, Jen now teaches LIFT, a Small Group Personal Training (SGPT) class designed to meet the strength-training needs of menopausal and perimenopausal women. This is a fee-based class. Talk to Jen to learn more, or sign up in the HAC App.
