When my oncologist told me I had Stage 4 colorectal cancer at 47, the conversation lasted maybe 20 minutes. Twenty minutes to turn my world upside down, explain treatment options, and send me home with a stack of pamphlets.
Don’t get me wrong — my oncologist is brilliant. She saved my life. But here’s the thing: oncologists are trained to focus on one job, and they do it incredibly well. They identify your cancer, stage it, and design a treatment protocol to kill it. That’s what they’re paid to do, and frankly, that’s what you want them obsessing over.
But cancer treatment isn’t just about the tumor. Your body has to survive the treatment, metabolize the drugs, and hopefully come out the other side stronger. That part? That’s mostly on you.
The System Isn’t Broken — It’s Just Incomplete
I’ve been through three different cancer centers, worked with some of the best oncologists in the country, and even became the first human to receive a specific type of TCR-T immunotherapy for solid tumors at the NIH. The medical system isn’t broken. These people are doing miracles every day.
But the system has gaps. Big ones.
Your oncologist might spend 30 seconds mentioning that chemotherapy can cause neuropathy. They probably won’t tell you that vitamin B6 and alpha-lipoic acid might help prevent it, or that your MTHFR gene variants could affect how well you process folate-based chemo drugs.
They’ll prescribe anti-nausea meds but might not mention that ginger capsules work for some people, or that your CYP2D6 variants determine whether ondansetron will actually work for you.
They’ll talk about maintaining nutrition during treatment but won’t have time to explain why your albumin levels matter, or how to read your own lab results to catch problems before your next appointment.
This isn’t their fault. They have 15 minutes per patient and a waiting room full of people who need their expertise on the tumor part. The rest falls through the cracks.
What I Learned to Track (That No One Told Me To)
After my diagnosis, I taught myself genomics, immunology, and pharmacogenomics. Not because I wanted to become a doctor, but because I realized I had to become my own care coordinator.
Here’s what I wish someone had told me to pay attention to:
Your genetic variants matter for drug metabolism. I have variants in COMT, CYP2D6, and MTHFR that affect how I process everything from pain meds to chemo drugs. When I brought my pharmacogenomic report to my doctors, they adjusted my medications accordingly. Better outcomes, fewer side effects.
Lab trends matter more than single values. Your oncologist looks at whether your white blood cell count is in range. You should be tracking whether it’s trending up or down over time, how it responds to treatment cycles, and what your personal baseline looks like.
Albumin levels predict how well you’ll tolerate treatment. Low albumin means poor protein synthesis, which means your body can’t repair itself properly. If your albumin is dropping, you need to address nutrition before your next treatment round.
Supplement timing matters. Some supplements can interfere with chemotherapy. Others can help. The key is knowing which ones to take when, and being transparent with your medical team about everything you’re taking.
I bring everything to my doctors. Every supplement, every lab result I’ve analyzed, every research paper I’ve found relevant to my case. Some doctors roll their eyes. The good ones listen, learn, and work with you.
The Nutrition Black Hole
This is where the system really fails cancer patients. You’ll get a generic handout about eating protein and avoiding raw vegetables during treatment. That’s it.
You won’t learn that:
- Your taste changes during chemo are predictable and manageable
- Certain amino acids can help protect healthy cells during treatment
- Your micronutrient needs skyrocket during cancer treatment
- Food timing around treatment can affect both efficacy and side effects
I had to figure out on my own that taking certain supplements 48 hours before chemo could help protect my healthy cells, or that eating specific foods after treatment could help my body clear the drugs more efficiently.
The oncology dietitians are overworked and often stuck giving generic advice. The good ones will work with you individually, but you have to ask for that consultation specifically.
Becoming Your Own Research Department
Here’s what I did that made a difference:
I learned to read my own lab results. Not to diagnose myself, but to spot patterns and ask better questions. When my neutrophil count started dropping consistently, I could bring that trend to my doctor’s attention before it became a crisis.
I mapped my genetic variants to my medications. I used my 23andMe data and clinical pharmacogenomic testing to understand how my body processes drugs differently. This led to better dosing and fewer side effects.
I tracked everything. Sleep, energy, symptoms, medications, supplements, lab values. I used spreadsheets to find patterns that 15-minute appointments couldn’t catch.
I found my tribe. Other patients who were doing their own research, sharing resources, and comparing notes. Not for medical advice, but for practical tips on navigating the system.
The Supplement Question
Let me be clear: supplements are not treatment. Get the best conventional treatment first, then optimize everything else.
But dismissing all supplements is just as dangerous as believing they cure cancer. The research on certain supplements during cancer treatment is actually pretty robust:
- Glutamine for chemo-induced neuropathy
- Vitamin D optimization (most cancer patients are severely deficient)
- Omega-3s for inflammation management
- Probiotics for gut health during treatment
The trick is knowing which ones are safe with your specific treatment, what dosing makes sense, and when to take them. I bring everything to my doctors, and we make decisions together.
Building Your Own Care Team
Your oncologist is the quarterback, but you need a whole team:
- A primary care doctor who understands cancer survivorship
- An oncology dietitian (if available)
- A pharmacist who knows drug interactions
- Mental health support (therapy, support groups, whatever works)
- Other survivors who’ve walked this path
I also built relationships with specialists who could help optimize everything outside the direct cancer treatment — sleep medicine, functional medicine doctors who understand genomics, nutritionists who work with cancer patients.
The Long Game
If you’re reading this newly diagnosed, this probably feels overwhelming. It was for me too. Start small:
- Learn to read your own lab results
- Get genetic testing if you can afford it
- Track your symptoms and side effects
- Ask your doctor about supplement interactions
- Connect with other patients who are taking an active role
If you’re already in treatment, don’t try to change everything at once. Pick one area to focus on — maybe nutrition, maybe sleep, maybe understanding your labs better.
If you’re in survivorship, congratulations on making it this far. Now’s the time to optimize everything you couldn’t focus on during active treatment.
The Bottom Line
Your oncologist’s job is to cure your cancer. Your job is everything else — and it’s a big job. The patients who do best are the ones who become informed partners in their care, not passive recipients of treatment.
This doesn’t mean becoming a know-it-all or arguing with your medical team. It means showing up prepared, asking good questions, and taking responsibility for the parts of your health that fall outside your oncologist’s 15-minute window.
I bring everything to my doctors. The best ones appreciate it. The others… well, maybe they’re not the right doctors for you.
The system saved my life, but I had to save my quality of life. I’m NED (no evidence of disease) and feeling better than I have in years. Not because I’m lucky, but because I learned to fill the gaps.
I’m Aaron — a stage 4 colorectal cancer survivor. I’m writing a book about what I learned so you don’t have to start from scratch.
Keep reading:
The CRC Roadmap 
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