Doctor’s book draws on experience

Family Medicine Specialist doctor Beverly A. Zavaleta is a cancer survivor and advocate of patient education and is the author of Braving Chemo. (Miguel Roberts/The Brownsville Herald)

Undergoing chemotherapy is no walk in the park, as Beverly Zavaleta M.D. knows from personal experience, though she hopes her book “Braving Chemo: What to Expect, How to Prepare and How to Get Through It” will help make the experience a little more bearable for others who go through it.

Family Medicine Specialist doctor Beverly A. Zavaleta is a cancer survivor and advocate of patient education and is the author of Braving Chemo. (Miguel Roberts/The Brownsville Herald)

The Harvard-educated family medicine specialist, who shuttered her Brownsville practice in 2012 and went to work as a physician adviser for Valley Baptist Medical Center-Brownsville, was diagnosed with triple-negative breast cancer in May 2015, and two weeks later started a five-month regimen of chemo treatments.

Because triple-negative is an aggressive form of cancer, her sessions took place at two-weeks intervals rather than every three weeks as with some breast cancers, and Zavaleta found she would just start to recover from a session when it was time to go in for another.

“It was a pretty intense regimen,” she said. “When you’re on that type of regimen you don’t have much of an off week. … Breast cancer chemotherapy in general is fairly intense, I would say moderate to severe in terms of intensity. Not quite as intense as something like for leukemia or a bone marrow transplant.”

Zavaleta said didn’t intend to write a book about it. Rather, it came about as the result of a friend’s sister being diagnosed with breast cancer a month or so after Zavaleta’s own diagnosis. They were full of questions about everything having to do with chemo, and she was able to provide some answers.

“I was not giving medical advice to them but just helping them with questions that they had after her sister’s doctor visit,” Zavaleta said. “I was a little bit ahead of them in my treatment.”

Via email and text, she shared what she knew about side effects, what to do about nausea and itching, intravenous lines and so on. Expressing gratitude for the guidance, her friend suggested Zavaleta should write a book, saying “if we needed this information there’s got to be other people who need this information too.”

She resisted at first, reasoning that there were already plenty of resources available online. Besides, she didn’t feel like writing a book, though her friend wouldn’t let it go.

“She said, no, you really need to write a book, and she just kept after me, man,” Zavaleta said. “So finally I sat down and I printed out all the emails and texts and gathered all the materials that I had used when I was going through my treatment. … I sat down and banged out a draft and started working on it. That was April of 2016 that I started working on the first draft.”

Getting a book out is a long process, and she spent a year or so doing revisions and soliciting feedback from “beta readers” — cancer survivors, English professors, and friends with journalism and marketing backgrounds.

“And then I actually shelved the project for quite a while, and then in April of 2019 I pulled it back and said, OK, I really need to get this published,” Zavaleta said.

She hired an editor and got to work expanding and improving the book, set up her own publishing house (Sugar Plum Press) and in November 2019 published it. As a physician, Zavaleta could go to the medical literature when she had questions about her treatment, but that’s not an option for most people. “Braving Chemo” is laid out to provide information in a way that’s easily accessible, she said.

“When you’re on chemo you’re tired, and reading for more than about 15 minutes I would get a headache,” Zavaleta said. “And not just a headache. It gives you like an eyeball ache.”

Zavaleta avoided dense text and instead arranged everything in “little bites,” she said.

“Two-page sections. Get in, get out. I really tried to stick to that format,” Zavaleta said. “That’s what I tried to do: make it super usable and actionable and practical.”

“Braving Chemo” has 224 pages and seven chapters: Getting Started, Preventing and Treating Side Effects, Preventing Infection, Nutrition, Appearance Matters, Your Restless Mind, and Recovery. Despite the seriousness of the subject, Zavaleta injects some levity among the dozens of sections with titles such as “Worshipping the Porcelain Goddess: Nausea and Vomiting,” “Meet Mary Jane: Medical Marijuana for Nausea” and “Attention Coneheads: Dealing with Being Bald.”

Zavaleta takes on the tough questions in the sections like “Examine Fear of Death,” “More Than Too Much: Depression” and “Running Scared: Anxiety.” Everyone’s experience is different, it goes without saying, and “Braving Chemo” is not meant as a substitute for a doctor’s information, she stressed.

“This is an adjunct to what your doctor gives you, to what your chemo nurse tells you when you’re sitting there in your chair,” Zaveleta said.

Still, it can help, she said. The Leukemia and Lymphoma Society, the largest blood cancer organization in the country, concurs. LLS this month placed “Braving Chemo” on its list of recommended resources for patients.

Zavaleta said she’s “real excited” to have her book included on the LLS list and hopes it will make doctors, nurses, therapists and others who support cancer patients comfortable having the book in their offices and recommending it to patients.

“A book like this honestly is best if it’s in the libraries of the cancer center, if it’s given to the patient when they start chemo,” she said. “What I’m trying to do is get it into the hands of nonprofit organizations … that can just give it to patients as part of their welcome-to-chemo gift bag. Lots of organizations give patients bags with fuzzy socks, ginger candy, chemo turbans. We need all of those chemo therapy survival materials, but we also need information.”

Everyone starting chemo gets an hour or two of “chemo class,” which Zavaleta described as “good enough to start” but not enough all by itself.

“Guaranteed, after you have that first treatment, two days later you’re going to have tons of questions: Is this fever normal? Is my left elbow supposed to be itching right now? There needs to be something more robust in place,” she said.

“Braving Chemo” in paperback is available online through all major retailers, and the e-book version is available through any platform, though distributing it to everyone who stands to benefit from it is tough for a do-it-yourself publisher, Zavaleta said. That’s why she offers a book sponsorship program on her website, www.beverlyzavaletamd.com.

Clinics or nonprofits can sign up if they want copies donated, and sponsors purchase the books for donation. About a dozen groups and clinics have signed up for donations so far, she said.

“I look for sponsors to buy the books and send them to these organizations, which distribute them to patients, so they’re free to the patients,” Zavaleta said. “The biggest challenge is getting the word out about the book and about sponsorships. Right now I have about three locations that want books and I don’t have sponsors.”

Rounding up more sponsors is her top “call to action” she said, and encouraged anyone who might be interested to visit her website.

“What I wish the most is for medical science to evolve and that our newer drugs will be so wonderful that no one ever needs this kind of chemotherapy in the future and my book will be obsolete,” Zavaleta said. “That’s my absolute wish. But until then, my mission is to help people get through chemotherapy and make their life a little bit better during treatment, and helping them take care of themselves during treatment.”