Miss Puerto Rico, Jaylene Alvarez, 33, Says Red Devil Chemo Has Left Her Bedridden — and Tired of Pretending She’s Okay as She Faces Breast Cancer

Former Miss Puerto Rico Jaylene Alvarez, 33, went public with her breast cancer diagnosis earlier this year. She’s now deep into treatment, including the notoriously harsh “Red Devil” chemotherapy, and sharing just how grueling the process has been.

 

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“Friends, I’ve already gotten through the worst side effects of my second red chemo,” she said in an Instagram post translated in English, noting she’s completed 14 chemotherapy sessions so far with two more rounds of the Red Devil ahead.

“The red chemotherapy knocks me out in bed for two weeks. For some reason, they have a big effect on me.”

 

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Alvarez, who finished as second runner‑up in the 2021 Miss Universe Puerto Rico pageant, has long been admired for her advocacy work, and supporters rallied around her immediately after she revealed her diagnosis.

She has not shared the specific type of breast cancer she’s facing, but chemotherapy remains a cornerstone of treatment for many patients.

The “Red Devil” refers to anthracycline-based chemotherapy, which is a powerful, highly effective regimen often used after surgery.

Research in JACC: CardioOncology shows anthracyclines can improve disease‑free survival by 10% and overall survival by 7% compared to older regimens. Still, the benefits come with intense side effects, including nausea, vomiting, and hair loss, which helped give it its nickname.

The physical toll has forced Alvarez to step back from work, something she calls “the most painful thing for me.”

 

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She’s also pushing back against the pressure cancer patients often feel to appear strong at all times.

“I don’t want to romanticize this experience,” she said.

“This is one of the most horrible things a human being can go through… Cancer patients pretend to be okay. We’re experts at it because when we share what we’re going through, people don’t know what to say. So we pretend and say, ‘We’re fine.’ People see us and say, ‘She’s doing great.’ No, I’m not. We’re not.”

Despite the hardship, Alvarez is urging others in treatment to keep going.

“Even when I get stubborn and say I don’t want any more chemo. We’re almost done with this first stage — this process doesn’t end with chemo.”

Managing Chemotherapy and Its Side Effects

Chemotherapy is an effective tool for oncologists to help treat cancer by stopping cancerous cells from growing, dividing, and spreading to other organs. Chemo works by traveling through the bloodstream, killing cancerous cells. However, healthy cells are also impacted in the process, leading to side effects.

Patients almost universally experience fatigue, often alongside gastrointestinal side effects, such as nausea. Doctors have many effective medications to combat chemo-induced nausea.

“But mitigating that fatigue often depends on the patient,” says Dr. Renata Urban, a gynecologic oncologist at the University of Washington in Seattle.

“Neuropathy is probably one of the most challenging side effects,” says Dr. Renata Urban, a gynecologic oncologist at the University of Washington in Seattle. Neuropathy results from damage to the peripheral nerves.

It usually resolves after chemotherapy treatment, but sometimes symptoms can persist. While it’s typically characterized by numbness or a pins-and-needles sensation in the hands and feet, neuropathy can have several different symptoms, including:

• Weakness in the hands or feet
• Stabbing or burning pain in the hands or feet
• Difficulty gripping, such as when holding a fork
• Difficulty with fine motor skills, such as writing or buttoning a shirt

Nausea and vomiting are common side effects of chemotherapy. When chemotherapy affects the rapidly dividing cells in the lining of the stomach, the resulting cellular havoc in the gastrointestinal tract can lead to side effects such as nausea and vomiting.

However, doctors can help patients mitigate the hit with various medications before, during, and after treatment.

“Part of the chemotherapy prescription includes a set regimen of anti-nausea medications,” says Dr. Renata Urban, a gynecologic oncologist at the University of Washington in Seattle.

“We also ensure that patients have medications at home that they can use should they develop nausea after treatment.”

Hair loss is another side effect of chemotherapy.

WATCH: Coping with hair loss.

“For cancer patients, losing one’s hair can be unbelievably stressful. To start with, the dread of losing one’s hair can lead to some sleepless nights and feelings of anxiety,” Dr. Samantha Boardman, a New York-based psychiatrist and author, told SurvivorNet.

Chemotherapy can cause hair loss. It usually begins about three to four weeks after chemotherapy and continues throughout treatment.

It happens because this treatment targets quickly dividing cells throughout the body. That includes cancer cells but also hair cells.

Most patients can expect regrowth four to six weeks after treatment. However, it is possible that when your hair grows back, you may notice some changes in its color and texture.

RELATED: How are chemotherapy side effects managed for ovarian cancer treatment?

Tips for Navigating Chemo Side Effects

When dealing with fatigue, doctors don’t have an arsenal of weapons to combat fatigue in terms of prescription medications. However, you can do several things to help minimize the hit and restore your energy.

• Exercise: While it may be counterintuitive, physical activity can help alleviate side effects, especially fatigue. “Although ovarian cancer is not common, we often draw upon the experience of patients with breast cancer and colon cancer, who have shown that physical activity can not only improve quality of life but may also have beneficial impacts on cancer outcomes,” Dr. Urban says.
• Eat well: Even though nausea may interfere with your ability to eat a healthy diet, it’s essential to ensure you’re eating appropriately, getting enough protein, and not losing weight. Not only will nourishing your body support your recovery, but it may also help you feel more energized.
• Sleep: Want to mitigate fatigue? Be sure to maintain your regular sleep-wake cycle while on treatment. Sticking to a set sleep schedule helps reduce fatigue by ensuring enough hours for your body to heal and restore itself each night. It may also help you recover more quickly by keeping energy levels high during the daytime.

Understanding Early-Stage Breast Cancer and What Comes Next

Early-stage breast cancer means the tumor is small and hasn’t spread to nearby lymph nodes. According to Dr. Comen, the first step is usually surgery to remove the cancer.

This may involve a lumpectomy, where only the tumor and surrounding tissue are removed, often followed by radiation therapy to reduce the risk of recurrence.

However, treatment isn’t one-size-fits-all. Factors like age, tumor size, family history, and personal preference may influence whether radiation is needed or if a patient chooses a more aggressive approach, such as a mastectomy—removal of the entire breast.

After surgery, a pathologist examines the tissue under a microscope to help determine the next steps in treatment.

WATCH: Understanding Early Stage Breast Cancer

Diagnostic testing plays a critical role in shaping your care plan. If a mammogram or clinical breast exam reveals something abnormal, your care team may recommend:

• Diagnostic mammogram and breast ultrasound to get a closer look at the breast and nearby lymph nodes
• MRI scans for additional imaging detail
• Biopsy of suspicious areas, including lymph nodes, to confirm cancer
• Tumor marker testing to identify hormone receptors and proteins that influence treatment options
• Additional imaging to check for any signs of metastatic disease

Once all this information is gathered, your cancer is staged—based on tumor size, lymph node involvement, and whether it has spread. Staging helps guide treatment decisions, while hormone receptor and protein marker tests reveal how the cancer behaves and which therapies may be most effective.

Your healthcare team will consider all of these factors—alongside your personal health, values, and goals—to create a treatment plan tailored to you.

Regular Self-Exams Are Helpful In Between Mammograms

A self-breast exam is an easy way to monitor your breasts for abnormalities. It involves feeling the breast for swelling, bulging, or changes in the shape of the breast or nipple.

WATCH: How to perform a self-exam.

Checking for signs of redness, rashes, or discharge is also part of this exam. If anything is found that is concerning, you should contact your doctor. It’s important to note that self-exams should be done with regular mammograms.

Help Coping With a Breast Cancer Diagnosis

If you are facing a breast cancer diagnosis, your emotions are likely to run high, which is completely normal. Psychiatrist Dr. Lori Plutchik says emotions are often fluid when coping with a diagnosis.

“The patient or person going through the stressful event should accept that emotions will be fluid. You may feel fine one day and then feel a massive wave of stress the next. It’s also important for those you look to for support, whether that’s a therapist, friends, and family, or both, to understand the fluidity of stress-related emotions,” Dr. Plutchik said.

WATCH: How to cope with complex and changing emotions.

If a stressful event affects how you think and feel, it may be time to seek mental health treatment. This could mean traditional talk therapy, medication, changing lifestyle habits (like exercise and diet), seeking a support group, or many other approaches.

SurvivorNet experts suggest that women who need a little extra help coping with a breast cancer diagnosis.

• Let your family and close friends know, and let them help. So many cancer survivors tell us they want and need support, but are often too preoccupied to make specific requests. Urge those close to you to jump in with whatever practical help they can offer.
• Keep a journal. It can be extremely cathartic to let those feelings loose on paper. Grab a pen and a nice journal and chronicle your thoughts throughout the day.
• Join a cancer support group. Groups in nearly every community offer opportunities to connect with others going through a similar journey. You’ll learn constructive insight from others who can tell you what to expect and how to stay strong on tough days.
• Consider seeing a therapist. Ask your doctor to refer you to a therapist so you can discuss your fears and concerns in a safe space. Often, vocalizing your thoughts and feelings rather than internalizing them can provide relief.

Questions To Ask Your Doctor

If you have a breast cancer screening coming up or have recently had one, you may have questions you want answered. SurvivorNet suggests the following questions to kickstart your conversation with your doctor.

• Do I have dense breasts?
• Do I need to undergo additional or more sensitive screening?
• How is my risk level being assessed?
• Will insurance cover additional screening if needed?

Learn more about SurvivorNet's rigorous medical review process.

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