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Nutrition and Cancer Archive Questions

Below are Mindy Athas’s answers to Nutrition and Cancer questions
received through the Ask the Expert feature.

This content is provided for informational purposes only, and is not intended
to be a substitute for individual medical advice in diagnosing or treating a
health problem. Please consult with your physician about your specific health
care concerns.



Now displaying records 1 to 15 of 25.

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Q : 1

06/25/2012
I have prostate cancer and have been looking at what foods I should and should not eat. I've read that calcium is not good for the prostate. However, due to my ileostomy, I need extra calcium and salt. Also, if I want certain foods or supplements, some would pass through before being broken down which normally happens late in the digestive process (e.g. some medications are in capsule form but for me they need to be tablets).

In terms of calcium and prostate cancer, the jury is still out. While many studies suggest a link between the two, others refute it. So it may be best to follow general healthy guidelines until more concrete scientific data comes out. The RDA (recommended dietary allowance) for calcium in adult men is 1000 mg (milligrams) for age 19-50 and 1200 mg for age 51+ daily. To get this, you can either eat foods rich in calcium or take supplements. I would strongly suggest getting it from natural (food/drink) sources rather than pills, as the foods contain other beneficial items which can't be combined in a pill in the way nature packages them. To meet your RDA for calcium you could eat/drink: 8oz yogurt (300mg), mozzarella sticks (300mg for 1.5oz), 1 cup fat-free/skim milk (300 mg) and 1/2 cup of cooked spinach (145 mg) to get your 1000. Sardines have 300mg per 3 ounces and tofu has 250mg per 1/2 cup. There are also foods/drinks enriched with calcium such as orange juice and soy milk, if you are looking for non-dairy sources of calcium.


Q : 2

03/07/2012
At your hospital do you offer nutrition counseling as well as holistic advice in addition to medical and surgical treatment?

Yes, we have a full staff of clinical Registered Dietitians/Nutritionists. Some are outpatient in the cancer center ambulatory clinic and outpatient radiation oncology areas, but most are inpatient working with patients who are admitted to the hospital for treatment. In terms of what we do at UMGCC, it depends on what kind of nutrition help you need. In inpatient care, we offer a variety of nutrition support options such as tube feeding, IV nutrition and modified oral diets. We have a clinical nutrition team which includes RD's and dietetic technicians who work together to help improve or maintain your nutrition and hydration status while you're staying at the hospital. In the outpatient setting, RD's will see you either in the infusion area (while you get chemotherapy or other IV medications or fluids), the clinic area (where you see your medical and surgical oncologists/teams) or the radiation oncology area (if you are getting radiation treatments).


Q : 3

12/15/2011
I have read much about omega 6 fatty acid generating inflamation. Olive oil is much touted as "healthy" yet it is super high in omega 6. What does this mean for patients with cancer?

Omega 6 fatty acids can promote inflammation, however they remain part of a healthy diet and should be included in the form of unprocessed, natural foods. The typical American diet includes too much omega 6 in the form of factory-made processed foods. The problem arises when the balance is off: too much omega 6 and too little omega 3 fatty acids can upset the inflammatory response and chronic low-level inflammation can ensue, increasing the risk of chronic disease over a lifetime. To reestablish the balance, eat more foods rich in omega 3 and cut back on unhealthy sources of omega 6. Also avoid any foods containing the ingredient "partially hydrogenated" oils. These are trans fats and very much promote inflammation. Focus also on cutting back on saturated fats also in processed foods, but found naturally in fatty meats, chicken skin and other high-fat items like butter.


Q : 4

11/02/2011
What supplements are safe to use during chemotherapy? I am being treated with Herceptin, Carboplatin and Taxotere.

Generally we do not recommend taking any herbal, vitamin or mineral supplements during cancer treatment except a basic, kids (preferably chewable or gummy) multi-vitamin/mineral with only up to 100 percent of the daily value for all ingredients. Some physicians will also allow vitamin D, calcium and fish oil supplements, but you would need to discuss these (and the amounts) with your health care team.


Q : 5

08/20/2011
Does the fully hydrogenated oil found in peanut butter raise LDL cholesterol and lower HDL cholesterol like trans fats are purported to do?

Hydrogenated fats are liquid oils (soybean, grapeseed) that are chemically altered to make them into solid fats, which also makes them saturated fats. Saturated fats are solid at room temperature and are found in a variety of natural and processed foods (butter, beef fat). Partially hydrogenated fats, also called Trans fats, are liquid oils chemically altered but not fully saturated; they are mostly found in commercially prepared, processed foods (snack and dessert items). Both forms of hydrogenation (adding hydrogen atoms improve stability) allow increased shelf life for foods; so your snack cakes can sit forever without getting moldy or hard. Saturated fats, whether natural or chemically made, raise LDL, or bad cholesterol, but do not affect HDL (good cholesterol). Trans fats not only raise LDL but also lower HDL cholesterol: a double whammy. Elevated LDL and low HDL, as well as elevated tryglycerides, are all risk factors for heart disease and other health issues. Here is a link to the American Heart Association to help with explaining this: http://www.heart.org/HEARTORG/Conditions/Cholesterol/PreventionTreatmentofHighCholesterol/Know-Your-Fats_UCM_305628_Article.jsp. In terms of peanut butter, the ingredients will vary depending on the brands. The reason hydrogenated oils may be added to what should only be "peanuts and salt" is to help make the butter creamy, improve the grainy texture and help with preventing separation of the oil (which will rise to the top of the jar and must be re-stirred into the butter or it may taste dry). Peanuts are unlike other nuts (tree nuts like pecans, almonds, etc) as they are a legume (podded vegetable) that grows in the ground. They naturally contain carbohydrate, protein, fiber and fat: mostly monounsaturated (healthy) but also polyunsaturated (also healthy) and saturated (not so healthy). They are also a source of vitamins, minerals and antioxidants. Basically they are a healthy, although high-calorie, food.


Q : 6

03/01/2011
My sister has cancer. Do you have a list of foods that are a good source of magnesium?

A good resource is: http://ods.od.nih.gov/factsheets/magnesium. You can also view the list on our site here: http://www.umgcc.org/patient_info/nutrition_cancer.htm. The US RDA (recommended dietary allowance) of magnesium is ~300-400 milligrams (mg) per day for adults. You may need to ask your sister's doctor about magnesium supplements (pills) if she is losing magnesium faster than she can replace it.


Q : 7

10/04/2010
What should I take if I am not digesting enough protein?

In a normal system, digested protein is almost totally absorbed. When there is a deficiency of enzymes (pancreatic or intestinal), there may be malabsorption of protein; if you think this is your issue, discuss taking oral enzymes with your doctor. If your issue is malnutrition (poor nutrition intake), you may be breaking down skeletal muscle protein for energy; this would result in a loss of lean body mass (and weight loss, fatigue and other symptoms of malnutrition or wasting). Your body, in this state, will convert amino acids (the breakdown products or building blocks of proteins) and convert them to glutamine (or use stored glutamine or other amino acids) and further convert these into glucose: your body's preferred energy source. If your issue is injury (such as surgery), you would become catabolic, breaking down tissues for energy, including protein. This will impair your ability to recover and heal. Either way, you will need to take in more protein, either from your diet, or via tube feeding or intravenous nutrition. If you can, try to eat more protein-rich foods. All animal foods (meat, chicken, fish, eggs) are protein-rich, as are all dairy (milk, cheese, yogurt) products, nuts, seeds, nut/seed butters, soy products, beans, grains (breads, cereals, pasta, rice), and vegetables. I would suggest you meet with a dietitian at a hospital near you or where you are being treated.


Q : 8

07/31/2010
My father (68) was diagnosed with myeloid sarcoma (Chloroma, granulocytic sarcoma). We have tried researching what foods he should eat to help fight the cancer and what he should eat for protein, but the results are conflicting. We understand that protein is very important for cancer patients, can you suggest which food sources are best? I have read some articles that suggest consuming alkaline foods, and drinking more alkaline water, green tea and green algae. Is this really helpful? Can he eat eggs or is the yolk considered and acidic food to be avoided? We were told to also avoid cheese, yogurt and mushrooms.

In terms of trying to make the body or blood more or less acidic/alkaline, this is very difficult to do with food/diet. The body is tightly regulated to maintain a certain blood pH level at all times, so what you eat or avoid eating will not make a huge impact on this, if at all. I would not recommend following any acid/alkaline theory of diet. Instead, focus on eating healthy, whole, natural (unprocessed) foods. Eating smaller, more frequent mini meals/snacks may also help with tolerance and weight maintenance. You state your father takes green algae, I gather this is a supplement (pill, powder or other tonic), but green or blue-green algae can be contaminated with toxins and cause illness. I would avoid these if you can't be sure that they are uncontaminated. The supposed nutrients you are seeking from the algae can be found in much safer food sources. Choosing more fruits, vegetables, nuts, seeds, whole grains, lean proteins, and beans would be a better way to meet all his vitamin and mineral needs. Green tea is fine and can be a great source of antioxidants, but not much in terms of calories. So, you may want to add milk (cow, goat, soy, almond, or rice) and consider fruit or milk shakes made with fruits, juices, honey, ice cream or frozen yogurt. I am not sure why the doctor told you to avoid cheese and yogurt, as these are good sources of calories and protein. I have no problem with him eating the whole egg, which would give him more calories as the yolk contains fat. Do not believe everything you read on the internet. Always find multiple sites to verify what you think is true and use reputable websites. Some I suggest are: www.cancer.gov, www.cancer.org, www.eatright.org, and www.mskcc.org (memorial sloan kettering hospital); and our site: www.umgcc.org or www.umm.edu.


Q : 9

04/12/2010
Can eating too much fiber cause cancer?

I have never heard this before. Generally eating a high fiber diet is a health-promoting activity, especially if the fiber comes from whole grains (whole wheat, oats, flax, barley, etc.), fruits, vegetables, nuts, seeds and legumes (beans, lentils). Choosing breads and cereals with at least 3 grams of dietary fiber per serving is a good way to get the recommended 35-45 grams/day of fiber. There are two kinds of fiber: soluble (found in pectin in fruits-apples, pears, plums and oats) and insoluble (the tough chewy parts of plants that do not get digested: found in celery, skins of beans and corn, etc.) Both kinds of fiber are important for health. I would not, however, necessarily choose "fake" fiber such as medications like metamucil or using excessive fibers such as psyllium husk and chickory root. Read ingredient labels to avoid these in excess and choose fewer processed foods. In general, a diet rich in plants: especially fruits, veggies, whole grains, nuts and legumes are all shown to prevent/reduce the risk and recurrence of cancer, as well as many chronic diseases. As are the antioxidants found in those, as well as many other foods, such as dark chocolate, tea, some soy and other foods. It is also important to choose unsaturated fats-especially omega-3 fatty acids-and olive oil. I would suggest also checking out the cancer websites: www.cancer.gov and www.cancer.org for more info.


Q : 10

03/13/2010
Are Boca Burgers a healthy substitute for meat? My doctor said he really did not know, but added that they are a processed food.

My answer would first be a question: why do you want to eat them? If you are trying to eat less meat, then substitute in this order: beans/grains, then fish/seafood, then poultry (chicken/turkey), then true soy (tofu/miso). As an American you probably already eat too many processed foods-things that your great-grandmother would not recognize (cheese curls, gummy bears, twinkies, etc.) so adding more processed "fake" foods would not be advisable, in my opinion. Cutting back on all your snack and dessert-type items would be good, as well as cooking more at home, using less salt/salty foods, less sugar overall-especially refined foods made with white flour/sugar and pre-made, store-bought stuff. Eat more PLANTS and less food made in a PLANT! If you are trying to eat more soy, then add true soy foods: tofu (silken or firm), soybeans (edamame or soy nuts), soy milk (non-GMO soybeans and calcium-fortified) and Miso (bean curd paste). Soy "meats" are made from soy protein isolate and may offer none of the benefit from true soy and add to your processed food and sodium intake. If you are trying to become vegetarian, I would suggest trying black bean burgers or portabello mushrooms in place of meat on a bun. If you are a cancer patient I would also suggest limiting all your soy intake to 3 servings daily (generally a serving would be 8oz soy milk, 4oz tofu, 1 cup edamame, 1/4 cup nuts).


Q : 11

02/01/2010
Are there any known side effects from taking turmeric? How much is safe?

Any time you are thinking about taking a supplement, remember how poorly regulated they are in the United States. Supplements do not fall under food nor drug, so the FDA has trouble managing their safety and efficacy (how well they work), whether the bottle contains what is listed on the label, and whether each capsule contains more/less/none of what is stated. That being said, some supplements are safer than others. Being a spice/root (actually a rhizome or bulb), turmeric is considered relatively safe to use. General adult-only dosing (per a UMMC article) suggests 1.5 - 3 grams/day of the actual cut root or 1 - 3 grams/day of the dried powdered root. Turmeric has antioxidant properties related to its curcumin levels: anti-inflammatory especially (other anti-inflammatory sources include omega-3 fatty acids found in walnuts, fatty fish, flaxseed and fortified foods). In terms of cancer prevention/treatment, the studies are still underway and there is no current recommendation for its use in cancer therapy. It can, as with all supplements and herbal remedies, interfere with cancer treatment, so always tell your doctor and health care team about your supplement use. There are some contraindications to taking turmeric for people with kidney stones or gallbladder problems and they should avoid it. Also it is advised to avoid very large doses or use over long periods of time. This may result in stomach upset or ulcers. There is also a risk of drug interaction (blood thinners, ibuprofen and others), so always discuss with your doctor, pharmacist and health care team about any supplements you are taking. In terms of food, it is safe to use turmeric (also in Curry powder-especially good is the Madras version) as a kitchen spice. Add it to any savory dish (eggs, chicken, fish, vegetables) for a tasty dose of curcumin.


Q : 12

01/05/2010
My mother was recently diagnosed with stage 4 melanoma. All of her tests have indicated that her lymph nodes are clean and she is going for removal of the area in a week. Food has always been something she's struggled with and my siblings and I want to make sure she is eating the best diet possible. In looking up dietary considerations for people with cancer, I saw many conflicting things. She does like coffee occasionally and drinks Tulsi tea daily, should she avoid sugar and artificial sweeteners always? Also, are there any foods she should be sure to include or exclude from her diet permanently?

Tulsi tea should be OK as long as she is not under active treatment (chemo or radiation), as it could interfere. Otherwise, coffee and tea in general are fine to take daily as long as the caffeine does not make her jumpy or cause her difficulty sleeping. Coffee and tea both contain natural antioxidants and this is the best way to get them -- from the diet in their natural form. If she likes tea, I would also suggest green & white teas. They have the most antioxidants. I would not suggest taking any tea (or other herbal) supplements (capsules/pills/tinctures/powders/etc.) but rather get all antioxidants from naturally occurring foods or drinks. If she likes, she can take vitamin D: (1000-2000 IU per day), but ask her doctor to make sure this is OK. A chewable or gummy kids standard multivitamin/mineral is also fine to take daily. I prefer the chewable, gummy or capsule forms over any tablets, as they are better digested. The kids' versions also limit everything to only 100% of the daily value, which is safe for cancer patients. They also may cost less. Have her eat more antioxidant-rich foods: all fruits & vegetables (especially dark & bright colors, leafy greens & citrus), whole grains (100% whole wheat or oats), nuts & seeds (& nut/seed butters), cocoa & dark chocolate, beans (all kinds), oils (olive & canola) and some soy (milk, tofu, miso & soybeans). I would suggest avoiding partially hydrogenated oils (trans fats), BHT/BHA preservatives, food dyes and high fructose corn syrup. She does not need to avoid sugar but certainly she could choose more natural versions such as honey, real maple syrup & molasses. I would avoid using any artificial sweeteners, as side effects and long-term use may be questionable.


Q : 13

10/13/2009
I am a 2 year stem cell transplant survivor and I am doing very well. The only issue is a little bit of a GVHD reaction on the liver. My doctor prescribed a low dose steroid treatment (4mg a day). Are there certain foods to eat or avoid that would be beneficial?

In terms of diet, transplant patients need to take additional magnesium, calcium, vitamin D, and potassium-usually as supplements, as it is difficult to meet those increased needs (due to medication-induced losses) by diet alone. You can, though, focus on eating more calcium-rich, magnesium-rich and potassium-rich foods, such as dairy foods, almonds, fruits, vegetables, nuts, seeds, whole grains, and beans. Limit sodium and salt in your diet to less than 4 grams/day and drink plenty of water and other fluids without caffeine. You may also want to limit simple sugars such as sweets, candy, table sugar and syrups choosing more natural sweeteners such as 100% fruit juice, real Maple syrup and honey instead. Avoid all artificial sweeteners-even Splenda. Avoiding artificial ingredients such as food dyes, preservatives and high fructose corn syrup may also be advisable. As long as your team agrees, you can add back lactose-containing dairy foods gradually and also gradually up your fiber intake through brown rice, multigrain pasta, whole wheat breads & cereals, oat bran, flaxseeds, and legumes (podded vegetables), nuts, and beans. Focus on more fruits and vegetables; especially leafy greens, bitter greens, cruciferous veggies (cabbage, broccoli), beets, tomatoes, asparagus, artichoke, and carrots and choose brightly colored and dark fruits including all berries (if your transplant team approves). Use extra virgin cold pressed olive oil for most of your fat intake (review the Mediterranean diet), as well as avocado, nuts and seeds and their butters (cashew nut butter and sunflower seed butter are especially good). If spices don't bother your stomach, add cayenne pepper, turmeric (and curry powder), dill, and fresh herbs such as basil, parsley and cilantro to your food dishes daily.


Q : 14

07/05/2009
My father was diagnosed with colon cancer two years ago. His ileostomy was removed a month ago and now he is desperate to get some nutrients back in his body. The problem is that part of his colon was removed and now, after he eats, he goes to the bathroom right away. Do you have any suggestions on how to keep the food in his body longer so that he can absorb the nutrients?

If your father is missing part of his colon and part of his small intestines as well, he may be malabsorbing his food and nutrients. If the stools are pale, greasy, oily, and/or foul-smelling, he may be having fat-malabsorption called steatorrhea. You can have this diagnosed by his doctor through a series of tests including a fecal fat test. If he does have steatorrhea, he will need to take oral pancreatic enzymes with every meal and snack: this will help his gut absorb the fat and fat-soluble vitamins (A,D,E,K) from his food and ease the loose, frequent stools. If the enzymes alone don't help, he can ask his doctor either for a medicine that helps lower the gastric secretions in his stomach (to better absorb the enzymes), such as an H-2 blocker, like Zantac; or he can ask about pain medication such as tincture of opium, which can slow down the gut movement. Another medication option is Octreotide, which lessens diarrhea. Please discuss all medication options with both his doctor and pharmacist. You could also request a referral or visit with a Gastroenterologist (GI) doctor. In terms of diet, if the enzymes help, he can eat a regular diet but should eat small frequent mini meals every 2-3 hours all day. Never eat large heavy meals. He may want to try cutting back on sweets, sugary foods and other simple sugars (juice, soda, candy) and see if that helps. Make sure he gets enough protein: meat, chicken, fish, eggs, peanut butter, nuts, beans. You can also ask a pharmacist about getting probiotics such as those found in yogurt, but in capsule form which you can sprinkle over foods (much higher dose). Eating yogurt with live active cultures can help a litte, but the more concentrated forms you have to get from a pharmacist. I would definitely ask about the enzymes first and then go from there.


Q : 15

03/05/2009
I am going though Chemotheraphy and was told by a friend that I could try ginger root tea for nausea. My doctor was not sure of any side effects and suggested that I not use it. What would you suggest?

In terms of therapy, ginger appears to be helpful in treating nausea (but not vomiting), and motion sickness, and may also help in lowering inflammation in the body. It appears safe to use in cancer patients & during cancer therapy, including chemo. However, it does have some interactions, especially as a blood thinner, and can interfere with blood clotting, so do not take any ginger if you are on aspirin or Coumadin (or any other blood thinner medication). That said, you can take up to 4 grams/day of ginger in any form you prefer: tea, tincture, capsule or root (to cook with). I personally would avoid any bottles (capsules/pills) as they are not well regulated in our country. See this National Cancer Institute website: http://www.cancer.org/docroot/ETO/content/ETO_5_3X_Ginger.asp?sitearea=ETO Using a long-standing reputable brand of ginger tea would be okay and I would suggest using it in food: you can buy the whole root and cook with it, or use pickled ginger, ginger chews/candy, sugared ginger or real ginger ale/beer (Trader Joe's sells a great version). Just check with your health care team to make sure they are okay with your using ginger.


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