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 14 of 14.

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Q : 1 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 : 2 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 : 3 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 : 4 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.
Q : 5 02/05/2009	My sister has stage IV breast cancer that has metastasized to the liver and bone. I want her to try taking milk thistle. Have you seen any positive results in patients using this supplement? My feeling is that it would be okay for you to let her try the milk thistle, but be cautious. It can have some side effects like upset stomach, diarrhea, rash and even anaphylaxis: so watch closely for any reactions after trialing a very small amount. If she has any allergies to aster family plants (daisy, artichoke, kiwi or thistle), she should not take it. It can also possibly interfere with some cancer drugs: so watch for any change in effectiveness in treatment once she starts taking the milk thistle. I would make sure to obtain it from a reputable source and limit the dose to the max that has been studied: up to 600 mg per day (given in 2-3 doses). There is very limited human study in clinical trials, but the data does seem to suggest it is very helpful and not harmful for the liver. The silymarin component acts like an antioxidant and anti-inflammatory agent. I personally have not seen any patients on it, but not all patients tell me all the herbs they take. Do be sure to tell her health care team the amount she takes so they can document and watch. The information suggests it is most helpful in the liver to promote healing and improve normal liver function, but it will probably not act like a cure, so it is important for her to continue her cancer treatment as her health care team recommends. I would also recommend encouraging her to intake more natural antioxidants too: bright and dark-colored fruits and vegetables, extra virgin olive oil, beans, dark chocolate/cocoa, green and black tea, honey and real maple syrup. Try to have her take a walk outside daily, if possible, drink more plain water, and sleep 8-9 hours at night in a dark room. These things all improve the body's natural immunity to help healing and repair. Also try to make her laugh and keep her happy and as stress-free as possible.
Q : 6 01/09/2009	Are there any benefits from eating chocolate that has 70% or more cocoa? Chocolate-especially the cocoa-rich version (dark chocolate) is rich in naturally-occurring antioxidants, which come from the cocoa itself. That is why the darker the chocolate, the higher the antioxidant level, as it contains more cocoa (which is bitter & not sweet) & less additives (such as milk, syrups & sugar to make it more palatable). Milk chocolate contains little antioxidant benefit and white chocolate (not even really chocolate as it contains no cocoa) has none. Antioxidants are substances which help your immune system ward off illness and disease and are found naturally in foods (fruit, vegetables, whole grains, olive oil, tea, coffee, nuts, and soy foods) and in our bodies (melatonin is made when we sleep in a dark room). The more antioxidants in your system, the less risks you may have for illness and disease. Saying that, you could get just as many antioxidants and fewer calories and fat from fruits and vegetables as well as other food sources such as green tea. But if you like chocolate-especially the darker versions-go ahead and indulge but sparingly. Limit yourself to 1 ounce of chocolate daily and choose a good quality chocolate (not Hersheys!). Calories from chocolate can add up quickly and gaining any weight can affect your disease risk, making these antioxidants less of a benefit.
Q : 7 06/22/2008	I was recently diagnosed with lobular carcinoma in situ. Can and should I take soy products, and which are best? My understanding of soy is that it is okay to have up to 3 servings/day of real soy-that is: soy milk, soy cheese, soybeans/edamame, tofu and miso. A serving is about 8oz of soy milk, 1oz soy cheese & soy beans, & 4oz of the other foods. Using soy protein isolates: those "soy" foods such as soy hot dogs/meats, textured vegetable protein (such as in soy "eggs" and "meat"), Boca burgers, soy bars, etc. is NOT recommended. So, if you like soy & are willing to stick with the original foods (milk/tofu,etc) then you are fine with those as long as you stay within the 3 servings/day. Soy does have antioxidant capacity & is deemed safe in those quantities per current literature. I would say, use in moderation as you like but limit or avoid the soy protein isolate foods. If you don't like soy, then choose other antioxidant-rich foods instead. There is no need to add it to your diet if you don't already use it. Do remember to eat plenty (5-9 servings/day) of fruits & veggies!
Q : 8 06/21/2008	My friend has cancer and has decided to follow the natural route, but I am a bit concerned. She is eating limited vegetables, only a few types of fruit, brown rice, and pasta. Her only protein is fish once a week and cheese. She drinks sherbet made with icing sugar, and tartaric acid mixed in water each day. Is this diet healthy? Isn't sugar bad for cancer cells? Actually her intake of fruits & vegetables appears high in antioxidants, which is very good. She also gets some protein from the vegetables (2gm/serving), and the carbohydrates (3g/serving), and lots from the beans (7g/serving: same as animal protein), but she certainly could up her intake of fish & cheese to at least 2-3 times weekly. She could also add nuts, seeds & peanut butter, all of which would give her protein, antioxidants & also some heart-healthy form of fat. The brown rice (and wheat pasta) are good sources of fiber, as are the fruits & veggies. In terms of sugar, there is limited science to support avoiding it: cancer cells eat the same "foods" as all the other body cells. They are just cells gone bad. They do not follow the "rules" of the body & have "gone wild." But it is fine to avoid white processed sugar & items made from it, such as pastries, donuts, etc. Eating natural sources of sweet such as honey, molasses & real maple syrup are good alternatives & also provide antioxidants. Antioxidants found naturally in foods/drinks help to protect the body by strengthening the immune system, but that does not apply to supplements, pills, tinctures & powders. So drinking brewed green tea is good, but taking a green tea capsule is not. In terms of the sherbet & icing, these are concentrated forms of sugar & are probably OK, as they provide extra calories in a concentrated form. This can help with maintaining her weight. Overall, I would focus less on the sugar intake & encourage more antioxidant-rich foods, including olive oil, green/white/black tea, dark chocolate/cocoa, all fruits/vegetables & 100% juices (especially the dark & brightly colored ones), beans, some soy (milk, tofu, soy beans/edamame), fish & other omega-3 rich foods. She could also add eggs (perhaps the omega-3 version), some other forms of dairy (milk, cottage cheese, yogurt) or other animal protein, as she likes. She should be eating every 2-3 hours all day via 3-4 meals + snacks. Small, frequent mini-meals are ideal. Drinking plenty of fluids, including lots of water, is important for hydration & also provides additional calories & antioxidants. (Think 100% juices, milk, vitamin water, iced teas, etc.) Other important things to focus on are physical activity (as able), getting 8 hours of sleep at night in a dark room, and doing activities she enjoys: keeping her happy & stress-free. These things also improve immunity, and a strong immune system helps fight off future cancer cells. She should try to maintain her weight, if possible, and try to avoid any nausea, vomiting, diarrhea or constipation. Hope that helps! Try to be supportive of her food choices & let her eat what she likes.
Q : 9 05/03/2007	My mother is cancer patient, and she had 90% of her stomach removed last year. She is about 90 lbs now and it appears she is having problems keeping food down. Are there other alternatives for cancer patients who have a feeding tube? We have tried supplemental drinks as well. If she already has a feeding tube, I am assuming it is in her small intestine (a J-tube). If this is the case, she should be able to meet all of her nutrition needs via the tube feeding. If she is losing weight with the tube feeding, then a dietitian in your area needs to evaluate how many cans she needs per day; you may want to increase her intake by 1 to 2 cans if that is the case, but check with her health care provider to make sure. If she has a feeding tube but is not tolerating the cans of tube feeding, then she needs to be seen by a doctor right away to fix any problems with the tube or its placement. If she is vomiting up tube feeding that came from her small intestinal feeds, that could mean the pyloric sphincter between her stomach & small intestine may be loose/open, allowing food to travel up/backwards. This also is a medical problem that a doctor would need to evaluate. So, first I would have her feeding tube placement checked by her doctor. If her problem is vomiting from food she has eaten by mouth, that is another issue. The stomach is mainly a holding area for food to be pre-digested before it goes into the small intestine. Enzymes, secretions & contractions in the stomach help to grind up the food to make it more liquid. When the stomach has been resected (removed as you said), then all the work goes to the small intestine, which can adapt over time to take over this function of digestion. Depending on what is left of her stomach may affect how easily her small intestine will adapt. One of the most important things she can do is to eat very, very small portions: 1 fistful of food at a time. This will help her body adapt & also ease digestion & the risk of vomiting. It is common to have fullness, weight loss & vomiting after this type of surgery. She will need to learn to eat differently than before: much smaller portions of food but eating more often (every 2 to 3 hours all day long). Some tips for her eating: eat foods separately from liquids. Have her eat a handful/fistful of protein-rich food (like tuna salad with crackers) & chew it for a long time until it turns watery/mushy in her mouth. Then about 30 minutes later she can sip on some liquids (like tea w/honey or water). Then repeat this process in about 2 hours. The goal should be 6 to 8 small "snacks" daily which she can build up over time to little meals of 2 fistfuls of food each. Foods to eat: grains (bread/cereal/noodles/rice), protein foods (eggs/fish/chicken/meat), dairy foods(milk/yogurt/cheese), fruits & vegetables. If she has any symptoms of a condition called "dumping syndrome" (bloating, nausea, diarrhea, dizziness, weakness, sweating, and rapid heartrate, which can happen 30 to 60 minutes after eating & again at 2 to 3 hours after eating) she would need to avoid sugar-rich foods such as sweets, juices, candy, cookies, pies, baked goods ),sugary drinks. Sometimes very hot or cold foods may also cause this problem. Some people also cannot tolerate milk products. If this is a problem, use Lactaid milk or soy milk. It is OK -- even good -- to use supplemental drinks. She may only be able to drink 4 oz (1/2 cup) at a time; just have her keep trying. Using Boost Plus or Ensure Plus may be a good option, as they are higher in calories. Again, the main points here are: check w/doctor about the feeding tube, eat very small portions but eat often, separate foods & liquids by 30 to 60 minutes, & consider avoiding sweets if signs of dumping syndrome.
Q : 10 03/13/2007	Can you please offer some expert opinion on the vitamin supplement Juice Plus? It is being shamelessly promoted as a cure and prevention for cancer and what I have read about it has really shocked me. It looks like a total scam. Can you please comment on this product and check out the information at a few of these sites. A lot of people are pushing this product to cancer patients and if the marketing is as dishonest as it seems to be, more expert opinion is badly needed to protect patients. Thanks in advance. It seems to me that anything that sounds too good to be true is usually not true. Some things to keep in mind: dietary supplements are not tightly regulated by the government, so you could have variation between bottles & even within one bottle of this supplement; also, there are things in whole foods (phytochemicals especially) which we are unable to just pluck out & put into a capsule-which is why eating the whole food is so much better. Also, this supplement (as are most) can be very expensive (versus eating more whole foods). My recommendation is to eat more fruits & vegetables (fresh/frozen/canned) & drink more water, and take a regular (& inexpensive) multivitamin/mineral supplement of which you could take a chewable to ease digestion. In terms of curing or preventing cancer, if we had the answer to that one-well...the science is just not there yet. My advice is to eat more dark green leafy vegetables, more brightly colored fruits, & add beans, fresh herbs (like cilantro), spices (like curry powder), whole grains, and green tea to your diet. A better place to spend extra money (rather than on supplements) might be on organic fruits/veggies & hormone/antibiotic-free meat, chicken, dairy & eggs. As for the consumer: it is truly buyer beware: we all need to become more savvy about what we read, as we are all tempted by the allure of the magic bullet. Good luck.
Q : 11 02/20/2007	My husband was diagnosed with colon cancer in 2006 at age 34. He was treated surgically and did not need chemotherapy or radiation. We want to see a nutritionist who can help us learn to live a healthier lifestyle to help prevent any future cancer recurrances. Can you please tell me whether we can make an appointment with your office or do you only work with patients undergoing chemotherapy treatments? Since you were treated here, I can meet with you here at the hospital (maybe when you come in for follow up w/ your surgical oncologist?) I can also email you info or I can speak w/you on the phone. (My number is 410-328-5462). Let me know what kind of info you would like. I have an antioxidant diet & also high calorie/protein info, or whatever else you need.
Q : 12 01/22/2007	I do eat right, the best I know how, and stay with my vegetables. But when I was told that I have an abnormal Pap smear, I got confused. So where did I go wrong? You did nothing wrong! Sometimes pap smears are abnormal & this can be common: just follow up with your doctor to see what the test may mean. It is important to talk to your doctor or other health care provider to see what you need to do next. Keep eating vegetables & also fruits, but remember: there are many factors that can cause illness & your diet is only one of them. Good luck & take care!
Q : 13 01/19/2007	My Dad is starting TEC chemo treatment and is supposed to not take milk, milk products, or calcium-rich foods. Can you give me a list or resource for calcium rich foods. Also, there was a note regarding scalp cooling which may help prevent hair loss. What is this and is there anything else we can do? I am not familiar with scalp cooling, but you can try researching it on the Internet. Some good websites to try: www.cancer.gov, www.cancer.org, www.aicr.org. As for the calcium question, it is mostly found in dairy products (milk, cheese, yogurt, ice cream, cream) but also in smaller amounts in green leafy vegetables (collard greens & broccoli). It is also found in sardines or canned salmon w/bones & in any prepared foods that state "cheese" in the ingredients (like pizza or mac-n-cheese). You can also search any specific foods on this website: www.calorieking.com. Remember, too, that most multivitamin/mineral supplements contain calcium; read the labels. Otherwise, make sure your dad is eating small, frequent meals every 2-3 hours all day with plenty of fruits, vegetables & whole grains/beans & nuts. And make sure he is drinking water: 8-oz. 8 times per day; this will help him get through his chemo. Good luck.
Q : 14 01/11/2007	My mom is 72 and was just told she has advanced breast cancer. I'm considering having her get treatment at you facility sometime soon, but until then would very much like to know how I can help my mom feel better. She is getting her third day of some type of radiation tomorrow. Today, she told me she has lost her appetite and is feeling very week. What kinds of food would make her feel better? Thank you so very much! One of the best things you can do is to offer her small portions of foods & drinks every 2 to 3 hours all day. Eating very small portions of foods may be easier for her to handle. Find out if she is having any nausea, upset stomach, gagging or choking on foods, vomiting or dry heaving, or diarrhea. These "stomach" upsets can be caused by cancer treatment or the disease itself, and many times a doctor or nurse may have some suggestions to help. In terms of poor appetite, this is very common, and she needs to know it can come & go, so she will need to eat despite not feeling like it. It is OK to eat or drink small portions as long as it is frequent: she should not go more than 4 hours without eating. Keep snack-type foods handy: dried or fresh fruit, nuts/seeds, crackers, cheese, small-sized yogurts, individual snack packs of pudding & applesauce, popcorn, etc. Encourage her to drink milkshakes (homemade or store-bought) or supplements like Ensure Plus or Boost Plus. You can add protein powder to shakes too. Also try to get her to eat some protein every day: tuna salad, eggs, chicken, peanut butter, beans, and dairy (milk) products. She can also try Soy milk, ice cream, pizza, soups, and juice to keep her calorie intake up. Hope this helps. You may also want to get her into some type of support group so she knows she isn't alone. Good luck!! Mindy!

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