Today's New York Times has a terrific article by Jane Brody on eating after a cancer diagnosis--
Excerpts from --
July 6, 2004
For Survivors of Cancer, All Calories Are Not Equal
By JANE E. BRODY
Dyer [a dietitian diagnosed with third recurrence of cancer] increased her exercise; reduced her alcohol intake; avoided saturated fats in animal foods and the trans and hydrogenated fats in processed foods; switched to olive and canola oils; gave up red meats and poultry but ate more soy foods, fatty fish and eggs, rich in omega-3 fatty acids; doubled her fiber intake through whole grains, legumes and nine or more servings a day of fruits and vegetables; replaced diet sodas with tomato and orange juice, and green tea; stuck to low-fat dairy products; and added nuts and flax seeds to her diet.
She describes her plan, including what to do when eating out, in a book, "A Dietitian's Cancer Story" (Swan Press, $15.95), and offers two weeks of menus and recipes on her Web site, www.cancerrd.com.
Part of the sales of the book benefit the American Institute for Cancer Research. The book can be ordered through the institute at (800) 843-8114.
Also helpful on the subject is the American Cancer Society's publication "Nutrition for the Person With Cancer: A Guide for Patients and Families," available by calling (800) ACS-2345.
Will Ms. Dyer's approach help keep her free of cancer? So far she has been healthy. And the diet will lower her risk of heart disease.
To help health care providers and their patients make the best choices based on the best available evidence, three years ago the American Cancer Society published in the journal CA a guide on nutrition during and after cancer treatment. It was designed to help the more than 1.2 million people who each year receive cancer diagnoses and the more than nine million Americans who have thus far survived cancer. The article is online (caonline.amcancersoc .org) or can be found in the May/June 2001 issue.
In addition to the nutritional advantages gained from the suggested dietary measures, making improvements in living habits has important psychological benefits by helping patients regain a sense of control over their lives.
Current approaches to cancer treatment - surgery, radiation and chemotherapy - may not only change a person's nutritional needs but also interfere with the ability to consume, digest, absorb and assimilate food. In most cases, cancer treatment increases a person's caloric needs while making it more challenging to meet them.
Small, frequent meals and snacks and foods that are easy to chew, swallow, digest and absorb - and that are appealing - are recommended, even if they are high in calories or fat. This is not a time to try to lose weight or worry about how healthful foods might be. Meeting one's caloric needs is the primary goal; during treatment, it is often helpful to add beverages like Ensure or Boost as temporary aids.
Cancer patients are also urged to engage in light, regular physical activity to counter fatigue; to stimulate appetite and digestion; to prevent constipation; to maintain energy and muscle mass; to provide relaxation; and to reduce stress.
But the cancer society's experts warn against consuming high levels of certain supplements that may do more harm than good. Folic acid, for example, can interfere with the action of some chemotherapeutic drugs, like methotrexate, that act as folic acid antagonists. And high doses of antioxidants, like vitamins C and E, which patients sometimes take in hope of protecting normal cells, may reduce the effectiveness of therapies that work by causing oxidative damage to cancer cells.
The experts recommend as a prudent approach during treatment "not to exceed the upper limits of the Dietary Reference Intakes for vitamin supplements and to avoid other nutritional supplements that contain antioxidant compounds."
Cancer treatment often suppresses immune responses, and so it is also important to pay particular attention to food safety. Do not eat raw fish or undercooked meats and poultry or drink unpasteurized juices; rinse all fruits and vegetables; and protect foods eaten uncooked from the drippings or utensils used on raw meats, poultry and seafood.
Once active treatment ends, the goal is to rebuild muscle strength and correct problems like anemia that may have been caused by treatment. Again, this is not a time to diet; the emphasis should be on eating healthful foods.
Although daily exercise may not prevent recurrence or slow the progression of cancer, the experts note that it can "reduce anxiety and depression, improve mood, improve self-esteem and reduce symptoms of fatigue, nausea, pain and diarrhea."
Eating for Good Health
The cancer society experts say, "There is no evidence to support fasting as a healthy practice during cancer treatment or beyond."
Vegetarian diets and macrobiotic diets based on whole grains, fruits and vegetables, beans, fermented soy products, nuts, seeds and teas "can be consistent with a healthy diet" as long as consumers are careful to take in enough calories and essential nutrients.
But the experts found "no data to support the claim that a macrobiotic diet reduces cancer incidence or recurrence" any more than the less restricted regimen the society recommends, which includes animal protein foods in moderation.
Alcohol is best avoided or consumed in moderation - at most a drink a day for women, two for men - since it is associated with an increased risk of breast, lung and digestive cancers. Purple grape juice helps protect against heart disease. Teas are all right for cancer survivors, as long as they are made from plants that are ordinarily used for foods or beverages. Caffeine is all right, too; it has no link to cancer.
The jury is still out on the benefits and risks of estrogen-rich soy foods for survivors of breast and prostate cancers, though they are not believed to be hazardous when consumed in moderation, say, at one meal a day. But breast cancer survivors should avoid supplements of soy concentrates and isoflavones.
High-fat diets, in general, are not advisable for cancer survivors, or for anyone. In place of animal-derived fats and polyunsaturates, some experts recommend monounsaturates like olive and canola oils and the fats in avocados, nuts and fish, which have been associated with protection against cancer and heart disease. Foods high in sugars may have no adverse effect on cancer, but they have limited nutrient value and often supplant more healthful foods.
As Ms. Dyer discovered, until there is evidence to the contrary, eating lots of fruits and vegetables and whole grains rich in potentially protective fiber and phytochemicals should be the goal for all cancer survivors. In fact, for everyone.
Copyright 2004 The New York Times Company