By Rachel Spencer, MS RDN CNSC

Is there a diet for anxiety caused by cancer? Cancer and cancer treatments may cause a range of emotions, most of them negative. Worry, fear, stress, and anxiety often top the list. If you or a loved one have just received a cancer diagnosis, you may have many new feelings that you want to understand and treat.  Working with a therapist or meditation coach is often the most effective treatment, as well as having good communication with your cancer physician and caregivers. Many people also ask how their diets can affect their mood or what is the best diet for anxiety? It turns out, the food you eat can affect the way you feel emotionally. Read on for some interesting research on how your diet can affect your mood, and act as cancer support. 

Blood Sugar 

We’ve all been there – after eating a piece of cake or a candy bar in the middle of the day, you feel great! But then an hour later you feel tired and miserable. Big swings in your blood sugar can lead to a low mood, fatigue and headaches which can worsen anxiety. Try to choose complex carbohydrates, like whole grain crackers, whole wheat toast or similar foods, as these are digested slowly leading to steady blood sugar level. If you do crave sweets, have a piece of fruit and a source of protein. It’ll satisfy your sweet tooth but still keep your blood sugar steady. 

Magnesium & Zinc

Minerals like magnesium and zinc are not common to talk about, but can have big impacts on your mood. Low magnesium is very common, and is tied to poor sleep and increased anxiety. Add magnesium to your diet with leafy greens like swiss chard, kale, or spinach and beans and nuts and seeds. Dark chocolate also is a good source of magnesium, and can satisfy a sweet tooth. Similarly, low zinc levels have also been tied to mood disorders.  Zinc is found in egg yolks, red meat, and nuts and beans. Both minerals are often added to fortified grains like breakfast cereal, which can be a great way to increase your overall vitamin and mineral content as well. 

Omega-3 Fats

Omega-3 fats, like EPA, DHA and AHA, are found in fatty cold-water fish and also in nuts and seeds. They are often referred to as ‘anti-inflammatory’ fats, and they can help your body in many different ways. Studies have shows that both intake of foods sources, as well as supplemental omega-3 fats, improve both anxiety and depression. But make sure to speak with your care team before starting any supplements, as omega-3 can interfere with some medications. 

Caffeine and Alcohol

That second cup of coffee in the morning have you feeling jittery? All that extra energy can often raise your heart rate and worsen anxiety, making you feel mentally worse. Try switching to half caf or black tea, which would reduce your overall caffeine intake but still give you an energy boost. Alcohol is a known depressive, meaning it slows down your body and mental functions. This can worsen any low mood, and worsen depression. Try to reduce or eliminate alcohol from your daily pattern, reserving it in moderation for special occasions. This can help improve your mood, and your general inflammation levels as well. 

Overall, eating a balanced diet that is rich in lean proteins, whole grains, healthy fats and lots of brightly pigmented fruits and vegetables will increase your antioxidant intake and reduce your inflammation. Using spices like cinnamon, turmeric and ginger in your cooking can also add valuable anti-inflammatory properties your diet. Lower inflammation and higher antioxidants helps not only your response to cancer treatment and overall prognosis, but may also improve your mood and anxiety levels. If you have questions about how to incorporate any of this advice into your diet, please reach out to our Registered Dietitians on OncoPower. Our platform exists to provide cancer help for patients and caregivers, through medical and cancer support services – Join Today! 

Meditation. This word can seem scary at first. Taking time to sit in silence? Quieting the mind? Not ‘thinking’? What does that even mean?

For many of us, Meditation is a concept that goes against everything we have been taught. Since we were young, the majority of us have been programmed to constantly work hard-play hard, which consists of working long hours that eventually leads to burnout. We might have lived with the fear that if we took a break, or slowed down, we would be holding ourselves back from ‘success’. Our society has engraved in us to constantly be busy. We might even feel pressure, now in this moment, to always be doing something: whether it’s working, making plans, going to dinner, taking care of loved ones, etc. However, in doing so, we neglect our own needs of taking time to ourselves, finding stillness, and going within. The result? Increased stress/anxiety, heightened blood pressure, insomnia, digestive issues, depression, and illnesses (to name a few).

Through the practice of Meditation, we are able to take a second out of our day to pause, center our thoughts, and ease our minds. The power of Meditation allows us to slow down our breathing to come back to a place of stillness. Through the power of our breath, we begin to take ourselves (and our bodies) out of ‘fight or flight mode’ that stress can bring. We learn how to cultivate a sense of trust within ourselves. And with practice, we start to embody the feelings of peace that we may have longed for.

Meditation is when we take the time to close our eyes and sit with ourselves, whether through silence, music, or using guided meditations. When we meditate, we begin to reprogram the subconscious mind to be in alignment with our conscious mind. It is now scientifically proven that Meditation begins to strengthen the neural pathways in the brain that activates our ‘feel good’ receptors and dopamine production. It is also very effective to help reduce stress when going through cancer treatment.

Meditation is a lot like going to the gym. It can take time and patience to strengthen our Meditation ‘muscle’. You might not notice the results following one session, but with practice you slowly start to see the results. Meditation begins to change you from the inside out, and is an incredibly useful practice for cancer support.

Physically, you can heal the body, release tension, activate your digestive system and slow your heart rate. Mentally, you begin to slowly creep out of depression. Stress and anxiety begins to dissipate and might not be as present as it once was. Emotionally, you feel more stable, more happy and at peace. You might feel like you have control over your emotions and can make decisions with a clear mind. Spiritually, you begin to feel more connected to something greater than yourself. Your intuition becomes stronger and you embody a deep presence that everything is going to be ok. 

There are so many incredible benefits that Meditation can bring. Meditation assists you in managing stress from cancer treatment rather than letting stress control you. Your thoughts soon become present, but they do not consume you and your emotional state. Sitting alone with ourselves – and our thoughts – seems scary. But with practice, it becomes easier and easier. Even just two minutes of Meditation can have a changing effect on the body, mind and soul. It all starts with giving yourself a few moments to be alone with YOU.

How To Mediate? (Natalie’s tips)

• To begin, either start laying down or sitting upright.
• You can always set a timer for 5, 10, or 20 minutes.
• If sitting upright, have your feet planted on the floor and your sit bones rooted on your chair. Keep your spine nice and long and roll your shoulder down your back. Allow the shoulder to relax.
• Close your eyes. With the eyes closed, your eyes are slightly lifted gazing at the space between the eyebrows. This is so you notice the difference between sleeping and meditation.
• Begin by taking three long, deep inhales and exhales. With each breath you take, imagine all stress and anxiety leaving the body.
• Feel free to put on some relaxing music while you focus on your breath.
• You can use a Mantra – a word / phrase – to assist you if the mind starts to wonder. 
• A Mantra can be: Inhale PEACE, and Exhale LOVE.
• We highly suggest using our Mindfulness Meditation Modules found on the OncoPower app.

If you have more questions and/or would like to start your Meditation journey, feel free to check out our OncoPower App for guided meditations and additional support. The OncoPower App is a cancer support community to assist cancer patients. Happy Meditating!

As a helpful resource to our current and future OncoPower members, we are going to be assembling past ‘Frequently Asked Questions’ on nutrition and cancer and posting them occasionally on our blog. We hope these FAQ’s will serve as a reference point for anyone with similar questions and act as a spark for new conversations on related topics. Please feel free to consult our Registered Dietitians using our Ask-A-Doc service for any follow-up questions you may have, we are here to provide support for cancer patients! 

Q: Can I substitute honey in my green tea instead of sugar? 

A:  We all have sugar circulating in our body, it’s our body’s main source of energy. And if you are regulating your sugar appropriately, if you don’t have diabetes, insulin resistance, if your cancer isn’t causing any blood sugar-related issues, then having white table sugar in your tea, as long as it’s one or two teaspoons of sugar, it should be fine. If you want to use honey, that is also totally fine. Your body doesn’t really know the difference between table sugar and honey, but if you like the taste you can go ahead.

What you do want to be careful of is having tons of sugar at once or tons of sugar all the time.  This is going to cause your blood sugar levels to be high, which can cause excess growth and excess cancer cell production.  So, focus more on quantity than type of sugar consumed if you are looking to curb cancer risks. 

Q: What is a superfood?

A: A ‘superfood’ is a term for a food item with higher than normal levels of antioxidants and phytochemicals in it.  This term was coined by the media, and it doesn’t have a scientific definition so isn’t typically used by experts.  Foods which are commonly referred to as ‘superfoods’ are blueberries, kale, sweet potatoes, salmon, dark chocolate, and pomegranates.  These foods are certainly very healthy, and all people should be encouraged to eat them – but the most important key to an anti-inflammatory diet is variety. 

Q: What is the best diet for a breast cancer patient on chemotherapy? 

A: Breast cancer is unfortunately very, very common. General cancer nutrition guidelines apply here, however specifically for breast cancer care there are a few points that stand out.

First, you want to make sure you are monitoring your weight – it’s one of the few cancers where treatment can cause weight gain. Research shows that if you gain more than 12-15 pounds you can have worse outcomes – so you want to make sure that you are aware of this, and can talk to your doctor if weight loss during treatment is appropriate.

Next, whole soy foods like tofu, tempeh, edamame, or soy milk should be included in the diet at least 1-2 times a day. Soy contains a plant-form of estrogen, which can be beneficial for breast cancer patients. Focus on whole soy foods not soy protein isolate, as there is not as strong of research on this kind of food.

Additionally, flax seeds are also beneficial for breast cancer patients. They are high in lignans, a kind of phytonutrient, which has been shown to benefit patients with breast cancer specifically. They are also high in fiber and omega-3 fats, so they are triple threat for inflammation levels.

As far as supplemental vitamins, you should always discuss with your doctor before starting any herbal or vitamin supplements. Each person’s case and medications are unique and may generate different recommendations.  That being said, breast cancer patients have been shown to have some benefit from a standard multivitamin three times a week, but you want to make sure it is good quality and from a reputable source. 

Q: Is beef and chicken okay for a breast cancer survivor? 

A: In terms of protein sources, your lean poultry – chicken and turkey with no skin on it, are totally fine. There are no recommendations for how much is too much, so having some animal protein, some poultry, is just fine. In terms of beef, that’s something you want to limit to once or twice a week. We do know there is a link between red meat and cancer, not necessarily breast cancer but we always want to make sure we can prevent other cancer occurrences. So red meats like beef, lamb, pork, and especially processed meats like sausage, bacon and ham should be limited or eliminated from the diet.

Other good protein options would be beans, legumes, and lentils. These foods they have protein plus fiber to feed your gut bacteria and reduce inflammation levels. You should also consider soy foods and fatty cold water fish like salmon and mackerel, which is rich in omega-3 fats that help reduce inflammation as well. 

Q: Is Vitamin D good for cancer?

A: Vitamin D is one of the only supplements I recommend people take – of course, discuss with your care team so they can check your blood level for appropriate supplementation amounts. But most people, especially in the US, are low in vitamin D. We know now that vitamin D is a workhorse of the body. We used to only think it was only involved in bone and dental health, but now know it’s tied to immunity, respiratory function, and cell proliferation which relates to cancer risk and progression. So most people can benefit from a supplement – Vitamin D3 is best absorbed by the body, but your cancer care specialist can discuss specifics with you. 

We’ll be posting more FAQs in the coming weeks, but for now join our community at OncoPower and enjoy support for other members, advice from cancer physicians, mindfulness practice and more!

Receiving a cancer diagnosis is certainly stressful news.  The term “stress” refers to an outside circumstance.  Behavioral health therapists use the term “distress” to label our internal response to stress.  In explaining this to my patients, I say that stress is the toxins in the  air around me.  Distress is when I breath in the toxins  The goal of monitoring and managing distress is similar to learning to use a hazmat suit and oxygen tank in a toxic environment.

Even though it is very common for those receiving a cancer diagnosis to focus on physical symptoms, medical treatments and side effects, it may surprise you to discover that you may also suffer in non-physical ways.  This is because we are not just physical beings, but have mental, emotional, psychological and spiritual aspects, too.  

Distress is an umbrella term that covers the normal thoughts and feelings that normal people have when bad things happen.  The feelings can be: sad, mad, anxious, worried, scared – and most of the time, a perplexing mosaic of these emotions.  Distressing thoughts tend to center around the fear of the unknown. “Is my treatment going to work?”  “Is it going to hurt?”  “Is it expensive?”  “Will it change how I work?”  “How will this affect my retirement?” 

A very important part of helping you in your journey with cancer is to help you monitor and manage your distress levels –  just as you would monitor any other side effect.  There are two primary reasons why this is so important.  First reason: as distress levels rise, quality of life sinks.  But by working on lowering distress levels, you will improve your quality of life.  When a disease process is usurping the controls you normally have, one of the most important methods to reclaim control is using the tools you do have to manage distress levels.  

The second reason to manage distress levels is because when you feel less distress, you tend to heal better. This is because your mind and your body are really one unit – connected in a myriad of ways we don’t completely understand.

Basically there are three tool boxes that you already have to draw from to help manage your distress levels.  The first one is your internal resources: your psychological strengths, your intellect, your resiliency.  Internal resources are the resources that you have built into your brain during previous times of crisis.  Sometimes these were minor changes you made to handle small crisis and you recovered in hours or days.  Cancer tends to be a major crisis and many patients tell me that it is the worst thing that has ever happened to them.  This will usually mean that distress levels are higher than they have ever been.  This also means that it may take more time to successfully manage.

The second toolbox which provides your resources to manage your distress levels is your support system. This includes your friends family and community.  These are the people who call, send cards, bring casseroles, and when you have a bad day, listen. Many times cancer patients voice surprise by the number of people that rally around them.  (As well as the people who don’t know what to do and seem to move a little farther away.)  I encourage people to realize that the bigger the crisis –  the bigger the team needs to be.

The third toolbox for dealing with crisis and distress is your medical team.  Many patients are surprised to learn that they may need several doctors, nutritional specialists, physical therapists, and behavioral health support.  Many patients also find relief from the distress by seeking out relaxation therapies, massage, yoga etc.

CAN I REALLY MANAGE MY DISTRESS LEVEL?

Clinically speaking, the simple answer is yes!  You have done this before in other situations.  I am not going to tell you it’s easy, but I will tell you patients consistently improve the quality of their life by initiating steps which lower distress.  Even though at the beginning of the process, it may seem overwhelming, let me suggest three questions to begin lowering your distress level, and thereby improving your quality of life.

First, ask yourself, what internal resources have I used in the past when I’ve been in difficult or negative situations?  Usually in discussing this question with patients, I remind them that the wrench I use on my mower can be used on my motorcycle, and on my automobile.  Even if being diagnosed with cancer is the most difficult and most distressing situation you have ever been in, the tools that you have learned to use from other life experiences can also work in this situation.

Second, what things do I need from my support team and who do I need to add to my support team?  It is not unusual for new situations to call for new team members and new behaviors.  The more specific you are with identifying your needs, the easier it is for your team to help you meet those needs.  Many people on your support team will not know what support you need until you tell them.

Third, what do I need from my medical team?  Your medical team is likely to have more members than you might have imagined or have used in the past.  Take a look at all the departments and providers that are available at your treatment site.  It is not unusual  to add providers and services.  That is part of the rationale behind OncoPower: to add value to your treatment plan.

Many patients cancer asks what is the best diet for cancer? As a helpful resource to our current and future OncoPower members, we are going to be assembling past ‘Frequently Asked Questions’ on nutrition and cancer and posting them occasionally on our blog. We hope these FAQ’s will serve as a reference point for anyone with similar questions and act as a spark for new conversations on related topics. Please feel free to consult our Registered Dietitians using our Ask-A-Doc service for any follow-up questions you may have, we are here to provide cancer support! 

Q: Does eating organic food help cancer treatment? 

A: Organic foods are raised with a very strict set of rules about pesticide use, land management, and other farming practices.  There is very limited data to say that organic foods are any different or better from conventional foods.  It is true that conventional foods do contain some pesticide residue, however this is monitored by the FDA and USDA to make sure it is within safety limits.  Some research shows that organic foods have higher antioxidant content than conventional foods, however it has not been shown that the difference is significant to health.  For cancer prevention and treatment, it is more important to eat a high amount and a wide variety of fruits and vegetables, than worrying about whether they are organic or not. 

Q: Should you stop eating meat during chemotherapy?

A: All of our best research says that a plant-based diet, or one that is moderate in animal products reduces inflammation and cancer risk.  There is strong data to suggest limiting or eliminating red and processed meats from your diet is key to cancer prevention.  There is not any similar data on poultry like chicken and turkey, or fish.  In fact, cold-water fatty fish like salmon and mackerel are high in omega-3 fatty acids which can reduce your inflammation levels. When you are undergoing chemotherapy, the goal of nutrition therapy shifts a bit to maintaining nutrition and muscle status while minimizing nutrition-related symptoms – animal proteins are sometimes the best bet for this.  You should feel comfortable eating moderate portions of poultry and seafood, about the size of a deck of cards, at any meal.  

Q: Is raw, blended fruit and vegetable juice OK during chemotherapy?

A: Juicing is something that is very common and popular, because it is so much easier when you don’t have an appetite to drink your fruits and veggies than eat 5-7 servings a day. That being said, drinking a juice is not quite the same as eating a big salad – you’re missing out on most of the fiber, the satiating effect of chewing, the fullness sensation. Generally speaking, you can juice as long as you make sure you are balancing the fruit and vegetables to avoid too much sugar – its very easy to overdo it and drink too much sugar at once.

You always should check with your doctor to make sure raw foods are approved if you are immunocompromised, and as always, make sure to practice good food safety by washing your fruits and vegetables well before use. Juicing can be one way to increase your produce intake, but it should not be the only way. 

Q: Can I drink Ensure supplement as a stage 4 colorectal cancer patient? 

A: Ensure is an oral nutritional supplement, designed to be an addition to healthy foods not necessarily designed to be the only thing you are taking in. It is usually used when people are having really poor appetite, maybe they are suffering from certain side effects, or maybe their metabolism is just super high and they need the extra calories. So I would say that you definitely need to eat food in addition to those supplements, focusing on an overall anti-inflammatory diet, but that any oral nutrition supplement can be a good addition to help make sure you are meeting your overall calorie needs during cancer treatment. Trying to find a brand that contains good quality ingredients, like Orgain or Kate Farms, can improve your inflammation level as well.

Q: Is high dose vitamin C good for cancer?

A: Vitamin C is an antioxidant that fights against free radicals that cause damage to the DNA in our cells. I would caution against taking large doses of any vitamins. Because it is an antioxidant, the mechanism that it works by can sometimes interfere with different cancer treatments. So if you are on a specific treatment and you take high doses of vitamin C it can make the cancer treatment less effective. Your body doesn’t need mega doses of anything, it needs just the right amount of everything.

But if Vitamin C is something that you are worried about, you can always eat food sources that are high in Vitamin C like strawberries, red bell peppers, oranges, and broccoli. With these food sources, your body will only absorb as much as you need plus you will get the benefits of fiber and other phytonutrients that are in the foods. Vitamin C is water soluble, so if there is extra you just urinate out the extra – but mega-does of antioxidants are not necessary and could be unsafe. 

We’ll be posting more FAQs in the coming weeks, but for now join our community at OncoPower and enjoy support for other members, advice from cancer care specialists, mindfulness practice and more!

Many diets have come and gone – Low Fat, Low Carb, Paleo, Raw and many more. Right now, there is no more popular or trendy diet than the Keto Diet.  Its supporters suggest that it will help you lose weight, regulate your blood sugar, help with energy levels and some even suggest that it can improve your cancer survival.  Current research in cancer care has been limited to mainly preclinical studies (petri dish and mouse models), reports on patient case studies, and small randomized clinical trials. What does the available clinical data actually say? 

What is the Keto Diet? 

The keto, or ketogenic diet, is a high fat, moderate protein, low carbohydrate diet. It is designed to change your body’s primary fuel source from carbohydrates to ketones, which are a byproduct of fat breakdown in the liver. There are several different variations on the diet which include more or less carbohydrates – typically less than 50-130 grams of carbohydrates a day.  The classic ketogenic diet used in scientific research is the most strict, but some beneficial effects have been seen for a modified keto diet as well. 

Why would a Keto Diet help cancer patients?

Cancer cells rely on burning glucose, a carbohydrate, at much higher rates than non-cancerous cells for energy. By reducing the amount of carbs eaten and therefore glucose in the bloodstream, it is proposed that cancer cells would be stressed and cancer treatments would be more effective.  Ketogenic diets also have been shown to reduce fat mass and insulin levels, which can lead to an anti-cancer environment within the body.

What are potential positives of the Keto Diet for cancer patients? 

Importantly, in the majority of studies on this diet in cancer patients it was shown to be safe and well tolerated, with no increased serious adverse effects.  Cancer patients were able to continue on cancer treatment while on this diet, and most studies had fair to good retention rates – meaning most people found the ketogenic diet reasonable to follow for short periods of time. This was especially true for a modified keto diet, which has a more relaxed carb limit. 

For patients who are on PI3K inhibitors, like Piqray, a ketogenic diet could be quite useful. PI3K is a commonly mutated enzyme in cancer cells that binds insulin and stimulates glucose breakdown. This allows cancer cells to grow and spread quickly.  If a patient is on a PI3K inhibitor and eats a moderate or high carbohydrate diet, the effects of the drug may be limited.  A mouse model showed that a ketogenic diet increased the effectiveness of this drug in pancreatic, bladder, endometrial, and breast cancers and there is an ongoing study to see if there is a similar effect in humans. 

Other potential benefits of a ketogenic diet have been shown in for brain cancers.  Brain cancer cells cannot use ketones for energy, but regular brain cells can.  Several studies have shown positive benefits for progression free survival and tumor size in gliomas and glioblastomas, however the data overall is mixed.

A small, non-randomized study was done in Japan recently, looking at using the keto diet as an adjuvant therapy in multiple kinds of advanced cancer. This included colorectal, breast, pancreatic and non-small cell lung cancer. The 37 patients followed a strict ketogenic diet with less than 30 grams of carbohydrates per day with mild calorie restriction for up to a year of follow-up.  Though it was looking at a limited number of patients, they were able to show improved survival in multiple cancer types.  

What are potential negatives from the Keto Diet? 

One major negative that stands out for anyone looking to follow the ketogenic diet, especially the strict classic version, is that it is hard work! It requires reading food labels of everything you eat, measuring food on a gram scale and planning meals out very carefully.  Dining out or eating at a loved one’s home becomes fairly challenging, and overall it is a huge disruption to the way life is typically lived. This makes the keto diet hard to stick to long term.

Additionally, as a ketogenic diet is lacking in whole grains, dairy, and most fruits and vegetables, there is a very real possibility that a patient could develop nutrient deficiencies. Research shows that most B-Vitamins, Vitamin C, iron, calcium, potassium, magnesium, and Vitamins A, E, and K are at risk of being low when following a low carbohydrate or ketogenic diet.  These diets are typically low in fiber, which can alter the gut microbiome and make regular bowel movements challenging. It is essential that a ketogenic diet be initiated and followed only under the supervision of your physician and a dietitian to ensure it is well planned and adequate in all nutrients. 

A ketogenic diet often results in weight loss, which can sometimes be from loss of muscle and bone mass. Cancer patients are at high risk of malnutrition due to their high energy needs, nutrition-related side effects of treatment, and fatigue levels.  Inducing weight loss and restricting the kinds of foods allowed could lead to the development of malnutrition, which is known to lead to worse cancer outcomes overall.

As a ketogenic diet is high in fat, there is a risk that it may worsen cardiovascular markers like cholesterol and triglyceride levels. A meta-analysis of six randomized controlled trials was not able to detect a significant change in these markers. It is important to note that patients were being monitored by dietitian and doctors who designed and prescribed the diets to ensure that they are balanced in animal and plant sources of fat. If not planned correctly, a keto diet could easily become a bacon/cheese/beef diet which would likely lead to worse cardiovascular health.

Overall Recommendations

There is no one diet, one food, one supplement or one nutrient that can entirely cure or prevent cancer. The emerging research around the ketogenic diet and cancer is interesting and there is reason to believe it may be helpful in certain cancer types or populations. There has also been evidence that it can make a few types of cancer including leukemia and breast cancer worse, so caution must be taken. Overall, the data is not strong enough to recommend its use broadly in cancer patients.

Until more robust data is available, following a healthy, plant-based anti-inflammatory diet that is rich in whole grains, lean proteins, and brightly colored fruits and vegetables like that recommended by the AICR and the AND is going to be beneficial for most cancer patients. This diet will provide the most support for cancer patients. If you are interested in starting a ketogenic diet, please speak with your care team first so that they can monitor your condition on this diet and help you plan balanced intake to make sure you are meeting all of your nutrition needs. 

If you have any questions about the ketogenic diet or about healthy nutrition during cancer treatment, please join our community at OncoPower.  We have Registered Dietitians who are more than happy to help you on your journey. Nutrition is highly personal and you should always feel comfortable reaching out for personalized advice. We have many other qualified cancer care specialists on our platform, who are able to answer a range of questions – join and find out more!

This article is not intended to be medical advice and should not be interpreted as such. Always discuss any potential treatments with your doctor before starting. 

Have you wondered if you need to start taking a vitamin, mineral or herbal supplement to help fight your cancer? There are thousands on the market, how do you know what you need or if it is even safe? Keep reading to find out information on what is needed during cancer treatment.

What vitamins should I be taking to battle cancer? 

This is such a common question that people have during treatment. This is likely partly due to the fact that most cancer treatment is a pill or injection, and this makes people think that more pills or supplements would treat cancer better or faster.  In reality, the best nutrition you can provide your body is a wide variety of fruits, vegetables, whole grains and lean proteins. By eating these kinds of foods, you will be automatically providing your body with the nutrients it needs to fight cancer and stay healthy. When you eat a whole piece of fruit, for example, you get a wide range of vitamins, minerals, and phytochemicals – not just one isolated compound. 

The only supplements I generally recommend to most patients are Vitamin D and Omega-3 fatty acids, since intake of these is generally low for Americans.  If you a having a really hard time getting in enough food, a multivitamin three times a week may be beneficial as well to help provide support for cancer patients.  

Should I be taking high doses of vitamins during cancer treatment?

Generally speaking, dietitians and cancer physicians discourage taking high or ‘mega’ doses of any vitamin or mineral during cancer treatment.  This is because they may have negative interaction with your treatment, and it actually may make treatment less effective – especially if you are in a curative treatment program. Antioxidants may interfere with the mechanism of some chemotherapy treatments, so very high doses of these should especially be avoided. A well balanced diet with a variety of fruits and vegetables will provide your body with the necessary, but not excessive, amount of antioxidants and other nutrients needed.  There has been no clinical evidence of any single or combination antioxidant supplemental having a significant impact on cancer care.

Are herbal and botanical supplements safe to take?

This is a hard question to answer broadly because there are hundreds, if not thousands of herbal products on the market and few of them have been rigorously tested in randomized controlled trials to test for side effects, interactions, and efficacy.  The National Center for Complementary and Integrative Health publishes fact sheets summarizing the research on selected herbs and botanicals, which may aid your choice of supplement. Also suggested is the Memorial Sloan Kettering AboutHerb website, which is very easy to navigate and has information on most mainstream supplements. It is always key to discuss any herbal supplements you wish to take with your care team – they have access to databases which provide more information than a Google search would, and can help make sure you are making the right choice for you and your treatment. 

How do I know my brand of supplement is pure? 

Because supplements are regulated as food and not as prescription medicine, they do not require strenuous FDA oversight. The same herb sold over two different brands may have different potency and dosage information, depending on where it was grown and how it was processed.  Independent labs such as the USP, NSF and ConsumerLab.com verify that supplements are not contaminated by heavy metals and other harmful substances, and that their labels are accurate. These services publish lists of supplement brands that meet quality standards. It is important to note that these services do not comment on supplement efficacy, only quality and purity. 

What are the most common herbs that have drug interactions?

There are a few main classes of herbs to avoid as they interfere with commonly taken cancer-treatment drugs. First, there are blood thinning herbs which interact with anticoagulants like warfarin. These herbs include garlic, ginko, ginseng, dong quai, St. John’s Wort, and feverfew. Second, there are antioxidants which interfere with chemotherapy medications. These are grapeseed and pinebark extracts. Next, there are phytoestrogens which could interfere with hormonal cancer treatments. Ginseng, dong quai, red clover and extracts of soy should be avoided if you are taking a hormonal treatment or have a hormone sensitive treatment. Note that whole soy foods are perfectly safe, but soy extracts should be avoided. Last, herbs that stimulate the immune system can alter the effectiveness of immune suppressing treatments like cyclosporine or tacrolimus. You should avoid taking astralagus or huang qi, and some research suggests that medicinal mushrooms and echinacea should also be avoided. This is not a comprehensive list, but just shows a few of the ways that herbs and botanical supplements can interfere with cancer treatments.

A large number of cancer patients take dietary supplements as a complement to their traditional medical treatment and diet.  Your cancer care team should be supportive of this practice, and it should always be an open dialogue to make sure you are staying safe when making these choices. If you have questions about any specific supplements, you can always reach out to our providers at OncoPower – we are here to support you on your journey and have a range of cancer support services available. 

This information is not intended as medical advice and should not be taken as such. Always discuss any medical decisions with your doctor before starting.

Each Tuesday in January our Director of Nutrition, Rachel Spencer, RDN, will host a class on an aspect of Cancer Nutrition.  This week’s session discussed protein needs and nutrition for oncology surgery recovery – below is a summary of what she discussed.

What is protein?

Protein is one of three macronutrients in our diet, along with carbohydrates and fat. It is an important component of a healthy diet; we need protein to build muscle, maintain our immune system, and heal after an injury. It is found in animal foods, such as chicken and fish, as well as plant foods like soy, beans, and lentils. Older adults especially need to make sure they are eating adequate protein, as their requirements are higher than younger folks.  Aim for eating 15-30 grams of protein in a sitting to ensure you’re hitting muscle preserving targets.  This is about as much as a piece of chicken the size of a deck of cards, a protein shake, or a cup of black beans. 

How much protein should I eat before and after surgery? 

When preparing for surgery, it is important to make sure you are in the fittest, most nourished condition to best heal and recover.  This especially applies to protein, as any cut through your body needs protein to heal those damaged tissues. Aim for three large protein servings a day or 5 smaller portions – keep it simple by just increasing the size of your chicken breast, or add in more beans or lentils to the tacos you make. Greek yogurt and string cheese are very high protein and make a wonderful snack. 

After surgery, ramp it up more if possible and try to avoid eating starchy foods or fruits and veggie alone – always add hummus or cheese to crackers, use ultra-filtered milk in your cereal or oatmeal, and apples and bananas should be eaten with nut or seed butter. Your care team or Registered Dietitian will tell you if it is appropriate to add a protein shake or powder to your diet, and find one that you enjoy the taste of.

What protein shakes are best? 

There are hundreds of protein shakes on the market under dozens of brands, and it can be really hard to know which one to choose.  The most important thing to learn is ‘can I see myself drinking this every day?’  Research shows that Whey Protein is best for muscle gains, and Pea are best if you are following a plant based diet.  Look for a shake with 20-25grams of protein, and minimal added sugar. Try not to use shakes as a replacement for a meal unless you are battling a very low appetite, instead use them as a balanced snack between meals.

You can absolutely drink a variety of shakes, but best prices are obtained by bulk pricing. Protein powders that you mix yourself can be even more affordable. Most companies have coupons or deals online, and store brand versions are available though the flavors are often not quite as good as name-brand products.

What other foods are good for recovery from surgery? 

Depending on where your surgery was, nutrition needs can vary greatly.  After an intestinal surgery, you may need to reduce the amount of fiber in your diet for a period of time to allow healing.  Stomach surgery could lead to advise of sticking closely to a small, frequent meal pattern or if you had a throat surgery you could be advised to have a modified texture diet such as liquid, soft, or puree.  Getting the widest variety of foods possible is key no matter what kind of surgery you had, while staying within your cancer care team’s recommendations.

What vitamins are essential for healing? 

Vitamin C, Vitamin A, Vitamin E and Zinc are some of the most important to wound healing and surgical recovery.  Generally speaking, it is recommended to get all of your vitamins and minerals from foods which you eat rather than taking a pill.  This is because there are many properties in foods, such as phytochemicals and antioxidants, which are not contained in vitamins.  Good food sources of these vitamins fall in line with the anti-inflammatory diet, including brightly colored fruits and vegetables, nuts and seeds, and lean proteins including chicken and fish. That being said, if you have a poor appetite, vomiting or diarrhea, or absorption issues, vitamin tablets may be appropriate for you but please speak with your care team before starting them. 

Preparing for and recovering from surgery is nutritionally no small task. By working closely with your cancer care specialists or the Registered Dietitians at Oncopower, you can ensure that you are on the right track to staying as fit and healthy as possible during this stressful time. Join our community at OncoPower to get personalized advise on any cancer-topic.

This is not intended as medical advice and should not be taken as such; be sure to discuss any medical treatments with your doctor before implementing.

Each Tuesday in January our Director of Nutrition, Rachel Spencer, RD, will host a class on an aspect of Cancer Nutrition.  This week’s session discussed nutritional management of cancer treatment-related symptoms – below is a summary of what she discussed.

What are common cancer symptoms and what causes them? 

Treatment-related symptoms can present in a wide variety of ways.  Symptoms severity may change if you are getting chemotherapy, radiation, or immunotherapy – providing cancer support will change depending on the modality. Chemotherapy targets disrupt cell division, targeting rapidly growing cancer cells but also affect other rapidly dividing cells in your body. These include those in your mouth and GI tract, your bone marrow and your hair.  Radiation is more targeted, and side effects are typically seen in the tissues and organs close to where radiation is delivered.  Immunotherapy and other targeted therapies have similar side effects to chemotherapy and radiation. Your team will discuss possible side effects with you, so you can be prepared for any dietary changes you may need to make. 

Symptom: Early Satiety, Poor Appetite, and Fatigue

Loss of appetite and early satiety can be a side effect of treatment, fatigue, depression or physically caused by the cancer itself.  Regardless of what the cause is, the recommendations are the same. Sitting down to large meal can be overwhelming when you aren’t hungry, so it is helpful to eat smaller, more frequent meals or snacks, perhaps 6-8 a day.  These should be balanced with a carbohydrate, protein, fat and fruit or veggie – for example: a piece of toast with peanut butter and banana slices, cheese and crackers with baby carrots, mac and cheese with broccoli.  It can also be helpful to add extra sauces, butter, cheese or gravy to dishes to make sure each bite is as calorically dense as possible.  

Fatigue is an extremely common cancer symptom, which we wrote about on our blog here. You should ask your doctor to check for a deficiency in your iron, Vitamin B or Vitamin D levels. If low, they can recommend appropriate supplementation. You can make sure your energy levels stay high by eating consistently with as few skipped meals as possible.  Low intake and low blood sugar are main culprits of nutritional-related fatigue. In addition, make sure each time you eat you get a good source of protein, like meat, fish, nuts or beans to ensure your muscles do not become weak.  As always, follow an anti-inflammatory diet which includes a variety of brightly colored fruits and vegetables, healthy oils like canola olive or avocado, nuts and seeds, and lean proteins.  In some research, low inflammation levels are associated with lower fatigue levels.

Symptom: Nausea, Vomiting, Diarrhea

Nausea, vomiting and diarrhea are some of the most common side effects of cancer treatment. If suffering from nausea, try choosing bland foods and avoiding any strong scents or flavors when cooking. Mashed potatoes, rice, smoothies, plain chicken or lightly seasoned beans are good choices.  Ginger and peppermint teas can be helpful to settle the stomach. Try to avoid eating your favorite foods when feeling nauseous, so you don’t associate something good with that bad feeling.  

Diarrhea can be uncomfortable, disruptive to your daily life, and dangerous if not addressed.  It is important to replace any fluids lost, choosing a beverage that contains electrolytes if suggested by your doctor. A good rule of thumb is eight cups of liquid + 1 cup for each loose bowel movement.  Foods with soluble fiber, such as bananas, oatmeal, beans, pears and flaxseeds will help gel stools.  Avoid caffeine, alcohol, and sugar-free products as these can worsen diarrhea. Importantly, you should always communicate changes in bowel habits with your cancer care team. Be sure to take any medications such as Immodium as recommended. 

Symptom: Mouth and Throat Sores

Mucositis or esophagitis are sores that develop in your mouth or throat, a common symptom of cancer treatment.  If you are receiving 5-FU or melphalan therapy, eating ice or popsicles for 30 minutes before and during therapy can reduce this side effect.  If you already have developed sores, the best solution is to avoid salty, acidic, or spicy foods to reduce irritation.  Alcohol and carbonation can also be bothersome, so try to limit this. Foods should be neither very hot nor very cold to improve tolerance.  Last, choose moist, soft-textured foods more often than crunchy or sharp foods which could irritate when eaten.

Symptom: Taste and Smell Changes

Taste changes can be very disruptive to eating habits and pose a serious risk to nutritional status of cancer patients.  If you are experiencing a lack of taste or if things just taste funny, try to use extra seasonings or strongly flavored items like lemon or vinegar or marinates to amp up flavor.  Fruity and salty flavors are often best, so try smoothies and mixed dishes to improve flavor.  Often foods can develop metallic or bitter taste, so avoid cooking in metal dishes or using metal silverware.  Sour or sweet drinks and candies can help improve any lingering bad taste in your mouth.  Beef and pork have high iron which can have a metallic taste. Choose poultry, fish, or plant proteins to make sure you are still meeting muscle-preserving targets. Good oral hygiene can also improve taste changes, so make sure you are brushing and flossing daily.

If it is smell that is bothering you, make sure you are cooking in a well-ventilated area or ask a loved one to cook instead.  Now may be a time to rely on healthy, ready-made meals or ask friends to drop off meals you can reheat. 

Symptom: Weight Loss and Malnutrition

All of these symptoms can have a big impact on nutritional intake, and could result in weight loss. All cancer patients should track their weight weekly.  For best accuracy, weigh yourself in the morning after using the toilet and before having breakfast.  Keeping track of this number and reporting it to your care team can help you catch any trend in weight loss, cueing interventions to prevent malnutrition.  Read more about malnutrition in our blog post here. 

Patients respond differently to their treatment based on the kind of drug given, the dose, and their own genetic makeup.  You may experience all of these symptoms, some or none – but being prepared and informed on how to manage them if they do arise can make a world of difference for your treatment, your nutrition status, and your quality of life. 

Do you want personalized advice on how to manage your cancer-related symptoms? Join OncoPower today and reach out to our Registered Dietitians. They are happy to help tailor your diet to help you optimize your nutrition status and provide cancer support services. 

Each Tuesday in January our Director of Nutrition, Rachel Spencer, RD, will be hosting a live class on an aspect of Cancer Nutrition.  The first session was on the effect diet has on inflammation, below is an overview of what was discussed.

What is inflammation? 

Inflammation is an immune response to any kind of stress put upon the body. Acute or short-term inflammation can be caused by an injury or exposure to a germ or allergen. It is a healthy process, as it helps our body heal from injuries in an appropriate way.  Chronic or long-term inflammation is caused by poor diet, lack of sleep, limited physical activity, exposure to smoke or alcohol among other things. It is bad as it leads to constant, low levels of certain hormones and chemicals that can cause harm to our body over time.  Prolonged inflammation damages cells, tissues and immune function in our bodies.  This damage can lead to a range of chronic diseases, including cancer. 

How does diet affect inflammation?

Normal digestion and metabolism of food leads to different chemical and hormones being released and circulating in the body.  Depending on the food being broken down, this can lead to beneficial effects or negative effects.  For example, consistent intake of foods in high sugar and refined carbohydrates leads to high insulin levels causing cell growth, and possibly cancer. Additionally, oils like peanut and sunflower are high in omega 6 fats which causes inflammation in our body.  On the other hand, foods that are high in fiber like beans and vegetables have been shown to be beneficial to the bacteria in our guts and reduce inflammation.  The goal is to avoid foods that are processed or artificial and to instead choose unprocessed foods are high in compounds called antioxidants and phytonutrients, which protect against inflammation. 

What are antioxidants and phytonutrients? 

Antioxidants are a large group of compounds which protect against harmful substances called free radicals in our bodies.  Free radicals do damage to the DNA in our cells, which can lead to cancer occurence and progression.  Antioxidants include vitamins A, E, and C, minerals like Selenium, and various phytonutrients.   

Phytonutrients, or plant nutrients, include phenols, flavonoids, tannins, lignans and others. They are often responsible for color in plants, such as lycopene in tomatoes.  Each has a unique action, many of which are anti-cancer in nature. These compounds have also been linked to prevention of diabetes, heart disease and dementia.

Antioxidants and phytonutrients are typically highest in concentration in foods that are very brightly colored. This includes blueberries, sweet potatoes, pomegranate, and leafy greens.  They are also present in whole grains, herbs and spices, and nuts. 

What makes up an anti-inflammatory diet? 

First of all, this eating style is not a diet for weight loss, it is designed to improve health outcomes.  That being said, shifting to this diet pattern may result in weight loss.  The foundation of an anti-inflammatory diet is a rainbow of fruits and vegetables, at least 5-7 different kinds a day.  It should contain mostly whole grains such as brown rice, quinoa, whole wheat, and barley.  Protein choices can include lean poultry and fatty fish like salmon and sardines, beans, lentils, as well as soy foods like tofu, tempeh, and edamame. Herbs and spices should be used generously, fresh if possible.  Foods that should be avoided include: processed meats, refined grains, convenience foods, high sugar foods and alcohol. 

This diet pattern is inherently high fiber, high antioxidant, and low glycemic index. These features have all been linked to cancer prevention. The goal is to add more of these foods into your diet over time, to reduce your inflammation level that is a result of foods. Other lifestyle modifications should also be made to reach this goal: move with intention at least 150 minutes a week, practice good sleep hygiene, reduce stress as much as possible, and stop smoking.

Interested in making some of these changes to your diet, but not sure how to get started? Join OncoPower to speak with a Registered Dietitian and get personalized advice today to support your cancer care.  And be sure to tune in each Tuesday in January for more information on Cancer Nutrition from our Director of Nutrition, Rachel Spencer, RD.