Cheryl McGee has battled breast cancer. Twice. She's undergone surgery,
chemotherapy, radiation and treatments for infection, but dietary management
was never part of her treatment protocol. "I don't know why nobody ever
told me to go to a nutritionist or how important diet is to recurrence,"
McGee said. "A nurse once told me in passing to try to stay away from too
much sugar," but that was it. On her own initiative, she started to eat a
healthier diet, loading up on fresh fruits and vegetables. "I'm feeling
better than I have in a long time."
What should my diet be to reduce breast cancer recurrence? (Lee Avison, GAP photos via Getty Images)
Scientists continue to learn more about the effects dietary changes can
have on people with breast cancer, and this year, for the first time, the
American Cancer Society is confident enough in the research to issue guidelines
encouraging more attention to exercise and diet to help maximize health and
reduce breast cancer recurrence.
A weighty connection
Past studies have indicated that overweight and obese women have a
higher risk of recurrence from breast cancer than women who are slimmer. That's
because carrying around so much extra weight can compromise the immune system,
leading to chronic inflammation. This increases levels of estrogen that
contribute to cancer formation, said Joseph Sparano, associate chairman of the
Department of Oncology at Montefiore Medical Center in New York.
Sparano and Jennifer Ligibel, a medical oncologist at Dana-Farber Cancer
Institute in Boston, have recently conducted trials showing that the
relationship between obesity and increased risk of breast cancer recurrence and
death is true for patients treated with the most current chemotherapy regimens.
With this in mind, breast cancer survivors can be proactive with their weight
and diet. "When women are diagnosed with breast cancer and are scared,
they usually will do anything such as change diet to prevent another
'bullet,'" said Lillie Shockney, administrative director of Johns Hopkins
Breast Center and its Cancer Survivorship Programs. "But the problem is
sustaining the changes, which usually last about six months and then wane as
the fear subsides." Shockney said people are more likely to stick with dietary
changes if they make them a little at a time. Looking at labels to determine
nutritional content and becoming more informed about what you're eating is a
good start.
What to eat
The American Cancer Society advises survivors to reach a healthy body weight,
to exercise and to limit high-calorie foods. Portion control can help you reach
those goals, but what foods, specifically, should you be shunning or embracing?
Doctors and nutritionists versed in the latest research recommend a plant-based
diet rich in natural compounds known as phytochemicals, said Amanda Bontempo,
oncology dietitian at Montefiore-Einstein Center for Cancer Care.
Phytochemicals have health-promoting properties that work together with
vitamins and nutrients to prevent, halt and lessen diseases. They act as
antioxidants to protect against or repair damage to cells and are found mostly
in colorful fruits and vegetables but also often found in beans, grains,
onions, garlic and corn. Breast cancer survivors "should eat a variety of
antioxidant-rich foods every day," Bontempo said.
Her dietary advice follows:
Less of: Red meat, processed meat, trans fats, saturated fats, refined
carbohydrates, refined sugars and other "white" foods. The American
Cancer Society warns that alcohol could increase the risk of
estrogen-receptor-positive breast cancer recurrence and recommends no more than
one drink a day. Soda should also be avoided because it interferes with calcium
absorption and has absolutely no nutritional value.
More of: Whole foods such as fruits and vegetables, whole grains, nuts,
seeds, legumes, olive oil and lean protein such as fish, poultry and beans.
Include semolina pasta, whole-grain breads and whole grains themselves like
bulgar, barley and quinoa, but do keep portion size in mind. Tumeric, ginger
and other healthy herbs and spices contain potent antioxidant and
anti-inflammatory properties that may inhibit tumor cell growth and suppress
enzymes that activate carcinogens.
Cruciferous vegetables such as broccoli, cauliflower, kale, cabbage and
Brussels sprouts, also rich in phytochemicals, help fight breast cancer by
converting a cancer-promoting estrogen into a more protective hormone. They're
also a good source of vitamin C and soluble fiber, which helps control weight
by slowing down digestion and making you feel full.
Omega 3, the fatty acid found in flaxseed and oily fish such as
sardines, salmon, tuna, mackerel and herring, may benefit the immune system by
reducing inflammation and the risk of metastatic cancer.
Allium vegetables that include garlic and onion are known to be
protective and can be added to almost any dish. Tomatoes, berries, whole
grains, apples, legumes and green peas are also rich in anti-cancerous
properties.
White and green teas are recommended because they contain antioxidants
that may stave off breast cancer recurrence.
Whole soy, which mimics estrogen, can be eaten in moderation, Bontempo
said, but processed soy is high in estrogen and should be avoided. For those
being treated with tamoxifen, any soy can interfere with therapy, so consult
with your doctor.
Vitamin D can directly or indirectly control carcinogenic genes in the
body, studies show. Sun-dried tomatoes, shiitake mushrooms, egg yolk, fortified
cow's milk, fortified soy milk and other foods contain high levels of vitamin
D. "Supplements and sunlight are also sources of vitamin D," said
Bontempo, "but every breast cancer survivor should consult a physician
before taking any supplement, because supplements are not FDA regulated and
could contain harmful chemicals." Vitamin D, required for optimal calcium
absorption, can also be found in spinach and white beans. Water should be a
survivor's go-to drink. It flushes toxins out of vital organs and carries
nutrients to cells.
The good news
Most women today who are diagnosed with early-stage breast cancer can
expect long-term survival, making the prevention and control of other diseases
caused by unhealthy foods imperative. "Eating should not be a chore,"
Bontempo said, "and survivors need to learn to enjoy their food and choose
indulgences wisely."
Find a dietitian
The Academy of Nutrition and Dietetics offers an online tool to find a
dietitian near you who specializes in cancer. Visit
eatright.org/programs/rdfinder/.
(It may take a minute to load because it's map-based.) Once there, enter
your ZIP code, click on "Expertise Area" and select
"Cancer/Oncology Nutrition." The American Cancer Society offers free
over-the-phone counseling on nutrition by registered dietitians specializing in
oncology. Follow-up materials and support is also offered. Call 800-227-2345
for more information.
Chicago Tribune
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