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So confused about what to eat during chemotherapy

SF73
Posts: 278
Joined: Oct 2017

I had my first chemotherapy on 10/31 (Carbo/Taxol for now and Avastin will be added starting next session). I did not experience any major side effects so far so I am grateful. Even before the chemotherapy has started, I put myself on a pseudo-ketogenic diet, very little carbs, no sugar, no fruit, lots of vegetables, some dairy in the form of cheese and yogurt, and protein except for red meat. In the last month, I lost 10 lbs - down to 124 lbs - which concerned me but recently I added more fat to my diet and am no longer continuously losing weight. 

I just came across an article about cancer dormancy https://en.wikipedia.org/wiki/Cancer_dormancy.  And now I am wondering if I am doing the right thing but creating a hostile environment for cancer during chemotherapy. Since chemotherapy can only target cells that are actively dividing, if the cells don't get the nutrition (sugar, carbs?) they need would they stay in the dormant state throughout the chemo? Am I overestimating the importance of nutrition in cell division process? Feel free to let me know if I am being silly:)

I have also read that vitamin supplements may have an impact on the way chemo works and that's why it is not recommended. Prior to the cancer diagnosis, at every checkup I was told that I had vitamin D deficiency (20-25 ng/ml) but never took any supplements for it. When would be a good time to start? After chemo?

Abbycat2's picture
Abbycat2
Posts: 644
Joined: Feb 2014

but I remember that carbohydrates including sugar as well as protein and fat form the basics of nutrition. Carbs/sugar are broken down into glucose— a simple form of sugar- to provide energy to the body. Proteins and fat provide necessary building blocks for the body to grow, repair and sustain itself. The brain goes bonkers over sugar- much of the broken down carbs and sugar in the form of glucose-go right to the brain. I guess what I am trying to say is that glucose is important in order to remain healthy and alive. Keep in mind that cancer is not some foreign entity that has invaded your body- even if it seems that way! Cancer is a mutation that occurs when various bodily conditions occur at the same time to create a “perfect storm”. I think genetics play a role in this timing. Cancer is you as much as my cancer is me just as all the cells of my body are me. I am not including all the bacteria that are both inside and outside of our bodies- i.e., on our skin. We are comprised of far more bacteria than human cells. Strange and creepy but true!

TeddyandBears_Mom's picture
TeddyandBears_Mom
Posts: 1575
Joined: Jun 2015

I was told to eat whatever I wanted or felt like eating. My oncologist wasn't big on supplements. I know there are many ladies on this board that are very strict with their diets and are doing well. There are also many of us that eat mostly healthy but still do eat sweets in moderation. I'm not sure there is a right answer for you. Lots of debate on whether diet impacts cancer. My suggestion is to talk to your doctors for guidance.

Love and Hugs,

Cindi

ckdgedmom's picture
ckdgedmom
Posts: 166
Joined: Oct 2017

I gained 5 lbs with each chemo session because the darn decadron I was given made me an eating machine...and all I craved was carbs.

I never felt sick (took my anti nausea meds on schedule) but no pasta was safe around me!

I think balance is the key to feeling good so maybe adding a few more carbs in (healthy carbs---sweet potatoes, healthy bread, fruit) might help.

as for supplements, my pharmacologist had be do the following (and another friend not at the same hospital or even same year was told the same)

L-Glutamine 

Omega 3

Vitamin B6

calcium

plus a multivitamin

the L-Glutamine is to help prevent neuropathy...

I took them and did fine...no neuropathy and no problems....but check with your doctor first...

 

derMaus's picture
derMaus
Posts: 561
Joined: Nov 2016

My body was so significantly altered by steriods that I wasn't in my right mind, eating-wise. I turned into a carb fiend, and could eat an entire plate of pasta then be hungry again a half-hour later...and that was AFTER I'd had them dial the steriods down from 21 mg to 8 mg per infusion. I tried to avoid sugar and processed foods as much as possible, but sometimes it just came down to what I could hold down. Once chemo was over the steriod cravings went away (so did the moon face); my system settled back to normal and some of the weight/puffiness came off. I did take vitamins and supplements all the way through chemo, as cleared by my onc. When I had radiation I had to stop all vitamins and anti-oxidants, especially the letter vitamins (A, C and D), but I resumed as soon as treatment was over. I don't think you're being silly with your cell-division question, it's the same kind of thing I wondered. I came to the conclusion that since cancer cells are nutrient hogs, even if I took my diet down to zero carbs (not really possible), the cancer cells would still be first in line to siphon off whatever calories came into my system. I REALLY wish I'd had an integrated oncologist that I could have discussed these things with, but alas...

MAbound
Posts: 906
Joined: Jun 2016

There are so many schools of thought about what to eat or not eat during and after treatment that you can make yourself absolutely nuts with it all! We'd like to think we can starve cancer cells by getting the carbs and sugar out our diet, but there needs to be some common sense about that. All carbs are eventually broken down into their simplest sugar as the body processes it to be used as fuel, so it's really not possible to starve cancer cells without starving healthy cells (especially those all important killer T-cells that help fight cancer). Trying to eliminate healthy carbs along with the not-so-healthy deprives the body of nutrients it needs to be in a good place to fight cancer, infection and just function correctly. 

You are absolutely right that chemo drugs are designed to prefer and go after cancer cells when they are in their most active phase. If you are going to go through all that chemo puts you through, you really don't want to be doing anything that interferes with it which includes extreme diets or taking antioxidents until you are done with chemo. 

Chemo is pretty hard on the digestive system, which is why we get all of those drugs before, during, and after chemo to help us get through it. Mouth sores, poor appetite, heartburn, constipation and/or diarrhea are all symptoms of that, so during chemo you may want to consider favoring foods that are on the less acidic side. I think that is why many of us have said that watermelon is really good during chemo. It's highly alkaline. Just google "alkaline food lists" to get lists of foods that may be easier on your digestive system during chemo. You can still eat anything, but just be aware of what agrees or disagrees with you and you may find that it's the acidic foods that can cause discomfort.

After chemo, what you want to focus on most is eating healthier than perhaps you did prior to your diagnosis. Take the time to know what you are putting in your body whether it is food or supplements. The Mediterranean diet, as CQ learned, is the one recommended for post-cancer treatment, so that's a good place to start.

It can take some time, but I also think it makes a lot of sense to eat organic to the extent possible and get all processed foods out, period. It's so scientifically engineered, it's hard to believe it's real food anyway and is the main source of a lot of unneccesary and often hidden sugar. I've found that not buying processed food compensates for the higher cost of organic and that my grocery bills are pretty much comparable before and after making the switch. It does require more thought and effort to eat this way, but it's still way easier than some of the other more restrictive or exoctic diets.

If you plan on taking any supplements after chemo, do not skip getting some professional guidance about what to take and letting all of any doctors you see know about them. Just because they are OTC does not mean that they are without side effects or drug interactions. Because supplements are not regulated like prescriptions are, there is a lot of risk in taking them: you may not be getting the dose the label claims you are, manufacturing conditions can lead to contamination of products, they may not be in a bioavailable form, or combinations may give you extra ingredients you don't want or need to name a few issues. It's the wild west out there in supplement world, so even with professional guidance it would be worth the cost of a subscription to consumerlab.com to get the only unbiased, independently tested information on supplements that I've been able to find. 

Hope this helps you as you go forward!

derMaus's picture
derMaus
Posts: 561
Joined: Nov 2016

This is a great post, very helpful. I subscribed to Consumer Lab after you mentioned it previously, and I've found it very helpful. If there's a particular supplement anyone want to know about, feel free to PM me and I'll try to look it up for you. Thanks again, MAbound!

MAbound
Posts: 906
Joined: Jun 2016

The only problem with consumerlab.com is that they haven't tested every kind of supplement there is out there nor every brand that produces a particular supplement yet. There's a lot and they are very thorough with everything they have tested so far, but their library is far from being comprehensive and complete at this point, so expect some gaps on information you might be interested in.

Cass83's picture
Cass83
Posts: 151
Joined: Feb 2017

I took and still take vitamin D, milk thistle, and a calcium chew during chemo and now after. It can be very confusing, but I am a minimalist when it comes to taking anything, even natural stuff, so these have worked for me so far.

Editgrl's picture
Editgrl
Posts: 903
Joined: Jun 2015

As Mabound said, there are so many schools of thought regarding an anti-cancer diet, it can make your head spin.  All I can tell you is what I did which was to continue with what was essentially a Mediterranean diet during chemo.  I did move to 100% organic and ate a lot of vegetables, salads, soups.  I used quinoa a lot because of its protein content and basically l replaced all rice and pasta with that, though occasionally I did have some whole grain gluten free pasta.  Greek yogurt also has higher protein count than "regular."  I did not go "high protein" but I was concerned about weight loss as I am very slender and tried to keep some sort of exercise going as well. I had no appetite issues during chemo, and except for occasional bouts of heartburn (guess I shouldn't have had that falafel) and the almost mandatory rounds of constipation which diminished after my first couple of rounds, my digestive system handled it okay.

I took Vitamin D, B1, B6, B12 and L-Glutamine during chemo with my oncologist's blessing and according to her suggested dosages.  I also took Pro-Greens, a not-too-great tasting powder for a couple of days at the beginning of each chemo cycle.

I have also looked into the ketogenic diet, and it appears that it can be useful for some cancers, but it is a difficult diet to stay on, and to go completely ketogenic is a major change for your body.  You may want to look at paleo as a starting point instead or Mediterranean.  Also, you don't want to be subjecting your body to the "keto flu" while it is already dealing with the (possible) effects of chemo.  If you decide you want to look at that after chemo, I would strongly suggest that you work with a keto "coach" preferably someone who works with cancer patients.  And as far as supplements, definitely work with a qualified naturopath and keep everyone informed as to what you are taking.  I work with a naturopathic oncologist though I did not connect with her until after my first round of chemo and I have found her extremely helpful.

 

SF73
Posts: 278
Joined: Oct 2017

All your comments are so very helpful. Thank you for taking the time to share what you are eating during/after chemo. I will work with a professional and share what I have learned with everyone. Even though I am trying my best to be on a ketogenic diet it is hard to know if I am doing a good job. We still eat out a ton and hard to know what hidden carbs/sugar I am getting through those meals. Ordered the ketone meter today.  Maybe that will provide a bit more info. Today I will also see my PCP and ask for a few tests (IGF-1 insulin growth factor, lipid panel, HbA1c, calcium, magnesium, vitamin D levels) Hopefully she will prescribe me Metformin. Last night I read that Megestrol has a tendency to increase blood glucose levels. I am currently taking 160 mg/day at the moment. Even if I don't have any of the insulin resistance issues, maybe it is good to add Metformin to the mix just so that it can balance Megestrol out. 

Editgrl's picture
Editgrl
Posts: 903
Joined: Jun 2015

You might want to check out Dr. Nasha Winters' book "A Metabolic Approach to Cancer."  Fascinating book with a lot of good information about ketogenic diets as well as cancer in general.

SF73
Posts: 278
Joined: Oct 2017

Thank you! 

Yesterday my general practioner prescribed me Metformin. I am excited to try it out. We are still waiting the results of the genomic profiling of the tumor. So not sure if my cancer has the mutation that will respond to Metformin therapy but I am excited that we are adding one more tool (Carbo/Taxol/Avastin, Megestrol, and Metformin) Hope the effects are additive. My biggest fear is that all these drugs will cancel each other out :)  At the moment I feel like I am fighting this on many fronts but one area I am not doing a great job of is getting enough sleep. It has always been hard for me to fall asleep and stay asleep. With the stress of cancer, it is now even harder. Even if I am in a good mood in the evening by 11 PM pubmed calls me and I feel like if I don't study the literature I will miss out on something that might help me. Will have to promise myself not to do that at night. 

Editgrl's picture
Editgrl
Posts: 903
Joined: Jun 2015

Until about a year ago, I never had any problem falling asleep quickly and staying asleep.  However, roughly a year ago, I began waking up 2-3 hours after falling asleep and had trouble getting back to sleep.  I now have a "routine" and maybe one or two things can help you too.  I make myself a cup of chamomile tea an hour or so before bedtime.  A very small dosage 2.5-3mg of melatonin about 30 minutes before bedtime.  I bought myself an infuser and lavender oil makes my bedroom smell lovely at night.  I listen to Tibetan bowls as I drift off.  I recently added cannabis to the routine and that helps a lot.  Now, if I do wake up, it is usually only for a short period of time and then I am back to sleep for the rest of the night.

SF73
Posts: 278
Joined: Oct 2017

This is something I am determined to work on. I am sure it will take some time to get rid of all bad sleep habits I have developed but now is the best time to address all those issues. 

derMaus's picture
derMaus
Posts: 561
Joined: Nov 2016

Myself, I use Ativan, and have for years, ever since perimenopause blew my sleep patterns to bits. Desperate times, desparate measures, etc...but I love the idea of the Tibetan bowls, I may add that to my chemical repertoire. 

Editgrl's picture
Editgrl
Posts: 903
Joined: Jun 2015

I have the Insight Timer app on both my phone and iPad which is how I listen, but there are also videos on YouTube.  

janaes
Posts: 785
Joined: May 2016

this is an interesting topic.  A few months before my cancer diagnosis i seperatrd from my husband ( hes mybex husband now) and was going to therapy through the process.  My therapist would ask how my sleep was. I always said it was good and it was.  When i got my cancer diagnosis i was still sleeping (before hysterectomy) until my cancer started pushing on my blatter.  I woke up maney times to gothe bathroom for a couple of weeks. Then surgery comes around and then being told i had to do chemo.  It shook my world and have not been able to sleep good since.  Now i take my vitumins at night and am thirsty and and get up at least once a night.  Most of the time i go right back. To sleep but not always.  One day im hoping to get back to where i was.

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Anne0803
Posts: 15
Joined: Nov 2017

I've heard about Keto Diet and I want to try it =).

I had my Chemo treatment last December 2016 with Taxol/Carboplatin.  My doctor said I can eat anything, it is important to be strong enough during the treatment.  Loosing weight is not advisable as they cannot tell if the cancer causing that or other cause.  As of today I am pretty healthy.  Trying my best to loose 20 lbs. Cool

evolo58
Posts: 293
Joined: Dec 2017

I think it all boils down to what you and your doctors and your onco dietitian say about your case, and how YOU feel. Even if it's a placebo, as some might think, if it contributes to your state of mind, it may help your attitude. I was green-lighted for black seed oil (though I will need to temporarily discontinue that two weeks before surgery), Vitamin B-12, non-acidic Vitamin C and probiotics. Others ... not so much. I also was not told to discontinue my calcium pills, Vitamin D, fish oil (for my eyes ... I have Graves) and multi-vitamin.

The diet onco advised against eating sushi (naturally), salads in restaurants, etc. Focus more on fruits and veggies at home. If you're not a big fruit eater (looks guilty), work with applesauce and bananas at first. Cooked veggies are great, as are raw ones you thoroughly wash at home. You cannot trust people at restaurants with raw/rare food, meat or fish. Carbs and sugar are OK, but moderation is really, really key ... no eating a whole box of See's chocolates :). Exercise is REALLY important. Even if all you can manage is to walk down your driveway, get up!

I WAS appalled to see so many empty-calorie snacks offered for chemo patients. YOWZA. I like snacking, but I couldn't find even unsalted pretzels or plain almonds.

One way or another, I think that re-focusing on your diet and trying to correct a flaw or two or three is a must. Chemo drains your body of so much, and a stronger body may mean a better healing time. I'm no nutritionist or anything, but ....

pinky104
Posts: 574
Joined: Feb 2013

I did the Atkins diet years ago and remember reading that even in the strictest phase of the diet, you still need 20 grams of carbs a day in order to have BM's.  When I did my chemo the last time, the nurses mentioned that it's good to avoid soda because it's thought that cancer feeds on sugar.  Of course, that means staying off a lot more than just soda.  I have read somewhere in the past that low levels of vitamin D can contribute to developing cancer, so I've made sure I get enough of it ever since then.  I read one study once where the writer said there is a suspicion that vitamin E blocks something you need to keep your body from getting cancer.  My father was very much in favor of vitamin E because he felt it saved his life after a heart attack at 42 (he lived to 84 and died of renal failure caused by congestive heart failure, but he most likely had hemochromatosis, because I do and it's genetic).  He took vitamin E and made my mother take it, too.  They both had cancer--prostate for him and breast cancer twice for my mother, and I have to wonder if the vitamin E supplements contributed to this.  But then, I have 6 mutations that were found in my genomic testing plus the one for hemochromatosis that was found in a separate blood test so that could be what really caused all the cancer.  I also had a half sister from my father's side of the family, a cousin from my mother's side, and a maternal grandmother who had cancer, so it's possible that there were bad genes on both sides of the family. I don't have enough knowledge to come up with my own answers to your very thoughtful questions, unfortunately.  I've had UPSC twice now, and my GYN/onc seems to think I'm likely to get it back again in another 5 years or so.  Maybe I don't live right, or maybe it's all genetics.  More likely, it's some combination of both of those.  I've started Turmeric/Curcumin and Metformin in the hopes that they will help me avoid it for longer or I won't get it back at all.  The results remain to be seen....

SF73
Posts: 278
Joined: Oct 2017

It seems no one knows for sure what diet is ideal during and after cancer treatment. I read a paper titled 'Dietary Recommendations During and After Cancer Treatment: Consistently Inconsistent?' that compared the nutrition advice from the top cancer centers in the country and showed how inconsistent the information is. I personally find the theory of ketogenic diet and how it can help with low grade inflammation, blood glucose and insulin levels elegant. Just because a theory sounds good (cancer cells love glucose, normal cells can adapt to use ketone as their primary source of energy while cancer cells cannot adapt. so by eliminating carbs from your diet maybe you can starve cancer cells) does not mean it works. Scientists were able to show tumors do shrink through calorie restriction and ketogenic diets in mice. But of course not all findings in mice translate to humans. There are very few and very small studies where actual cancer patients were asked to be on a ketogenic diet. This paper does a good job summarizing the history and potential mechanism. 

Obsessing over my blood glucose and ketone levels has been helpful in my case. These are actionable numbers! If I eat right, drink lots of water, and exercise more the numbers move in the right direction. That gives me a sense of control. Everything else about cancer is hard/infrequent to measure.  So evolo, you are absolutely right. It does boil down to how the diet makes me feel. And this diet makes me feel in control.

Pinky, when I was first diagnosed, I also wondered if I lived wrong somehow. I have no history of cancer in my family, am 44 years old, have a child, had my first period when I was 15 - not early -so I should be low risk. Yes, my BMI was 27 which puts me in the overweight category, yes I have a stressful job and did not get enough sleep. But there are many people who make the same and even bigger mistakes and do not end up having cancer. We simply don't know enough about this disease. I really suspect that there is some connection between diabetes / insulin resistance and uterine cancer. So glad to hear you are on metformin. I am too! I hope you will never experience another recurrence. 

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CheeseQueen57
Posts: 833
Joined: Feb 2016

Let me put my 2 cents in. Let me preface this by telling you I am a dietitian and worked for more than 30 years, lastly for a pharma company specializing in diabetes. I even met with a dietitian specializing in cancer after my frontline treatment and with the integrative oncologist when I was at MD Anderson. I too did not have a wreckless lifestyle and no risk factors for this wretched disease. It just happened. The experts gave me very little advice outside what I was already trying to do. Focus on Mediterranean diet, eliminate red meat, eat mostly organic, plant based, avoid nitrates, limit alcohol.  My personal philosophy is if I’m going to die sooner, I’m not going to eat a diet that isolates me from my family, which I can’t go out once in a while and is tasteless and eliminates my favorite foods. A big part of living is eating and I’m not willing to do drastic things (ketogenic, totally vegetarian,  etc) without much evidence that it‘s going to make a hell of a difference in my demise. Also I don‘t often have the energy these days to do heroic things in the kitchen. So that’s my philosophy. Do whatever you want. Doubtful it’s going to make any real difference unless you‘re really off the tracks with your diet. 

SF73
Posts: 278
Joined: Oct 2017

So wonderful to hear we have a dietitian among us!  Your post reminded me of this article I recently read in the New Yorker. I added the link and a little excerpt at the bottom. Even though the author talks about an autoimmune disease, I thought her experiences, especially the part about wanting to capture biosignals in the "fanatical pursuit of wellness" is similar to what I am going through right now. I don't know if this is a lifestyle I can sustain. But the diagnosis is very new and cancer is still all consuming. I am not living with cancer. At the moment, I have paused living to deal with cancer. After chemo is completed I am sure I will re-assess. 

https://www.newyorker.com/magazine/2013/08/26/whats-wrong-with-me

"You can’t muscle your way through the enervation and malaise of autoimmunity—if you could, I would have. The real coming to terms with autoimmune disease is recognizing that you are sick, that the sickness will come and go, and that it is often not the kind of sick you can conquer. But, once you’re feeling O.K.-ish, trying to be the Best Patient in the World can become an isolating preoccupation, even another form of debility. I thought about my aunts, and the matter-of-fact way that they lived with their illnesses—as something to deal with, but not something to fuss over. In order to become well, I would have to temper my own fanatical pursuit of wellness. On the model of D. W. Winnicott’s good-enough mother, the trick was to be the good-enough patient, and no more."

 

NoTimeForCancer's picture
NoTimeForCancer
Posts: 2637
Joined: Mar 2013

AMEN, CQ!  

TeddyandBears_Mom's picture
TeddyandBears_Mom
Posts: 1575
Joined: Jun 2015

That pretty much sums it up for me too Cheese! I eat healthy stuff but also enjoy my sweets (too many sometimes!). I have maintained a very healthy weight and stay active. My doctors don't believe that eating "bad stuff" is the cause of cancer. They do, however believe exercise and weight are important.

Sorry to hear that your strength isn't where it needs to be. I have lost track of what/when you start treatment again. I think of you often.

Love and Hugs,

Cindi

Amatullah
Posts: 36
Joined: Jun 2017

My dr. told me to eat what appealed to me, but to make sure I got plenty of protein, because it takes a lot of protein to heal the body after radiation and chemo.  I take the supplements that help with inflammation and neuropathy mostly.  I've lost close to 50 pounds, but not on purpose and I needed to.  I just stopped liking sweets and I used to drink over a thousand calories a day in Dr. Pepper, but it doesn't taste good anymore.  Most food just doesn't appeal to me, but I force myself to eat anyway.  I'm not sure what we eat matters as much as what we end up not eating because we've filled up on empty calories.  I pay attention to what I crave because I think our bodies give us hints.  I've been craving fruit and nuts, cottage cheese, cheese and eggs and a few other things.  Proteins that I'm sure I need.  We can figure out how to balance things if we use common sense.  It doesn't have to be as hard as we make it.

SF73
Posts: 278
Joined: Oct 2017

Great to hear about your weight loss, Amatullah. Also great to hear that your body started craving the right kind of food. My weight loss was not intentional either though I am happy that it happened because I want to eliminate any source of estrogen. I still don't understand whether fat cells store estrogen previously produced by ovaries or have the ability to produce new estogen and whether or not while losing the weight if there is any release of estrogen to the body but I feel eventually having a normal weight and body fat percentage might help me. 

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