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Your Oncologist is NOT a nutritionalist

Trubrit's picture
Posts: 5504
Joined: Jan 2013

I was just reading an article about Leaky Gut Syndrome.  At the end of the article, it mentions talking to your Doctor before starting any supplemental regime. That led me to think about some of the comments I have read on various forums, including here. Folks upset with their Oncologist because they were not told what they could or could not eat.  

When I was seeing my Radiation Oncologist, I never failed to appreciate - not being at all mathmatically inclined - just how much work goes into deciding exactly how much radiation each of his numerous paients should be administered and just where on the body, which has to be so precice so as not to damage surrounding organs and such. 

It boggled my mind, how much study went in to being a Radiation Oncologist. How much study went into being an Oncologist.  And how much dedication it takes to be a GOOD - dare I say, excellent Oncologist. 

Thus, that led me to wonder why we expect our Oncologist to also be nutritionalist.  I have been known to ask my Oncologist about sugar & Cancer, and told that it doesn't matter.  While they need to know some basics, at the end of the day, they are NOT nutritionalist and we should not expect them to be.  They do NOT know everything about everything. What we need to expect is for them to know their job, and if we need further information, to go to those who are experts in that field or do as much research as we can. 

Going back to my Radiation Oncologist. I once looked at his extensive bookshelf, titles that I could barely pronounce, and I told him how much I appreciated all of his knowledge. His skill, most of which I couldn't even comprehend and never will.

This is just a muse, and does not require any replies. But, if you agree or disagree, I don't mind reading your thoughts. 




Posts: 420
Joined: Apr 2018

One of the things I felt that the Interventional Radiologist SHOULD have been more cognizant of when they were ramming ports into every cancer patients is how haveing a malignancy increases your risk of blood clots---the oncologist as well. This is from the nih.gov site--

A hypercoagulable or prothrombotic state of malignancy occurs due to the ability of tumor cells to activate the coagulation system. It has been estimated that hypercoagulation accounts for a significant percentage of mortality and morbidity in cancer patients.

Interesestingly enough Covid 19 also increases coagulation --

Among the many mysteries is exactly how SARS-CoV-2, which is the novel coronavirus that causes COVID-19, triggers the formation of blood clots that can lead to strokes and other life-threatening complications, even in younger people.Jun 11, 2020

Why not recommend cancer patients a baby aspirin daily I thought. Just my 2 cents.

SandiaBuddy's picture
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When I read about Covid-19 long-haul symptoms, I often marvel at how much it sounds like chemo. . .

SnapDragon2's picture
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Joined: Nov 2019

Amen, Tru!  You will not find all the answers with just an oncologist.

They are there for chemo.  Oncologist are not schooled in nutrition, supplementation, ect.  Our bodies need a strong immune system and overall health to help fight along with chemo.  If I had only listened to my onc I am pretty sure I would be dead by now.  He didn't even recommend a surgeon up front much less when I asked about supplements and diet he got really mad and said absolutely nothing but chemo and eat whatever you want, smh!!!  Ya, OK buddy... 

Research, research for extra help in the battle!!!  Be your own advocate...

We also in my opinion should see a cardiologist/vascular specialist also.  I haven't yet (wish I had known in the beginning) but its on my list for 2021.  My bloodwork shows chemo has done damage to my vascular system.


worriedson714's picture
Posts: 325
Joined: Dec 2019

I been trying to convince my dad of this since his onc said there is no need to cut down on sugar I was like wtf . My dad is choosing to listen to the onc about his diet which worries me but therapy is teaching me it's my dad's chooses . All I can do is be there to support and love him and hope he makes the right choices . 

My question is why isn't it standard for cancer patients to see a nutritronist ? who knows 

SnapDragon2's picture
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I believe some institutions do have dietitians, nutritionalists.  Unfortunately they are few.

Tueffel's picture
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Joined: Feb 2020

My dad got to hear that he should eat everything he wants during chemo. Tbh it was not wrong. If you have digestive problems, nausea or diarrhea you should eat the things that you would like to eat especially if you have surgeries ahead that will make you loose weight or if the cancer already causes weight loss. After the stoma surgery until the liver surgery he earned 7 or 8 kg in nearly 2 1/2 months. Every kg he lost after the liver surgery... 

Here in Germany we have colon cancer centers, certified by the German cancer association. This was implemented so cancer patient can receive the best care. So my dad saw a nutritionist after the stoma surgery. The problem was simple: our family is already interested in nutrition and experienced with that due to my dads MS. So everything the nutritionist told my dad, my dad already knew. 

My plan for 2021 is to talk with his oncologist or our primary care doctor how amino acid diet can influence tumor growth or in general what we could do to prevent a recurrence. 

SnapDragon2's picture
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Let me know what you find out about amino acid therapy please.

I've been researching it.  The Block Center in Chicago has it but its like $8000-$10,000 to get started.  It is very indepth therapy but still Just Wow.

All I know right now is was found thru extensive bloodwork that a species of sea cucumber did kill circulating cancer cells 25%.

Trubrit's picture
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Joined: Jan 2013

I think you will find that Oncologists are geared more at how to treat Cancer than prevent it.  


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You tell them Sue!!!

Annabelle41415's picture
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Your oncologist doesn't know everything, but mine was very adamant about taking some supplements as she said it reduces the effectiveness of chemo.  I'm not sure if that still holds true, or ever did, people tend to listen to their doctors because they want to trust them.  It sure can be a slippery slop.  My radiologist oncologist did send in a nutritionist for me to consult with though.  He never did try to tell me anything about it or recommend anything for me.  Some doctors want to think they know it all though, and when you are in that situation, it's hard to know what to do.


AnneO1965's picture
Posts: 181
Joined: May 2019

My oncologist was ADAMANT that I see a nutritionalist. She sent one in to talk to me as I was getting my treatment. Very informative. Lots of protein, low sugar, etc.  She also wanted me to not take any supplements, but advised me that when chemo was over to start taking a multi and D3. I'm still taking them to this day.

If I had questions she didn't know the answer to she set me up with a doctor that did or researched it herself and told me on my next visit.  

flutemon's picture
Posts: 41
Joined: Jan 2019

I'm grateful for a great cancer team!  With my most recent treatment of herceptin/perjeta I have really struggled with diarrhea - to the point that I have lost a lot of weight (never happened with folfox or folfiri). I requested medication, which I received, and they also provided a dietician/nutritionist to help with the gut.  

Any time I have asked the oncologist about supplements, vitamins, etc. he will share his thoughts, usually based on research and studies.  Not anecdotal. He's never really talked about what to eat. I'm glad.

So right now I'm off of dairy, most raw fiberous veggies/fruits, and pinto beans - which is really tough!  I grew up with frijoles y arroz (beans and rice) at every meal! I had warm apple pie with a scoop of homemade vanilla Blue Bell for new years eve - and I'm paying for it now!

Best advice, talk to an onc nutritionist/dietitian.

Trubrit's picture
Posts: 5504
Joined: Jan 2013

It must be very hard to give up food that you love, especially those you have grown up on.  When I left England, I left allot of foods behind - but most of them were probably better left behind.  Thankfully, all the healthy stuff is available over here. 

I still indulge, and I still pay the price. Sometimes it is totally worth it.  I

I hope you New Years treat reprucussions have gone, and you can look back on your warm apple pie & ice cream with a fond memory.


abrub's picture
Posts: 2178
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And I was visited while in the hospital to go over what I could and couldn't eat (with and post-colostomy.)  My surgical onc is the one who put me on Metamucil daily, as well as Chlolestyramine (for bile absorption). He has some awareness of nutrition, but yes, the hospital dietitian also reviewed everything with me.

Posts: 36
Joined: Jan 2020

This is a difficult issue. I've been told by my surgeon that since I already have cancer there is no point in quitting sugar now. My oncologist's website says that the idea that sugar causes cancer is a "myth". However, my mom, who is doing keto, has been after me to go low-carb for the sake of my cancer. However, if you google it, you will find reports about how low-carbing is bad for some types of cancer. I know there has been research to prove that keto is beneficial to certain kinds of brain cancer. But if you have any other kind of cancer, I would say, do some researching and see if you can find any studies about whether low-carb is beneficial. I have tried my best to cut back on sugar since I started round #2 of chemo. Although I have not been very successful around the Christmas holidays, I am trying to get back on the sugar-free wagon. However, I am not doing low-carb. 


Trubrit's picture
Posts: 5504
Joined: Jan 2013

Right now, you do what you feel is right for you.  It sounds like you have done your research, and you already know that much of what you read ends up with you in confusion. 

The other day I was researching what foods to eat and what to avoid when it comes to arthiritis. I read one report/study that showed citurs, nightshade plants, and others such things are all good for arthritis, and then another report said that these were the foods to AVOID. 

I also remember vividy, during chemo, when I was constipated, my Oncologist told me NO to laxatives. He went on vacation, and the Oncologist standing in for him, told me to take a laxative EVERY DAY.  

So, do your research, keep a record everyday of how your body is doing, and then do what works for you. 

Eat some sugar, have your carbs, all in moderation. This is not the time to be cutting OUT anything. 



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