The diagnosis of cancer can significantly impact a patient’s sense of well-being and control. They have entered a world of tests, scans and appointments where they are introduced to the language and procedures of surgery, chemotherapy and radiation.

Outwardly patients struggle to stay organized and upbeat, privately they agonize over what they might have done differently to prevent the cancer. By examining previous behaviors, many feel that they can alter their present and future health course. Their fundamental goal is to take control over their health and improve their quality of life.

Many narrow the focus of this “control” down to the subject of nutrition. Simultaneously, they become subjected to endless friendly advice such as “take this herb,” “you need to start juicing” or “try this colon cleansing method.”
Depending on whichever study you read, upwards of 90 percent of our patients have utilized at least one form of complimentary and alternative medicine (CAM). Many of the CAM therapies cannot be scientifically evaluated because the effects of treatment are mostly subjective, based on how a patient feels, both physically and emotionally.

Cancer patients look for supplements to:
• reduce side effects;
• decrease organ toxicity;
• prevent recurrences of cancer; and
• protect and enhance their immune systems.

Few realize these substances may not be benign. Most believe that a product derived from natural ingredients or that is labeled “natural” will be safe. Few have read or understand the supplement labeling laws set forth in the Dietary Supplement Health and Education Act of 1994 (DSHEA). When Congress passed this act it acknowledged that people feel dietary supplements may help provide health benefits and that consumers wanted the choice to determine whether or not dietary supplements might help them personally.

Under DHSEA, the FDA’s requirements for dietary supplement pre-market evaluations are subject to less regulation than is required on drugs, conventional food additives or certain other products. The burden for checking the safety of food supplements and establishing the truthfulness of labels falls to the consumer and the manufacturer. Some supplement manufacturing companies have developed quality assurance programs to assess and guarantee the standardized content of their products, but many have not.

All of this places the purchasing of dietary supplements into the buyer beware category.

Cancer patients know that it is important to eat a healthy diet, but conflicting advice from multiple, usually non-professional sources, can lead to frustration and confusion. Working as an Oncology Dietitian I see many confused and frustrated patients. The majority want a common sense set of rules that they can follow to actively play a role in their treatment plan.

The Nutrition Guidelines for Cancer Prevention from the American Cancer Society are an appropriate place to start:

Maintain a healthy weight throughout life.
• Balance caloric intake with physical activity.
• Avoid excessive weight gain throughout life.
• Achieve and maintain a healthy weight.

Adopt a physically active lifestyle.
• Adults: At least 30 minutes, moderate to vigorous physical activity, five or more days per week.
• Children and adolescents: At least 60 minutes, moderate to vigorous physical activity, five or more days per week.

Eat a healthy diet, with an emphasis on plant sources.
• Choose foods and beverages in amounts that help achieve and maintain a healthy weight.
• Eat 5 or more servings of a variety of vegetables and fruits each day.
• Choose whole grains.
• Limit consumption of processed and red meats.

If you drink alcoholic beverages, limit consumption.
• No more than one drink for women or two drinks for men, per day.

The challenge for the Oncology Dietitian is to improve nutrition habits while helping patients cope with disease and treatment side effects. For me this process starts by listening to the patient. I focus on the patient’s physical and social situation and the answers to these questions:
• What diet changes have you made?
• What do you want to accomplish with your diet choices?
• What future nutrition changes do you want to make?
• What advice have you received and from whom?

Through this process patients can play a more active role in their treatment plan while improving their health and quality of life.

Kathleen Newman, R.D., is a clinical dietitian with the UC Davis Cancer Center and UC Davis Hospice Program.

—By Kathleen Newman, R.D.

Posted on April 23, 2007 11:20 AM