Breast Cancer Spread: Can Dieting Reduce Risk?

overweight obese woman

What You Need to Know: Women with an aggressive subtype of breast cancer known as “triple negative” may be able to reduce the chance of disease spreading distantly by reducing their calorie intake. But… the data thus far is based on mice (and not human) studies.

Well, it does work for mice: The study published in the Journal Breast Cancer Research and Treatment, used mice models to investigate the impact of diet on triple negative disease, which is found in about one in five women with breast cancer. It found that when mice were given 30 per cent fewer calories, changes occurred in the body in the way cells were regulated. Mice on restricted diets produced more protective proteins in the tissues around the tumour, which make it harder for cancer to spread, the study by Thomas Jefferson University found.

My Take: We know that in among some groups of women (for example, women who are post-menopausal), obesity increases the risk of breast cancer. Unfortunately, treatment such as chemotherapy (and steroids) can cause weight gain. This weight gain can lead to worse cancer outcomes. Human trials are examining the impact of calorie restriction on outcomes. For now, I advise my patients to try to achieve, and maintain, an optimal Body Mass Index (BMI) of 20 to 25. I’m Dr. Michael Hunter.

The small print: The material presented herein is informational only, and is not designed to provide specific guidance for an individual. Please check with a valued health care provider with any questions or concerns. As for me, I am a Harvard- , Yale- and UPenn-educated radiation oncologist, and I practice in the Seattle, WA (USA) area. I feel genuinely privileged to be able to share with you. If you enjoyed today’s offering, please consider clicking the follow button at the bottom of this page.

Available now: Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Both can be found at the Apple Ibooks store. Coming Soon for iPad: Understand Breast Cancer in 60 Minutes; Understand Colon Cancer in 60 Minute; Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Thank you.

Reference: http://www.telegraph.co.uk/journalists/laura-donnelly/10856597/Dieting-may-reduce-chance-of-cancer-spread.html#source=refresh:

Cancer and Its Management: Lost your Appetite?

soup broth diet food

One of the most well-described nutritional problems in patients with cancer is anorexia, which is the loss of the desire to eat. Underlying causes of this common symptom include psychological factors (stress, anxiety, depression), tumor factors (altered metabolism, pain, early satiety, motility problems, swallowing difficulty) and treatment factors (fatigue, nausea, chemosensory alterations, mucositis, or inflammation of the lining of structures such as the mouth and throat).

Loss of appetite can contribute to cachexia — a profound metabolic derangement with a heterogeneous clinical presentation that results in loss of lean body mass. A recent international consensus defined cachexia as a “multifactorial syndrome defined by an ongoing loss of skeletal muscle mass (with or without loss of fat mass) that cannot be fully reversed by conventional nutritional support and leads to progressive functional impairment. Its pathophysiology is characterized by a negative protein and energy balance, driven by a variable combination of reduced food intake and abnormal metabolism.”[1] Cachexia often progresses through stages from precachexia to refractory cachexia.[1]

The diagnostic criterion for cachexia, established by international consensus, is weight loss > 5% (or > 2% in individuals already showing depletion of body weight or skeletal muscle mass).[1] Moreover, the wasting of skeletal muscle can occur even before overall weight loss becomes apparent, and despite the ingestion of adequate calories, tumor-related factors can interfere with maintenance of fat and muscle.[2] Although a secondary disorder, cachexia is often the proximal cause of death in patients with cancer.

“Weight loss shortens survival,” says Dixon, who emphasizes very early intervention for patients experiencing anorexia who are unable to ingest enough food. “These patients never feel hungry, so they need to eat by the clock or even ‘graze,’ eating small amounts of food all day,” explains Dixon.

But cachexia, she warns, can’t be reversed with calories alone. “Patients with more advanced cancers have deranged metabolisms. Their tumors can be a source of cytokines and signals that raise metabolism and suppress appetite. These patients often use fuel inappropriately. Instead of using fat for energy, tumors can create a situation in which the body uses lean tissue. You might be able to slow the process, but you can’t undo it, even with total parenteral nutrition. Medical therapies have been abysmal failures in these patients.”

This is why Dixon is a big advocate of screening, planning, and prevention. In some patients, this means a long-term feeding tube, usually a percutaneous endoscopic gastrostomy (PEG), for the administration of enteral feedings, should that become necessary. “Many patients are afraid of getting a PEG before they start treatment. Some will decide against the PEG, not realizing that the effects of radiation are cumulative. They make it through treatment, and they think they will start to feel better. However, many will hit their lowest point and become unable to eat weeks or even months after their treatment ends. If they have a PEG, they can start to use it at that point and continue for up to 6 months after treatment. For head and neck cancer patients with feeding tubes, consultation with a speech and language specialist is vital to develop a plan to preserve swallowing function.”

What about the patient who just doesn’t find any food appetizing? In this situation, Rebecca Katz turns to the oldest medicine known to man: warm, nourishing broth. She spent years developing the perfect recipe for “magic mineral broth,” which she calls the “ultimate culinary alchemy.” Magic mineral broth goes down easy, and patients find it very soothing. “It’s something that friends and families can make for the patient with cancer who is not feeling well; it’s like giving the body an internal spa treatment,” says Katz.

Magic mineral broth is a science-based, nutrient-dense concoction that can relieve many of the side effects of cancer treatment, such as nausea, vomiting, fatigue, and dehydration. It’s easy to swallow for patients with dysphagia. “A bowl of soup is appealing to almost anyone,” says Katz.

Recipe for Magic Mineral Broth

6 unpeeled carrots, cut into thirds
2 unpeeled yellow onions, cut into chunks
1 leek, white and green parts, cut into thirds
1 bunch celery, including the heart, cut into thirds
4 unpeeled red potatoes, quartered
2 unpeeled Japanese or regular sweet potatoes, quartered
1 unpeeled garnet yam, quartered
5 unpeeled cloves of garlic, halved
One-half bunch of fresh flat-leaf parsley
One 8-inch strip of kombu (a type of dried seaweed)
12 black peppercorns
4 whole allspice or juniper berries
2 bay leaves
8 quarts cold filtered water
1 teaspoon sea salt

Rinse the vegetables well, including the kombu. In a 12-quart (or larger) stockpot, combine all ingredients except salt. Fill the pot with water to 2 inches below the rim, cover, and bring to a boil. Remove the lid; reduce heat to low; and simmer, uncovered, for at least 2 hours. Add more water if needed to keep vegetables covered. Simmer until the full richness of the vegetables can be tasted. Strain through a large, coarse mesh sieve. Add salt to taste. Let cool to room temperature before refrigerating or freezing.
(Adapted from The Cancer-Fighting Kitchen. Courtesy of Rebecca Katz)

The small print: The material presented herein is informational only, and is not designed to provide specific guidance for an individual. Please check with a valued health care provider with any questions or concerns. As for me, I am a Harvard- , Yale- and UPenn-educated radiation oncologist, and I practice in the Seattle, WA (USA) area. I feel genuinely privileged to be able to share with you. If you enjoyed today’s offering, please consider clicking the follow button at the bottom of this page.

Available now: Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Both can be found at the Apple Ibooks store. Coming Soon for iPad:  Understand Breast Cancer in 60 Minutes; Understand Colon Cancer in 60 Minute; Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Thank you.

References: 

  1. Fearon K, Strasser F, Anker SD, et al. Definition and classification of cancer cachexia: an international consensus. Lancet Oncol. 2011;12:489-495. Abstract
  2. Suzuki H, Asakawa A, Amitani H, Nakamura N, Inui A. Cancer cachexia — pathophysiology and management. J Gastroenterol. 2013;48:574-594. Abstract
  3. http://www.medscape.com/viewarticle/814581_4

Bread, Pasta, and the Risk of Breast and Colon Cancer

pasta

Background: Carbohydrate foods with high glycemic and insulin-raising potential may influence cancer risk. This may occur though the insulin/growth-factor axis. Two sample carbohydrate foods of the Mediterranean diet, bread and pasta, have different glycemic and insulin-raising responses. Might they affect cancer risk differently?

The Study: Investigators from Toronto studied the association of bread and pasta with breast and colorectal cancer risk, using data from two Italian case-control studies. These studies included 2569 women with breast cancer, and 1953 men and women with colorectal cancer. Controls numbered 2588 and 4154, respectively (admitted to the same hospitals as cases for acute, non-cancer conditions).

Results: The odds ratios (ORs) of breast cancer for the highest versus the lowest quintile were 1.28 for breads, and 1.07 for  pasta. The association with breast was unchanged when comparing post menopause and overweight. The odds ratios of colorectal cancer in women for the highest versus the lowest quintile were 2.02 for bread and 1.37 for pasta. The associations remained significant only for breast in strata of menopausal women and overweight. No links were seen in men for wither bread or pasta.

What You Need to Know: These two cancer case-control studies showed stronger associations with bread (than pasta) among women, especially if the overweight. This suggests possible hormonal-related mechanisms. Suggestive, but not particularly actionable, except to say: Your mother was right: Everything in moderation. I’m Dr. Michael Hunter.

The small print: The material presented herein is informational only, and is not designed to provide specific guidance for an individual. Please check with a valued health care provider with any questions or concerns. As for me, I am a Harvard- , Yale- and UPenn-educated radiation oncologist, and I practice in the Seattle, WA (USA) area. I feel genuinely privileged to be able to share with you. If you enjoyed today’s offering, please consider clicking the follow button at the bottom of this page.

Available now: Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Both can be found at the Apple Ibooks store. Coming Soon for iPad:  Understand Breast Cancer in 60 Minutes; Understand Colon Cancer in 60 Minute; Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Thank you.

Reference: Annals of Oncology 2013 Oct 22 [Epub ahead of print]