Is There A Role For Diet In Cancer Treatment? My Opinion And Personal Experience - by Lauren MacDonald

Following the popularity of her previous blog, we have another post from Lauren MacDonald, a 29 year old junior doctor when she was diagnosed with stage IV cancer who is now celebrating one year NED. Here she discusses the role of diet in cancer treatment from her own personal experience.

Over the past few years I’ve received countless emails from people asking exactly what diet changes I’ve made since I was first diagnosed with cancer (in Feb 2014). Although it’s true that I’ve made certain changes, I’m always a little cautious about sharing them, mainly in case people think that because I’m a doctor that must mean the specific changes I’ve made are based on overwhelming scientific evidence. Although I’ve researched “cancer and nutrition” in detail, trawling through countless medical journals and review papers, I’m still not an expert in this field or a qualified nutritionist. Additionally, from what I’ve come across, there is still very little scientific evidence supporting the use of specific diets in cancer treatment anyway. The changes I’ve made to my diet have largely been in an attempt to nourish my body as much as possible, boost my immune system, and (*potentially*) help my body to fight cancer cells.

The Problem With Extreme “Cancer Diets”

Don’t get me wrong, for a little while right at the beginning, I definitely did get sucked into the idea that certain foods or diets might be able to rid me of cancer. I was guilty of dabbling with a few questionable/ridiculous diets (anyone for ground flaxseeds mixed with cottage cheese??!) but fortunately it wasn’t long before the medic inside of me woke up and put a stop to my nonsense. Yet the fact that I was sucked in at all shows just how easy it is for common sense to go AWOL when faced with cancer. For most cancer patients, changing their diet is as much a mental process as a physical act. It enables you to feel like you’ve got some control over a petrifying situation and I know I also felt comforted by the idea that nature might, just might, “cure all” (rather than toxic chemotherapy or other drugs).

Additionally there’s simply so much information available on the internet about “diet and cancer” that it’s almost impossible to avoid it as a newly diagnosed patient (who can often be found googling “cancer cures” at 2am). Without randomised controlled trials in this area (of which there have been very few – although I’m currently awaiting the results of an interesting one looking at watercress) it is difficult to separate fact from fiction. Ultimately, this can leave us patients, our friends and our families confused and vulnerable to inaccurate (and sometimes downright dangerous) information.

Cancer And Certain Diet Myths

The alkaline diet is one of the most popular “anti-cancer” diets. Fans of this diet believe that an acid diet encourages cancer formation, and that an alkaline diet is therefore the solution. The reason that acidity is seen as an issue is because while healthy cells get the majority of their energy from oxygen respiration, cancerous cells tend to inefficiently use glucose at a higher rate than healthy cells. This consumption of glucose results in acidic waste products, and consequently a higher acidity around cells which use this mechanism. BUT… THE FACT IS THIS: acidity is a consequence of the cancer rather than the cause. Therefore, an alkaline diet CANNOT affect cancerous cells. This is because tissue acidity is tightly regulated by our incredibly clever bodies (because otherwise we would die) and this cannot be altered simply by changing the food you put into your mouth.

Another anti-cancer diet I’ve seen tooted time and time again is the “no sugar diet“. Although there’s an established link between being obese or overweight and developing certain types of cancer, the suggestion that sugar “feeds” cancer is an over-simplification of some complicated biology. Yes it’s true that glucose is a sugar, but it is one required by every cell in the body to function, whether cancerous or not. Ultimately all carbohydrates, whether from vegetables or chocolate, are broken down to glucose for the body to then utilise for energy. The reason that the “no sugar diet” has become so popular is because cancer cells require sugars to grow – and their glucose intake is a lot higher than that of healthy cells (this is known at the Warburg effect). The hyperactive glucose consumption of cancerous cells results in a vicious cycle of continued stimulation of cancer development. However, all the cells in the body require “sugar” to survive so it’s impossible to rid yourself of glucose, no matter what you eat. There’s also no evidence that proves eating a low-sugar diet cures cancer.

The final diet which has limited evidence for curing cancer is the ketogenic diet. The ketogenic diet is a high fat, low carbohydrate, and typically a protein-restricted diet. Normally what we eat is composed of macronutrients: carbohydrates, proteins, and fats. The carbohydrates are things like bread, pasta, cakes and some of the fruits and vegetables that we commonly eat. Protein is found mainly in meat and dairy products. High-fat foods are things like bacon, peanut butter, creams, avocados, coconut milk etc. The average diet is about 50-75% carbohydrates and, thus, this is the energy currency that our bodies use. Contrasting with this, in a ketogenic diet about 90% of what a person eats is fat. There is very little protein and almost no carbohydrates. This simulates a fasting state in the body where instead of carbohydrates being used, the body uses ketones for energy. Some people claim this altered state can starve cancer, yet, there is very little evidence to support this idea (except perhaps for patients with brain tumours but, once again, the evidence is limited). There is some evidence, however, that a ketogenic diet can reduce inflammation in the brain and can help treat strokes and other neurological conditions like epilepsy. Among theories about the mechanism behind the ketogenic diet is that the mix of high-fat, low carbohydrates, and reduced protein intake may reduce firing of excitatory brain cells that can make the brain vulnerable to seizures. Unfortunately implementing this diet is a huge undertaking. It can incredibly challenging (and a little disgusting) to force such high fat foods into your body on a daily basis. I know my brother and his girlfriend tried the ketogenic diet as part of a study during her degree (Nutrition BSc) and they couldn’t maintain it for more than a few weeks.

How I Changed My Diet After My Diagnosis

During the first 12 months after I was diagnosed I went ALL OUT with my diet. I stopped eating anything sweet (chocolate, cakes, ice cream etc), juiced as though my life depended on it (daily – if not twice a day – so at least I got my moneys worth from my ridiculously expensive masticating juicer – it’s an Omega Vert in case you were wondering), added ground flaxseeds to everything, nibbled on raw garlic, made myself eat shiitake mushrooms with nearly every evening meal (despite not liking the texture), and washed all these foods down with gallons of green tea and chaga mushroom coffee. Then the cancer returned, making me a stage IV cancer patient, and I figured my mostly plant-based, highly restrictive diet wasn’t eliminating cancer cells and also wasn’t making my life that much fun. To add insult to injury I was also spending a fortune on my “anti-cancer diet”.

Given that my experiment didn’t “cure” me of cancer, I eventually relaxed my diet and simply integrated a few of my new healthy habits into my daily life. Fortunately, somewhere along the way (about four months after starting immunotherapy), I slowly began to journey from a stage IV cancer patient with aggressive tumours that kept popping up in various parts of my body, to someone with No Evidence of Disease.

What I Eat Now

I’ve pretty much reverted to eating exactly like I did before I got cancer. If I fancy a pizza, I have a pizza; if I fancy a bowl of ice cream, I eat the ice cream; if I fancy wine, I’ll have (red) wine (which apparently has anti-cancer properties anyway). Having said that, I now let myself be guided by what my body wants (I guess thats what people call “intuitive eating“) and my body invariably wants to be fed healthy, nourishing foods. The things I make sure to eat include:

Leafy Greens

Isothiocyanates (ITCs) found in leafy greens have been reported to help the body at a cellular level. The main ones I’ve added in to my diet (pretty much every day in a green juice) are kale, spinach and watercress. In addition to isothiocyanates, cruciferous veggies like broccoli also contain sulforaphanes and indoles – two types of antioxidants that protect the structure of DNA. The evidence is so strong that a pharmaceutical company in the UK, Evgen Pharma, is now designing drugs using sulforaphane. The drugs have been shown to kill cancer cells and improve the prospects of stroke patients.

Berries

Most mornings I have a handful of blueberries, raspberries, strawberries and pomegranate seeds, mixed with a spoonful of greek yogurt, a drizzle of almond butter and some mixed seeds. The ORAC scores of nearly all berries are very high, making them some of the best antioxidant foods.

Orange Foods

I make sure I eat plenty of carrots and sweet potatoes (carrots in my daily juices and sweet potatoes as wedges). This is because there’s some evidence that the beta-carotene found in orange foods is an essential nutrient for immune functioning, and given that I’m on an immune-boosting drug, it seems logical to try and give my immune system a helping hand with these foods.

Mushrooms

Several studies have linked higher mushroom intake to a reduced risk of breast cancer in premenopausal women. It has also been proposed that various mushrooms, such as shiitake, chaga, turkeys take and lion’s mane, may also help fight cancer. However, there is still no conclusive evidence that any type of mushroom can prevent or cure cancer.

Spices

The jury is still out on whether turmeric and ginger are “potent anti-cancer foods” but I still add them to all my juices. Make sure you add some black pepper to help with turmeric absorption.

Fermented Foods

Gut health! My favourite subject 🙂 Most of my blog posts seem to have been dedicated to this subject so I won’t go into too much detail here. The main foods I’ve kept in my diet are sauerkraut, kefir, apple cider vinegar, and cultured yoghurt. I try and have at least two of these foods everyday.

Nuts/Seeds

Have you tasted Pip and Nut’s Almond Butter? Not only is it pretty much the most delicious thing you will ever taste, it’s also a great source of protein, fibre and healthy fats. I also try to make sure I have a few brazil nuts every day as they are a great source of selenium.

Udo’s Choice Oil

I try to add a few tablespoons of this oil into my food at some point during the day (either on my breakfast, drizzled on salads or simply neat if I’ve forgotten to add it to a meal – it doesn’t taste too bad). This oil has the ideal ratio of Omega-3:Omega-6’s. I also try to get plenty of Omega’s by eating oily fish a few times a week. Omega-3 fatty acids exert anti-inflammatory effects and might help the body to fight cancer.

Matcha Green Tea

Matcha contains the highest percetange of polyphenolic compounds (catechin, gallocatechin and EGCG). EGCG has been reported to be linked to the modulation of multiple signaling pathways, finally resulting in the downregulation of expression of proteins involved in the invasiveness of cancer cells. It’s an acquired taste but I’ve grown to love it. Pukka Teas do a mild version that comes in teabags if you can’t handle the intensity of the powdered form.

The Take Home Message

I know this is really boring and not what you want to hear, but there really isn’t any one diet or food that will “cure” cancer. If there is (and I’m yet to come across it in my research) please, please let me know…

Using nutrition to support cancer treatment basically boils down to the age-old adage of eating a well balanced diet, enjoying your food, and not eating too much junk. The reality is that cancer is complex illness, and simple “cures” shared online should be treated with scepticism. Having said that, I truly believe that eating healthily has a role in cancer treatment – I just don’t think it will provide the sole “cure”. Personally I didn’t ever receive any diet advice from my healthcare team during my “cancer journey” and apparently this is not uncommon. This lack of nutritional advice for cancer patients in the UK needs to be addressed. In my opinion, we need a holistic approach to treating cancer and nutrition (along with exercise and stress reduction techniques) should be as much a part of cancer treatment as medicine and surgery.

I hope that this info helps anyone who is currently going through cancer treatment or just wants to live a healthier life. Remember, I’m not an expert in this field – these are just diet changes that felt right for me.

Organisations like Cancer Research UK have patient guides that are worth checking out for reliable information. Unfortunately, they aren’t as sexy as those offered up by online “wellness gurus” – but at least you know they’re based on real facts rather than far-fetched theories.

You can read more inspirational and informative posts on Lauren's blog www.laurencara.com.