|
WORKING WITH CANCER PATIENTS:
Traditional and Complementary Approaches
By Laurel Alexander
First
published
in "Positive Health" magazine
I work with breast cancer clients referred to me by The Nigel
Porter Unit at The Royal Sussex County Hospital. The women I see
may be preparing for surgery, going through chemotherapy or radiotherapy,
be on hormone therapy or be dealing with secondary cancer. This
article sets out the nutritional guidelines I use.
Nutrition
Food and drink are nearly always concerns for the women I see.
Their attitude is partially affected by their family. I often
hear someone say, "I can't do something separate for myself. It
means having to do two different meals". Other barriers
include bad nutritional practice in general. Sometimes it's about
cost,
for example; organic is more expensive. The basic suggestions
I make include:
• Have a moderate intake of
fish (preferably deep sea oily fish, such as salmon, tuna, mackerel,
herring, pilchard) and white meat
and poultry (preferably organic);
• Have plenty of organic fruit and vegetables;
• Eliminate or reduce intake of: saturated fats, alcohol, everything
refined (including white bread and flour), tap water, red meat,
smoked and cured meats, excessive salt, chemical preservatives
and processed foods, hydrogenated margarine, food additives,
wheat, tea, coffee, sugars and sweeteners and dairy;
• Drinking at least 2 pints of filtered or mineral water daily;
• Increase intake of protective foods including: alfalfa, almonds,
apples, apricots, asparagus, aubergine, avocado, bananas, beetroot,
bok choy, broccoli, brown rice, Brussels sprouts, green cabbage,
cantaloupe melon, carrots, cauliflower, chicory, Chinese leaves,
chives, citrus fruits, eggs (in moderation), flax oil or flaxseed
(balances oestrogen in the body due to its phytoestrogen effects,
regulates blood sugar level by slowing down the body's absorption
of carbohydrates, good for constipation, regulate blood glucose),
French beans, garlic, ginger, grapes, green pepper, green tea,
horse radish, kale, kiwi fruit, kohl rabi, leeks, lentils,
lettuce, linseeds, liquorice, olive oil, onions, oriental mushrooms (maitake/reishei/shiitake),
parsley, pears, pecans, pineapple, potatoes, pulses and beans,
pumpkin, pumpkin seeds, radish, red and black berries, runner
beans,
seaweeds (kombu, kelp, nori, arame, laver bread, dulse and
wakame), sesame seeds, soy products, spinach, spring onions, sprouted broccoli,
squash, sun dried fruit, sunflower seeds, swede, sweet potato,
tomatoes, turkey, turmeric, turnip, walnuts, watercress, wholegrain
bread, yellow and red peppers:
• Use olive oil for frying; Avoid microwaving food, char-grilling
and barbecuing foods and deep frying or smoking food;
• Avoid aluminium or non-stick pans; Use stainless steel, enamel
or Pyrex cooking utensils. Use pans with close fitting lids
and avoid using copper pans, which encourage oxidation and vitamin
C loss;
• Avoid smoking fat - if you cook with fat, don't let it become so
hot that it starts to smoke (the EFA linoleic acid is destroyed
at this temperature); Prepare food immediately before cooking
as vitamin C is destroyed once cells are damaged. Wash produce in
cider vinegar (or water and vinegar) to remove pesticides.
Don't chop too finely and scrub vegetables rather than peeling them.
Once food is cooked, eat it straight away; Avoid commercial
detergent. Wash cooking utensils in environmentally safe detergent, or use
bicarbonate of soda and rinse thoroughly under a hot running
tap. Preparing for surgery
Two days before going to hospital, I recommend the client begins
a course of arnica homeopathic remedy to lessen the bruising, swelling,
and soreness. I usually recommend 30c morning and night a day before,
the day of surgery and for a few days after surgery. I also recommend
the remedy nux vomica 30c for sickness following surgery. A further
homeopathic remedy that is useful after surgery is hypericum, which
aids pain relief and healing of nerve damage (which is very common
with lymph node dissection).
Certain foods will also help your body prepare for the shock of
surgery, especially those that are rich in an amino \ acid called
L-arginine, which stimulates ] the thymus gland, which in turn
stores i the infection-fighting T-lymphocytes or T-cells until
they are needed to ward \ off disease. Ironically, levels of L-arginine
drop during times of stress - but you can increase them again by
eating more poultry and fish, which are excellent ! natural sources,
and by taking a supplement.
Following surgery, I recommend clients drink at least 2 litres
of filtered or J still mineral water each day to flush J toxins
out of the body and soothe the 1 lining of the gut, which will
be disturbed by antibiotics. Drinking Aloe Vera juice can also
help.
Rubbing vitamin E oil onto a scar can help speed up the healing
process (to do this, break open a standard soft capsule). Another
regenerating goodie is rosehip. Rosa mosqueta is sourced from the
Brazilian rainforest and was originally developed to help reduce
wrinkles around the eyes. To minimize scarring, apply to the wound
once it has healed and massage into the affected area.
Nutrition and Chemotherapy
Nausea and Vomiting:
• Rinse the mouth often to eliminate any bad taste;
• Take small sips of fluids or suck on ice cubes an hour or so after
feeling sick to settle the stomach;
• Eat a cracker or toast to help put something back into the stomach
i without causing upset;
• Eat slowly and chew food well for easier digestion;
• If nausea is a problem in the morning, eat dry foods like cereal,
toast or crackers before getting up;
•
Drink cool, clear, unsweetened fruit juices, such as apple or grape
juice, or"' light-coloured sodas, such as ginger ale, that
have lost their fizz and do not; contain caffeine;
• Suck on mints, or tart sweets (avoiding tart sweets if there are
mouth or throat sores);
• Prepare and freeze meals in advance;
• Avoid sweet, fried or fatty foods;
• Rest, but don't lie flat, for at least 2 hours after you finish
a meal;
• Avoid food for at least a few hours before treatment if nausea
usually occurs during chemotherapy;
• Eat a light meal before treatment;
• Nausea is helped by teas made from ginger, fennel seeds, coriander,
orange, mandarin peel and mint. Other spices which help include
aniseed and cinnamon;
• Keep up fibre intake, as constipation can become a serious problem
(often caused by the anti-nausea drugs which are administered
with the chemotherapy).
Taste
• Brush your tongue with a toothbrush and water (and a little minty
toothpaste, if the taste and smell don't bother you). Tongue
brushing helps things to taste better. No doubt you have been advised to
use good oral hygiene, rinse with slightly salty water and
avoid lacerating your mouth/tongue/throat.
Hair loss
• Use vitamin E 1600ius daily, starting one week prior to chemotherapy;
• Drink lots of diluted orange juice; Fact Box
Presuming you have healthy kidneys, drinking several pints
of water one day before your treatment, during the infusion
and for 2-3
days after your treatment will help to flush the chemotherapy
through, otherwise there is a risk of cystitis.
Mouth Sores
Buy yourself a bottle of Milk of Magnesia. Pour off the top
of the liquid that rises to the top. Dip a Q-tip into the
remaining thick cream-like substance and rub on your sores. The substance
breaks down the acid that causes these sores. Another tip
for
mouth
sores is to snip the top of a vitamin E capsule and pour
the contents directly on the mouth sore. "Vitamin
C augments the effectiveness of radiotherapy and can help decrease
the anaemia, pain, appetite loss and weight loss
experienced by those on this form of treatment. Vitamin C also
protects the heart for those on the chemotherapeutic drug Adriamycin
(as does CoQIO). Vitamin C also enhances the effectiveness of chemotherapeutic
agents 5-Fluoracil and Bleomycin. Vitamin E reduces cardiac and
skin toxicity and hair loss for those on Doxorubicin, protects
lymph tissue against Bleomycin, and decreases cardio-toxicity of
Adriamycin. Beta-carotene potentiates the effectiveness of 5-Fluoracil,
Methotrexate and Cobalt therapy. Selenium is also radio- and chemo-protective,
and protects kidneys against cisplatin. Radiotherapy decreases
levels of vitamin E, B12, folic acid and C, so it is a good idea
to ensure a diet rich in these substances or supplementation while
on radiotherapy."
During chemotherapy, clients' appetites can fluctuate. I tend
to recommend 'grazing' with protein at every sitting. It is obviously
important that the client gets good protein and complex carbohydrate
but it is equally important that they eat what they fancy -regardless
of goodness. There needs to be some pleasure in life!
Coping
with Radiotherapy
• Keep some Aloe Vera gel in the fridge and apply liberally;
• Take kelp tablets, and other dark green things, like barleygreen,
spirulina or seaweed. Miso soup is excellent. Seaweed products
will help to counteract iodine deficiency and, with bananas and
ocean fish, help to keep your sodium-potassium balance right;
• Avoid the supplement genistein, which may have the effect of protecting
any cancer cells from radiotherapy.
Hormone Therapy
Another area I work in is with the side effects of hormone therapy.
When a client comes to me suffering from, normally, hot flushes
and night sweats, due to tamoxifen or zoladex, I use nutrition
to ease the symptoms. Supplements such as vitamin E, flaxseed,
magnesium, vitamin C, vitamin B complex, selenium and Co-Q-10 can
help ease symptoms. Additional help comes through homeopathy. I
am wary of using herbs because of their interaction with cancer
treatment drugs and, also, homeopathy works so much more quickly,
especially those that are good for hot flushes. I often ask the
women to keep a flush diary detailing when a flush happens, on
what part of the body and any noticeable triggers. This can produce
information such as a flush happening after food or a hot drink,
after exercise or sitting in a traffic jam that can be used to
help manage symptoms.
Fact Box
Health Canada is advising the public not to take certain drugs
with grapefruit juice. Although interactions between grapefruit
juice and certain drugs are well documented in medical and
scientific literature, this information may be unknown to
the public. There
are several substances in grapefruit that interfere with
the way the body handles certain drugs. Consuming grapefruit
juice (fresh
or frozen) or grapefruit sections can increase, or less commonly
decrease, the effects of some drugs, which could lead to
serious or even life-threatening adverse reactions. As little
as one glass
of grapefruit juice can cause this effect. It is advisable
not to drink grapefruit juice or eat grapefruit in any form,
if you
are taking medication for cancer (such as tamoxifen), until
you have talked to your doctor or a nutritionist about the
potential
for an adverse reaction. While sweet oranges and their juice
do not appear to cause the same reaction, sour orange juice,
such
as that from Seville oranges, may have an effect similar
to grapefruit juice. Tangelos are a hybrid of grapefruit
and may also interfere
with drugs. Most other citrus fruits, such as lemons, limes,
citrons, naturally sweet oranges and tangerines are considered
safe. National
Association of Pharmacy Regulatory Authorities, 402-222 Somerset
Street West, Ottawa, ON K2P 2G3, Canada. Tel: (613) 569-9658.
info@napra.ca. www.napra.ca/docs10/5091513.asp.
Weight Management
Another issue I work with is weight gain, due to hormone therapy,
and weight loss, due to stress. When the issue is weight
gain, it is often tied up with bad body image, for example
maybe
the woman has had a mastectomy. I approach this issue from
the self-confidence
and health angle, rather than the "let's lose weight" angle.
Based on nutritional data, we work together to create a
healthy eating plan. If appropriate, we link in a food
diary, which
monitors emotional responses and eating habits. My approach
is very much
about creating a flexible programme with the client that
they can incorporate easily into their daily life -with
the odd
deviation for good measure! There have been several women
who have come
to
me following diagnosis but before surgery, who have lost
weight due to trauma. These women need careful supporting
and reassurance,
as well as a nutritional programme aimed to build them
up in readiness for surgery and recovery and possibly further
treatment. As well as nutrition, I also use reflexology, Reiki, stress management
therapy, head and shoulder massage, relaxation training, guided
imagery and colour, style and image makeover as part of complementary
cancer care. But it is nutrition that always forms the core for
self help for most of the women I work with.
Supplements
In the first session, we talk about the importance of antioxidants
and I recommend a daily supplement intake of: • lOOOmg
(up to 3OOOmg) of vitamin C with bioflavonoids;
• Vitamin E 400iu. Selenium and vitamin C aid absorption;
• Selenium 200mcg.
Any further supplements are tailored around prioritizing health
needs and financial status. Other supplements I might recommend
include:
• Bee pollen, which provides more than a dozen vitamins, 28 minerals,
11 enzymes, 14 beneficial fatty acids and 11 carbohydrates and
is made up of around 25% complete protein, consisting of at least
18 amino acids. It enhances vitality, strengthens the immune system,
is a natural anti histamine, regulates blood pressure and assists
constipation (a side effect of chemotherapy);
• Zinc for immune function - 15-25mg;
• Flaxseed oil (capsules) each day;
• Oligomeric Proanthocyanidins which are 50 times more potent than
vitamin E and 20 times more than vitamin C as an antioxidant. Sources
are Pycnogenol (a patented form of pine bark extract) known as
Pine Bark Extract and Grape Seed Extract. These may also reduce
allergic reaction by inhibiting histamine. Therapeutic doses: pine
bark extract would be 30mg and grape-seed extract would be lOOmg.
NOTE: There is a clinical trial funded by Cancer Research UK and
conducted by The Royal Marsden Hospital and The Institute of Cancer
Research, to look at the healing properties of grape seed on radiation
fibrosis; a type of scarring that causes tissue to become hard
and stiff;
• Co-Q-10 is a component of every living cell. As body levels of
Co-Q drop, so does the general state of health. Co-Q-10 is best
absorbed with flaxseed oil. Therapeutic dose is 10-90mg per day;
• L-Glutamine is a fuel for the digestive lining which has been shown
to protect the digestive tract through chemotherapy. It is considered
essential to the body when the immune system is depressed and is
beneficial as a healing agent after surgery. Glutamine helps to
alleviate the side effects of chemotherapy such as diarrhoea, mouth
ulcers and 'leaky gut'. NOTE: Should be avoided if there is cancer
of the digestive tract;
• Vitamin B complex 50mg;
• Beta-carotene. (Active cancer: 25,000iu daily. Maintenance level:
10,000 daily). Or you could juice carrots;
• Chromium GTF (Active cancer: lOOmg daily. Maintenance level: 50mg
daily);
• Magnesium 100-200mg;
• Chlorella. There has been much research with regard to chlorella
and tumour regression. Macrophages are cells that are active against
cancer cells, foreign proteins and chemicals. A natural way to
help fight cancer is to stimulate macrophage production and macrophage
activity in the body. Chlorella stimulates the production of interferon
in the body, which in turn stimulates macrophage production. Other
studies have shown that it stimulates a white blood cell to exhibit
anticancer cell activity. This combined action in stimulating the
immune system gives chlorella an excellent anti-tumour capacity.
It is also a natural source of beta-carotene;
• Lactobacillus bacteria. Lactobacilli are the natural bacteria found
in our digestive tract. They have a number of benefits, such as
producing B vitamins that help to boost the immune system. They
protect against the invasion of other pathogenic bacteria, thus
freeing up the immune system to act on the invasion of cancer.
They can generally help to detoxify carcinogenic toxins that may
form in the digestive tract;
• Garlic possesses potent anti-viral, anti-bacterial, and anti-fungal
activity. Scientific studies have shown that it stimulates various
facets of the immune system.
Fact Box
Those on Warfarin should not use vitamin E or Co-Q-10.
References
1. Daniel R. Healing Foods, How To Nurture Yourself amd Fight
Illness. Harper Collins. 1996.
Resources
Arnot B. The Breast Cancer Prevention Diet. Newleaf.
Bruning N. Coping with Chemotherapy. Avery
Publishing Group.
Davies S and Stewart A. Nutritional Medicine. Pan.
Glickman H. Foods that Fight Cancer. Optimum
Nutrition. Volume 16: No 1: 16-21. 2003.
Grape Seed and Radiotherapy. Breast Cancer Care
News. Spring 2003.
Holford P. Boost Your Immune System. Piatkus.
Holford P. Say No to Cancer. Piatkus.
Olivier S. The Breast Cancer Prevention and Recovery
Diet. Michael Joseph.
Physicians Committee for responsible Medicine and
Vesanto Melina. Healthy Eating for Life to Prevent and
Treat Cancer. Wiley.
Plant J and Tidey G. The Plant Programme. Virgin.
S Yeager. New Foods for Healing. Rodale Press Inc. 1998.
About the Author
Laurel Alexander Dip Nut, MAR LNCP, Cert Ed, a survivor of breast
cancer, has a special interest in the use of integrated healthcare
in cancer treatments. She is a complementary therapist and
qualified in stress management, nutritional therapy and reflexology,
as well as being a Reiki Master/Teacher. As well as working
with individual cancer clients, Laurel also writes a Client's
Newsletter for the Nigel Porter Breast Unit and facilitates
a therapeutic writing group for clients and survivors of
breast cancer for the Unit. She can be contacted on Tel:
01273 564030 here.
Further Information:
Bristol Cancer Help Centre. Tel: 0117-980 9500; www.bristolcancerhelp.org
The Cancer Resource Centre. Tel: 020-7924 3924; www.cancer-resource-centre.org.uk
The Cavendish Centre (Sheffield). Tel: 0114 278 4600. www.cavcare.org
Directory of Complementary Therapy Services in UK Cancer Care.
Macmillan Cancer Relief. ISBN 0953678520. Tel: Macmillan CancerLine
0808 808 2020; www.macmillan.org.uk
Integrated Cancer Care (St Luke's Cancer Centre at the Royal
Surrey Hospital). Tel: 01483 406818;
www.integratedcancercare.org
Laurel Alexander Dip. Nut. LNCP. MAR. Tel: 01273 564030; here
New Approaches to Cancer. Tel: 0800 389 2662; http://80.177.61.246/newapproaches
Wessex Cancer Help Centre.Tel: 01243 778516.
|
