Nutrition Considerations while Living with Lung CancerOctober 22, 2016Em E. Biever, MS, RD, LDNSenior Clinical Dietitian, Dana-Farber Cancer Institute

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OutlineThe partner of good nutrition

Dietary recommendations

Supplements/Herbs

Common side effects of treatment

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Physical ActivityLinks between PA and reduced risk of several cancersHelps fight fatigueHelps improve insulin sensitivity, supporting stable blood sugarHelps prevent loss of lean muscleHelps boost moodNancy Campbell, exercise physiologist

617-632-4523

**50 studies looking at colon cancer and PA

Research says 50% of us still arent getting enough.

Is there a recommended diet?What should we be asking when assessing a recommended diet?Is it restrictive?

Is it sustainable?

How will it affect my/our quality of life?

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Is there a recommended diet?

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Dietary RecommendationsEat food. Mostly plants. Not too much. -Michael Pollan, Food Rules: An Eaters Manual

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Dietary RecommendationsParticular indications for cancer patientsColorful, Plant-basedCrucifers (green)Flavanoids (red/purple)Carotenoids (orange)Terpenes - citrus fruitsHealthful fats, lean proteins

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Dietary RecommendationsFoods to limitRed meatProcessed meats (bacon, salami, sausages, bologna)Nutrient-poor foods

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Are supplements beneficial?Consult with your care team before starting.

Labs checked for deficiency prior to initiation.

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Herbs/PlantsCurcuminActive ingredient in the dietary spice turmericPossible anti-tumor and antioxidant propertiesCaution: Inhibition of cytochrome p450

Green TeaEpigallocatechin-3-gallate (EGCG)May inhibit cancer cell growth and invasion

Johnson R, Bryant S Huntley AL. Green tea and green tea catechin extracts: An overview of the clinical evidence. Maturitas.2012;73(4):280-287.

**Curcumin is an ancient remedy which is still used today to treat various conditions including infections, respiratory ailments, digestive disorders, and to aid in wound healing. In the laboratory, curcumin has been shown to have anti-tumor and antioxidant properties, while clinical studies have provided mixed results. As is the case with many herbs and supplements, caution must be used ESPECIALLY when individuals are undergoing chemotherapy or radiation therapy. Curcumin may inhibit cytochrome p450 which is an enzyme responsible for metabolizing drugs, including chemotherapy drugs.

Managing Side Effects

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Managing Side EffectsNauseaRemove yourself from the cooking process/food prepAvoid strong smells and overly warm roomsAdd various forms of ginger, lemon, mintLemon aromatherapy Sit upright for eating and drinking

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Managing Side EffectsTaste ChangesCleanse your mouthGood oral hygieneBaking soda and saltLemon drops, mintsAvoid metal utensils and supplement cansTry foods at room temperature

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Managing Side EffectsTaste ChangesStrange/Bitter Taste?Swish before eatingTry neutral flavored foods: eggs, nuts, poultry, dairyTastelessnessMarinade with fruit-based or sweet saucesSqueeze citrus on bland tasting foodsSaut with onion, garlic or add curry, cinnamon, oregano, basil

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Managing Side EffectsLoss of AppetiteTake advantage of moments when you are hungryFreshen your mouth before eatingAim for small, mini-meals with added nutritionDrink for comfort vs. hydration during mealsRelaxand have your loved ones relax, too!

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Managing Side Effects: Aim for small, mini-meals with added nutrition

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Managing Side Effects: Aim for small, mini-meals with added nutrition

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Managing Side EffectsDiarrhea: adjust diet, minimal fiber, cooked vegetables, skinless fruits, banana flakes, isotonic fluids, probiotic

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Managing Side EffectsConstipation: adjust diet, increase fiber, raw cacao nibs, Smooth Move tea, Benefiber, psyllium husk powder, fluids, probiotic, massage, yoga, physical activity

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Finals Thoughts and Tips!

Resourceswww.danafarber.org/nutritionwww.naturaldatabase.comwww.mskcc.org/mskcc/html/11570.cfmwww.hsph.harvard.edu/nutritionsource/www.danafarber.org/exercise

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**50 studies looking at colon cancer and PA

Research says 50% of us still arent getting enough.

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**Curcumin is an ancient remedy which is still used today to treat various conditions including infections, respiratory ailments, digestive disorders, and to aid in wound healing. In the laboratory, curcumin has been shown to have anti-tumor and antioxidant properties, while clinical studies have provided mixed results. As is the case with many herbs and supplements, caution must be used ESPECIALLY when individuals are undergoing chemotherapy or radiation therapy. Curcumin may inhibit cytochrome p450 which is an enzyme responsible for metabolizing drugs, including chemotherapy drugs.

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