Breast cancer and nutrition
Hester Hill Schnipper, LICSW, OSW-C Program Manager Emeritus, Oncology Social Work
MARCH 18, 2019
Cancer diets are always a hot and controversial topic. There probably aren't many other subjects with as many viewpoints and strong opinions. If you go online or wander around a bookstore, you will be flooded with options and advice. The trouble is that there really aren't good answers or single suggestions that have been proven to make a difference.
When someone is first diagnosed with cancer, it is typical to think about diet and whether there are improvements to be made that might guarantee good health. During this period of crisis, we are all looking for anything that we can control. During cancer treatment, lots of us wonder what we can eat and does anything sound appealing. (Remember the joke about the ideal chemo meal being mashed potatoes, mac and cheese, and white bread.) When treatment has been completed, many people continue to search for diets that might reduce risk of future cancer trouble.
There are books that describe super foods and ascribe them super health powers (think blueberries and kale). There are even books that promise a particular diet will prevent or cure cancer. int: there is no such thing. You can be absolutely sure that, if there were, all of us would already know about it and be eating whatever was suggested.
The bottom line truth is that eating a healthy diet vis-à-vis cancer is not different than eating a healthy diet in life. Translation: lots of whole grains and fruits and vegetables, limited red meat and processed food, reduced animal fat. If you are interested in reading a very thorough review of nutrition for all kinds of cancer situations, the National Cancer Institute (NCI) site is excellent.
Consulting with a dietician who is trained in oncology care is often a helpful strategy. At BIDMC we have dieticians both downtown and at the Needham Cancer Center who can consult with you about your specific needs and questions.
Thinking specifically about breast cancer, there are a few hot topics: alcohol consumption, sugar, and low-estrogen foods. Again, remember that there are no absolute answers, and that the best advice is always moderation and common sense and adhering to what we all know about good diets. The alcohol link probably has the most evidence-based support, and the recommendations vary. Research has shown that drinking alcohol increases the risk of developing an ER positive breast cancer; there are a few studies that suggest that alcohol can also increase the chance of a recurrence of these cancers. The association with sugar is very complicated and well beyond the scope of this blog to explain. It is definitely not eating a piece of cake=feeding any cancer cells. It is related to insulin levels and inflammation and many other multi-layered factors. Some women hear that sugar feeds cancer and immediately try to eliminate it entirely in their diets. This is a big over-reaction. Think again about balance and moderation and knowing that it is never good for us to take in a lot of calories from dessert. It also can't be good for our general enjoyment of life to never again have ice cream or a brownie.
Low estrogen diets are more controversial. As an example, some researchers say that soy is a phyto (plant) estrogen and should be avoided in large amounts by women with ER positive breast cancers. Others believe that soy actually has anti-cancer properties and is a smart addition to diets.
If you want to stimulate a lively discussion, just ask a group of women with breast cancer about their diet opinions. You are likely to hear every possible perspective, ranging from women who have completely changed their diets to something they think is healthier to women who feel they have earned the right to indulge their food cravings at all times. Since there really are no absolute answers, we each have to find our own way—and our own diets.