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From: Ann Mc.
A Dietitian's Cancer Story Newsletter
Winter 2006 Greetings from Diana Dyer, MS, RD, author of A Dietitian's
Cancer Story
Newsletter Contents:
I. Survivorship Info
II. Clinical Trials for Cancer Survivors
III. Web sites
IV. Books to Suggest
V. Tidbits of Helpful Information
VI. Research Updates
VII. Book Ordering Information
VIII. Newsletter forwarding guidelines
IX. Newsletter sign-up instructions
X. Removal Instructions
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I. Survivorship Info
I have written in past newsletters and on my website about the importance
of the pending legislation called The Medical Nutrition Therapy Act of 2005
(Senate Bill 604 and House Bill 1582), which has bipartisan support in both
chambers of Congress. (http://cancerrd.com/faqs/faq74.htm) However, this
bill was not moved out of committees to be voted on last year, and will
need to be re-introduced in this new legislative year.
I will be attending the Public Policy Workshop in Washington, DC in
mid-March 2006 that is sponsored by The American Dietetic Association (ADA)
as a representative from the Oncology Nutrition Dietetic Practice Group of
ADA. I will be learning about ADA's priority nutrition issues and the
development and implementation of public policy. My objective will be to
bring to the attention of our lawmakers (from the viewpoints of both
Registered Dietitians and cancer survivors) the need for inclusion of
proactive and individualized medical nutrition therapy into true
comprehensive cancer care.
Many of you have already sent me a short comment describing a situation in
which professional services from an RD helped with the outcome of your
cancer treatment (or that of a family member), recovery, or how you believe
such professional expertise would have been of benefit if received after a
cancer diagnosis.
I am still gathering comments such as these. If you would like to share
your experience with me, I will have more information to convey to our
senators and representatives. Please send me a short email message at
newsletter2@CancerRD.com with "MNT in Cancer Centers" in the subject line.
Thanks for your help.
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II. New Clinical Trials for Cancer Survivors
A. MEAL Study (Men's Eating and Living Study)
The MEAL Study is investigating whether an innovative telephone-counseling
program can help men with localized, low-risk prostate cancer adopt a
cancer-preventive diet. The MEAL Study is currently enrolling men 50-80
years of age who have been diagnosed with prostate cancer within the
previous 48 months; who have completed initial treatment or have elected
active surveillance or watchful waiting; and who are without a medical
condition that would prevent adopting a high-fiber diet.
This study is recruiting subjects in the following locations:
UC - San Diego;
Roswell Park Cancer Institute, Buffalo, NY;
The Ohio State University, Columbus, OH;
Southeastern Medical Oncology Center, Goldsboro, NC;
Sloan-Kettering Memorial Cancer Center, New York City, NY.
For more information, please send an email message to
healthyeating@ucsd.edu or visit their web site at
http://www.healthyeating.ucsd.edu/pages/mealStudy.htm .
B. American Ginseng for Cancer-Related Fatigue
The objective of this study is to compare the efficacy of American ginseng,
at three different doses, to a placebo in patients with cancer-related
fatigue.
See the protocol summary at http://cancer.gov/clinicaltrials/NCCTG-N03CA
Researchers want to enroll 280 patients aged 18 & over diagnosed with
cancer who are experiencing cancer-related fatigue.
See the list of eligibility criteria at
http://cancer.gov/clinicaltrials/NCCTG-N03CA
See the list of study sites at http://cancer.gov/clinicaltrials/NCCTG-N03CA
See the list of study contacts:
http://cancer.gov/clinicaltrials/NCCTG-N03CA
or call NCI's Cancer Information Service: 1-800-4-CANCER (1-800-422-6237).
C. Randomized Pilot Study of Low-Residue Diet for the Treatment of Diarrhea
in Patients With Uterine, Cervical, or Prostate Cancer Who Are Undergoing
Pelvic Radiotherapy
RATIONALE: Eating a diet low in residue (foods high in fiber and fat, and
certain milk or vegetable products) may help prevent or reduce diarrhea
caused by pelvic radiation therapy.
PURPOSE: This randomized clinical trial is studying a low-residue diet to
see how well it works compared to no dietary intervention in treating
diarrhea in patients who are undergoing radiation therapy to the pelvis for
uterine, cervical, or prostate cancer.
Twenty (20) patients are being recruited for this pilot study at Case
Comprehensive Cancer Center in Cleveland, OH.
More information regarding eligibility and contact information for
participating in this important study can be found at the following web
site; http://www.clinicaltrials.gov/ct/gui/show/NCT00258401
D. Phase III Randomized Study of Levocarnitine (L-carnitine) for the
Management of Fatigue in Cancer Patients
Low levels of the nutrient carnitine may contribute to feelings of fatigue
in cancer patients. Carnitine plays an important role in cellular energy
production by helping in the metabolism of fatty acids, which represent a
major fuel source for tissues such as the heart and skeletal muscle.
Levocarnitine (L-carnitine) is a nutritional supplement that may help
alleviate fatigue by increasing the level of carnitine in the body.
In this trial, researchers will assess the prevalence of carnitine
deficiencies in cancer patients and examine the effect of carnitine
supplementation in patients experiencing moderate to severe fatigue.
Patients will be randomly assigned to receive levocarnitine or a placebo.
More information about eligibility, study sites accepting patients
throughout the country, and contact information can be viewed at the
following web site:
http://www.cancer.gov/clinicaltrials/ECOG-E4Z02
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III. New Web Sites:
A. www.lotsahelpinghands.com - Lotsa Helping Hands is a web site that
provides a simple and immediate way for friends, family, colleagues, and
neighbors to assist loved ones in need. It's an easy-to-use, private group
calendar, specifically designed for organizing helpers, where everyone can
pitch in with meals delivery, rides, and other tasks necessary for life to
run smoothly during a crisis.
B. www.redtoenail.org - RedToeNail.org is an online community designed to
help people whose lives have been touched by cancer. Whether you are the
one with cancer or it's a friend or family member who you are caring for,
RedToeNail.org offers a supportive online environment where you can share
your experiences via an online journal (blog), learn from others and find
support for the challenges you are facing. Why is it named redtoenail.org?
You'll have to go the site to read about that!
C. The National Center for Complementary and Alternative Medicine (NCCAM)
web site now links to a free database of info about herbs & dietary
supplements.
The information is available in both English and Spanish (click on icon in
upper right hand corner of web page).
http://www.nlm.nih.gov/medlineplus/druginfo/herb_All.html
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IV. New Books to Suggest
A. When Life Hands You Lemons, Make Lemon Meringue Pie, Joanna M. Lund,
Perigree Books, New York City, 2005. Joanna is the prolific author of the
Healthy Exchange cookbooks. Now diagnosed with inflammatory breast cancer,
she has written a delightful and thoughtful book about the lessons of her
cancer experience, from healing to hope. Yes, she even includes her famous
recipe for Luscious Lemon Meringue Pie.
B. Eating for Lower Cholesterol, Catherine Jones and Elaine Trujillo, MS,
RD, CNSD, Marlowe and Co. New York 2005. Many people with cancer also have
high cholesterol levels. This cookbook combines all the best anti-cancer
foods into recipes that will also help you optimize the dietary approach to
reducing cholesterol and triglyceride levels. I have little sticky notes
all over the place marking recipes I want to try! Another strength of this
book is the accurate and easy to understand nutrition information
interspersed among the recipes. More info can be found at the authors' web
site www.staybalanceddiet.com
C. 12 Best Foods Cookbook, Dana Jacobi, Rodale Press, 2005. Here they are:
blueberries, black beans, sweet potatoes, oatmeal, salmon, spinach,
broccoli tomatoes, walnuts, soy, onions and yea! chocolate. I won't have
any trouble finding a recipe to take to the Super Bowl party. I only rarely
eat desserts, but the recipes in this book look too tempting to pass up.
Here are two that sound delicious: Sweet Potato Pudding and Spinach
Strudel.
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V. Tidbits of helpful information
A. Disaster preparedness: The Healthy Hurricane/Disaster Cookbook
An excellent short handbook prepared by dietetic students at Florida
International University in Miami, Fl. This short booklet includes a
shopping list, healthy recipes, and snack ideas. The best suggestion is to
practice prior to a disaster by having a no-cook night each week to prepare
these recipes in a less pressured situation. The cookbook is free and
available to download and print from the internet at
www.fiu.edu/~health/hurricaneseason/Cookbook.pdf
B. Breast cancer exercise DVD - Developed through Brigham and Women'sT
Hospital and Reebok University, this DVD will help you understand your
treatment options and will give you the tools to regain your quality of
life after breast surgery and treatment. All proceeds donated to breast
cancer research. More information about the contents of the DVD and how to
order it can be obtained at the following link:
http://www.brighamandwomens.org/healthinfo/breastcancersurvivorsguidetofitnessdvd.asp
C. Over the years, I have received several inquiries from people asking my
opinion about the cancer-fighting benefit from drinking wheat grass juice.
I have looked and looked but never found much information available to back
up the popularity of this juice. I have tried it several times, but I am
simply unable to tolerate the taste of it.
Here is a web site that has analyzed the nutritional content of wheat grass
juice and compared it to spinach juice. It makes for interesting reading.
Scroll down to the bottom to read the article about wheat grass.
http://www.dolenutrition.com/Newsletter/DNI_NL20050829.htm
D. Confused about the new white wheat flour that is called a whole grain?
Here is a web site that explains that seeming oxymoron and guides you
through the nutritional maze about this new flour and its food products.
http://www.intelihealth.com/IH/ihtIH/EMIHC268/35320/35327/443278.html?d=dmtHMSContent
E. The University of California - San Diego has launched their innovative
Healthy Eating Program, a personalized counseling program designed to help
you adopt a diet that will promote health and fight disease. Based on
research conducted at UCSD, their dietary counseling program has been
proven successful with over 2,000 participants.
This program is personalized and convenient, with counseling done by
telephone to fit your schedule. More information can be obtained at the
following web site:
http://www.healthyeating.ucsd.edu/pages/he.htm
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VI. Research Updates
A. Dietary soy isoflavones inhibit estrogen effects in the postmenopausal
breast. Wood CE, Register TC, Franke AA, Anthony MS, Cline JM, Cancer Res.
2006 Jan 15;66(2):1241-9.
Recent research in post-menopausal monkeys (from which results are more
comparable to humans than research in rats or test tubes) suggests that the
dietary intake of the natural plant estrogens (phytoestrogens or
isoflavones) found in soy foods does not increase markers of breast cancer
risk. In fact, the results suggest that there may even be a protective
effect in some women from intake of the isoflavones in soy foods,
particularly in post-menopausal women who are exposed to higher levels of
estrogen compounds. (Estrogen exposure in post-menopausal women can come
from either hormone replacement therapy or endogenous estrogen production
from fat cells, also called adipose tissue.)
Isoflavone doses given were equivalent to the following human levels: no
isoflavones, 60 milligrams (comparable to the typical Asian diet), 120
milligrams (the highest levels that can be consumed through diet alone), or
240 milligrams (levels obtained through supplements). Estrogen doses were
designed to mimic either a low or high-estrogen environment found in
postmenopausal women.
Interestingly, the most protective effects observed from the intake of the
soy compound were found in monkeys who had the highest intake of
isoflavones and the highest estrogen levels, with no evidence of
stimulation of breast cell growth or other biomarkers for cancer risk in
breast tissue in this group. In addition, during the low-estrogen
environment, no evidence of increased breast cell proliferation was seen at
any level of isoflavone exposure, even at isoflavone doses several times
higher than in a typical Asian diet.
My comments: This is a well designed study that has added new and important
information toward resolving the current conflicting and confusing
information regarding both the safety and potential benefit of soy food
consumption for cancer prevention in post-menopausal women. However, it
does not provide information about potential safety or benefit in either
pre-menopausal women or women who use a combined estrogen-progestin hormone
replacement therapy.
More research needs to be done to fully resolve the concerns of
oncologists, ER+ breast cancer survivors, and those women at high risk of
breast cancer regarding the safety of soy and/or isoflavone consumption.
One conclusion of a recently held workshop entitled "Soy and Breast Cancer:
Resolving the Controversy" was to conduct a year-long intervention study in
women at high risk of breast cancer. The design of the study would allow
for both potential benefits and adverse effects to be identified.
B. Genistein, a Dietary Isoflavone, Down-Regulates the MDM2 Oncogene at
Both Transcriptional and Posttranslational Levels, Mao Li, et al, Cancer
Research 65: 8200-8208, 2005.
This is an in vitro ("test tube") type of research study, in which the
scientists were able to determine mechanisms of action of the isoflavone
called genistein found in soy foods that may explain the observed
associations between regular intake of soy foods and reduced risk of
several human cancers, such as breast, prostate, and colon.
In a dose and time dependent manner, genistein down-regulated (inhibited)
the expression and activity of an important oncogene (a cancer-promoting
gene) called MDM2. Genistein also induced apoptosis (programmed cell death)
and inhibited cell growth of a variety of human cancer cell lines.
In an additional in vivo (animal) study, genistein inhibited the expression
of this oncogene and tumor growth in animals implanted with prostate cancer
cells.
My comments: This interesting new research is yet another small piece to a
large puzzle as biology needs to be understood in order to make sense of
observations in populations related to diet's effect on cancer prevention
and treatment. As tools for doing research involving genes and the
molecules they produce continue to advance, look for much more research of
this type.
^*^*^*^*^*^ Take Home Message ^*^*^*^*^*^
I continue to use 1-3 servings of soy foods in my daily diet, as I have
done for the past 10+ years without a recurrence of my ER+ breast cancer. I
consume primarily the traditional (the least processed) soy foods such as
tofu, tempeh, miso, soy nuts, soy flour, and unsweetened soymilk, with
occasional use of a processed food such as a soy-based veggie burger as
part of my overall healthy diet.
C. Two recent studies about ovarian cancer
(1) Tea Consumption and Ovarian Cancer Risk in a Population-Based
Cohort SC Larsson and A Wolk, Arch Intern Med. 2005;165:2683-2686.
A prospective study in a large population of women in Sweden found an
association between increased consumption of tea and decreased risk of
invasive epithelial ovarian cancer.
Compared with women who never or seldom (less than monthly) consumed tea,
the relative risks for those who consumed less than 1 cup per day, 1 cup
per day, and 2 or more cups per day were 0.82, 0.76, and 0.54,
respectively. Each additional cup of tea per day was associated with an 18%
lower risk of ovarian cancer.
These results suggest that tea consumption is associated with a reduced
risk of epithelial ovarian cancer in a dose-response manner.
(2) Possible Chemoprevention of Ovarian Cancer by the Herbal, Ginkgo
Biloba - Abstract #3654 presented by Drs. Bin Ye and Daniel Cramer at the
American Association of Cancer Research's annual meeting in Baltimore, MD,
October 31,2005 http://www.aacr.org/default.aspx?p=1275&d=553
A case control study matching 600 ovarian cancer patients with 640 healthy
women as controls observed that women who had consumed ginkgo biloba
supplements for six months or longer had a 60% lower risk of developing
ovarian cancer. The protective effect was highest for non-mucinous ovarian
cancers. (See the following web site for a discussion of various types of
ovarian cancers
http://www.ovariancancer.org/index.cfm?fuseaction=page.viewPage&PageID=511&D:%5CCFusionMX7%5Cverity%5CData%5Cdummy.txt)
Compounds found in ginkgo called ginkgolides did cause ovarian cancer cells
to stop growing in cell cultures and were most effective in the
non-mucinous type of ovarian cancer cells.
My comments:
Ovarian cancer is still a silent-killer without a means of reliable early
detection or adequate treatments in the majority of cases. Thus it is
hopeful to know that there may be effective ways of decreasing the risk of
occurrence.
Both of these studies clearly fall in the category of early or preliminary
research. The first study has been published but is a case-control study,
not the stronger type of study called an intervention study where one group
receives a treatment and the other does not (preferably a randomized,
blinded, placebo controlled trial). The second study showing an association
of a decreased risk of ovarian cancer with consumption of the dietary
supplement ginkgo biloba has not yet been subjected to the peer review
process necessary for publication.
^*^*^*^*^*^ Take Home Message ^*^*^*^*^*^
If you are at high risk of ovarian cancer, it does seem prudent to increase
the amount of tea (green or black) in your diet. However, if you are
interested in consuming ginkgo biloba to potentially decrease your risk of
this cancer, I recommend first consulting with your physician as ginkgo may
interact with other medications (anticoagulants, antiseizure, insulin as a
few examples).
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VII - Book Ordering Information
Both editions of A Dietitian's Cancer Story (English version ISBN
096672383X) and the Spanish version (ISBN 0966723821) can be ordered from
any bookstore, library, Amazon.com, and directly from the American
Institute for Cancer Research (AICR) by calling 1-800-843-8114 or going to
AICR's web site .
Discounts for orders of 10 or more copies are available for both editions
by calling AICR at 1-800-843-8114 - asking to speak to Candis Navarette.
Many cancer centers, health care professional offices, and places of
worship have ordered books in larger quantities to have available to give
as educational and support information or to resell.
Bookstores and libraries may order directly from the book wholesalers
Ingram or Baker & Taylor.
Personally autographed copies of A Dietitian's Cancer Story are now readily
available through Nicola's Books in Ann Arbor, Michigan. It's easy to order
the book directly from this full service independent bookstore at their web
site, http://www.nicolasbooks.com , which has a space to indicate how you
would like the book inscribed. They will happily mail the book anywhere in
the world.
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VIII - Newsletter forwarding guidelines
This e-mail newsletter may be reproduced, printed, or otherwise
redistributed as long as it is provided in full and without any
modification. Requests to do otherwise must be approved in writing by Diana
Dyer. Please email that request to Newsletter2@CancerRD.com with "Reprint
Request" in the subject line. Please tell me which section of my newsletter
you are requesting to reprint and where it will be published.
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IX - New subscriptions to this newsletter
You may have received this newsletter because a friend forwarded it to you.
If you wish to sign up for your own free subscription, please visit my web
site at http://www.CancerRD.com , click on Newsletter and follow the
directions. I aim to send the newsletter 4x/year. Be sure to add
CancerRDnewsletter@cancerrd.com to your list of accepted email addresses
(i.e., spam filter).
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X - Removal from future Email updates from Diana Dyer
I know that life changes with time. Thus, if you are not interested in
receiving future updates and announcements from me via Email or have other
subscription requests, please Email that information to
Newsletter2@CancerRD.com .
(Special Note - Please use this Email address only for subscription
information. I do not check it regularly, and thus any personal messages to
me may not be read or answered in a timely manner.)
Those who choose to remain on this list can be assured that I will never
share or sell your name or Email address to anyone.
Diana
--
Diana Grant Dyer, MS, RD - Author
A Dietitian's Cancer Story (English and Spanish translation)
Available from AICR (call 1-800-843-8114)
My Website: http://www.CancerRD.com
"Information and inspiration for cancer survivors"
Proceeds donated to the Diana Dyer Cancer Survivors'
Nutrition and Cancer Research Endowment at the
American Institute for Cancer Research (AICR)
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