Donivan Bessinger, MD
Very often patients ask me about the place of nutrition in preventing and treating breast cancer. That question is a very big challenge! Diet is a very personal aspect of lifestyle, and all of us have different preferences. The large number of claims made in the popular press for various foods and supplements makes it hard for you to know what is sound health advice and what is not. However, it is also hard for physicians to write a specific diet "prescription" when so much of the available scientific information about nutrition and cancer is indirect. Most of it is not as convincing as the information which guides us when we recommend medications and procedures. But even though are many unsettled questions, I believe that there are reasonable arguments behind this general advice about nutrition and breast cancer.
Treatment
All of the principles of good nutrition become especially important during treatment for breast cancer. You help promote wound healing and recovery of energy levels after surgery, chemotherapy, and radiation by maintaining adequate calories from all of the food groups ("pyramid"). There must be a balance between protein and complex carbohydrates. Intake of saturated fats and refined sugars should be kept low. A "therapeutic" capsule to supplement vitamins and minerals is a good idea. This is not a time for strict reducing diets, though it is important to avoid any further weight gain.
It should also be said that nutritional measures alone cannot provide adequate treatment for breast cancer. Even so, good nutrition is an important part of recovering from breast cancer treatment.
Prevention
We have to be careful with the word prevention. The risk of breast cancer cannot be reduced to zero. However, nutritional measures do help reduce the risk of first-time and recurrent breast cancer. How much can we reduce it? Frankly, we just don't know.
Dr. Mitchell Gaynor, in Dr. Gaynor's Cancer Prevention Program (1999), takes a very enthusiastic attitude toward diet for "prevention." While I do not endorse everything he says, I think he gives a helpful and well-researched presentation of the arguments for adjusting diet (before and after breast cancer) toward including more cruciferous vegetables and tomatoes; sources of vitamins A, C, and E; soy products; olive oil, and fish. And especially to be avoided are alcohol and sources of saturated fat.
The theory of diet for cancer risk reduction emphasizes several principles:
Phytonutrients (nutrients from plants), especially those organically grown, are less likely to contain cancer-inducing chemicals.
The immune system can be influenced by many nutritional products. Adequate levels of vitamins A, C, E, folic acid, and the B group; and of selenium, zinc, and other minerals are especially important.
Antioxidants (such as vitamins A and E; and glutathione) scour away waste products of metabolism called "free radicals," which cause various types of cell damage. (Olestra fat substitute blocks absorption of vitamins A & E.)
Cruciferous vegetables (broccoli, cauliflower, cabbage, etc.) contain certain indoles which have a cancer-protective effect.
Omega-3 fatty acids (from cold-water fish such as salmon, halibut, tuna) are higher in populations who have a lower incidence of breast cancer.
Soy products (except soy sauce) contain estrogen-like substances which may act somewhat like the preventive drug tamoxifen, keeping more active forms of estrogen from stimulating breast cells. Also they have substances which slow growth of the new blood vessels needed to form tumors.
This is only a quick overview. It is just not
practical to have a diet which includes all suggested foods and
supplements thought to have anti-cancer activity, and all of this must be kept
in perspective. Be sure also
to keep in mind the importance of exercise, stress- reduction, and your
psychological and spiritual health
as you face breast cancer questions.
Uploaded 16 April 1999