The news comes in a phone call or an e-mail from your relative, friend or neighbor: They've been diagnosed with cancer.
What can you do? How about bringing over a meal?
Hold that thought. And don't hurry to the computer, because the information linking cancer and food isn't always reliable.
“The first thing people do is bring over the comfort food, and it's loaded with cheese and dairy, or it's cookies and cakes, and it's feel-good food, but it's detrimental to the recovery of the cancer patient,” says Cheryl Rojic, a holistic-health coach trained at Integrative Nutrition. She is also a survivor of breast and ovarian cancer and works with cancer patients.
“I think people panic. It's 'OMG, something's wrong, so let's feed them with comfort food.' Those foods can cause a happy reaction in the brain, but only for a short time. You can eat a couple spoonfuls of a cheesy casserole, and half an hour later, you're exhausted and depressed.”
Instead, Rojic suggests recipes that use fresh organic produce and raw foods: unroasted cashews, macadamia nuts or pumpkin seeds, which can be soaked in water and then blended into protein-rich purees and nut butters.
“Fresh, organic foods are usually the best — fresh berries, organic chicken, something like that, is better than the cheesy pile of pasta whatever,” she said.
Such foods also are full of healthier calories than casseroles and sweets. Lisa Wingrove, a clinical dietician at the University of Colorado Cancer Center, says breast cancer patients tend to gain weight, so she works hard to help them manage their weight by eating well and increasing exercise. (One of the best things you can do for a breast cancer patient is take her to a yoga class, or go for a walk with her, she added.)
Dieticians say well-meaning friends should ask their loved ones a few questions before heading for the kitchen.
• Has cancer altered your sense of taste? Appetite? Your sense of smell?
• Does your treatment program leave you with a sore mouth?
• Do sweet foods seem sweeter to you now?
• Do you find sour or spicy foods appealing?
• Do you prefer bland foods?
• What specific foods have you stopped eating?
• What kind of protein appeals to you now?
• Has your treatment program resulted in constipation or diarrhea? (Too much information, perhaps, but important in knowing which ingredients to use or avoid.)
Unless they've been a cancer patient or a caregiver, most people don't know that different kinds of cancer, and different cancer treatments, alter the way bodies process food.
“What we tend to find is that people, even before starting treatment, will have taste changes, because of changes in their hormones and the inflammation that occurs as part of your body's response to having cancer,” Wingrove says.
Boosting protein is important for cancer patients, the dietician says. When she meets with new patients to discuss nutrition plans, they often tell her that they've cut red meat from their diet.
“What are you replacing it with?” she will ask.
“Well, I'm not,” is the usual response.
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“A lot of people like carbohydrates and find them comforting, but there's no protein in that stuff,” Wingrove says.
“This is a disease that reduces the albumin (a simple form of protein found in blood serum) in your cells. If you're not eating protein, then pretty soon we've got a problem. Inflammation breaks down albumin, and cancer itself does too, so we need to work hard to maintain protein intake. And the proteins we've relied on all our lives, chicken or meat or fish, don't taste so good. Alternative proteins, like eggs, quinoa, legumes, beans and nut butters seem to be tolerated better,” Wingrove says.
“You need to eat protein to increase your albumin, and you're already competing against the disease breaking it down. Our biggest challenge is helping patients have good protein intake.”
Part of that challenge is that both cancer and cancer treatment may dramatically alter the way food smells and tastes.
“Some people will say that food tastes super-sweet to them, that foods they normally like — cookies, for example — are unpalatably sweet. They do better with sour flavors,” Wingrove says. “Another thing is smell. If you sit down to a pungent food, like lasagna, which is the ultimate comfort food that people bring over, you get that heavy aroma, and it makes patients feel a little queasy. Or it can make them feel like they've eaten a meal before they've even picked up a fork.”
And some people will feel like — how to put this tactfully? — that particular meal has already returned to say hello. Nausea can force a cancer patient to turn away from a five-star chef's greatest amuse-bouche.
“This usually is related to food hitting the taste and smell receptors before the fork even enters the mouth,” Wingrove says.
She recently saw a young breast-cancer patient who reported severe nausea, vomiting and diarrhea after her first round of chemo. The woman's doctor changed her treatment to reduce the nausea and vomiting, scheduled her to get extra fluids during infusion, and made an additional appointment for closer evaluation.
“I worked on foods to reduce diarrhea, and ways for her to use over-the-counter meds to help,” Wingrove says. Still, “some regimens are more nauseating than others,” she acknowledged. Dehydration makes nausea, pain and fatigue even worse.
Wingrove encourages those patients to try protein-enhanced smoothies and other beverages, and to request scheduled intravenous fluid intake twice a week.
She also says that room-temperature food, and “non-fragrant” foods, like mashed potato (or mashed taro, yuca root or steamed plaintain), may be better tolerated by patients prone to nausea.
When Rojic teaches “Healthful Habits” cooking and nutrition classes to cancer patients, she points out how the ingredients in her recipes address specific symptoms and needs.
For example, the cilantro in her gazpacho soup is a high-potassium and low-sodium herb that may help lower blood pressure. Tomatoes are full of lycopene, an antioxidant believed to prevent many cancers, and helps reduce cholesterol and minimizes heart disease. Cucumbers offer B vitamins and encourage hydration and detoxification.
But the best ingredient that friends and family can offer is their presence.
“People who bring over food tend to drop it off and go,” Rojic says.
“Maybe they're afraid to catch something, or worried that they'll say something wrong, or that you don't feel good. Company is what we crave. It's good for the soul.”
Recipe: Berry Blast Shake
Developed by Lisa Wingrove, serves 2.
- 1/2 cup uncooked rolled oats
- 1 tablespoon ground flaxseed
- 1 banana (for a thicker smoothie, use a frozen banana)
- 1 cup frozen berries (any type)
- 1 cup liquid (soy, almond, rice, soy or coconut milk, dairy milk, Ensure, Boost or generic version of Ensure or Boost)
Place ingredients in a blender, adding the fluid last. Blend to desired consistency. For a less-sweet version of this smoothie, use frozen or fresh cranberries instead of blueberries, raspberries or strawberries.
Recipe: Chipotle Gazpacho
Developed by Cheryl Rojic, serves 4 to 6.
- 2 large red bell peppers
- 1 clove garlic, peeled and trimmed
- 4 large ripe tomatoes, roughly chopped (about 1 1/2 pounds)
- 1 large cucumber, peeled, seeded and halved lengthwise
- 1/4 cup plus 3 tablespoons fresh cilantro
- 3 to 4 tablespoons fresh lime juice
- 2 to 3 teaspoons chipotle pepper in adobo (canned)
- 2 cups vegetable broth, divided
- Sea salt
- Freshly ground black pepper
- 1 large bunch green onions, thinly sliced
- 1 large avocado, peeled, pitted and chopped fine
- 3/4 cup jicama matchsticks (optional)
- Plain Greek yogurt for garnish (optional)
Roast the red bell peppers by broiling or grilling until the skins are blackened and easily peeled and seeded. With the motor of the blender or food processor running, drop in the garlic clove and process until minced. Roughly chop the tomatoes and the peeled, steamed peppers. Set aside. Roughly chop half the cucumber. Finely chop the other half.
In the food processor with the minced garlic, add the roughly chopped cucumber, tomatoes, 1/4 cup of cilantro, lime juice, chipotle and 1 cup of broth. Process until smooth.
Empty the mixture into a bowl. Stir in the finely chopped cucumber and remaining broth. Season to taste with sea salt and pepper. Cover and chill for at least 2 hours.
Just before serving, combine the green onion, avocado and jicama. Stir half of this mixture into the soup. Offer remaining onion mixture and Greek yogurt as a topping.