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Where can I find a dietitian who works with cancer patients?
Hi, I am a dietetic intern at the Albert Einstein Medical Center. I am in the process of developing a recipe booklet containing increased calories and protein foods for people with cancer. I found a recipe for a milkshake using Eggbeaters for added nutrition. Do you know if it is safe for these patients to be eating raw Eggbeaters even if they are pasteurized? Thanks for your help!
If Eggbeater's package says the raw egg whites are pasteurized, they should be safe except for very immune deficient patients. Interestingly you chose Eggbeaters since they contain egg whites where most of the protein in egg is located. Egg yolks are mostly fat on the other hand. I have always liked adding pasteurized eggs to malts and milkshakes for patients to give them the extra protein. You can't taste the raw egg either.
To my knowledge the doctors did not shunt the albumin into the stomach. His abdomen was not distended and he was able to loose quite a bit of fluid weight. He would never have been able to have the surgery had he not gotten rid of that fluid.
It was my understanding that the albumin was necessary in order for the diuretic to be effective, in that protein has to be present for the diuretic to work. Do I have that straight?
I think what I am going to do is get my husband to ask for a referral to MDA (MD Anderson Hospital) from Sloan Kettering so that he can have his bi-yearly check-ups there and a dietitian consult also. Once he is a year or so post-op I think that will be fine with them. For the meantime, he is this surgeons "trophy" as he told us and he wants to keep up with his progress personally. He presented his case at a seminar in England. Of course, I don't believe he will be sending my husband any round-trip tickets to New York for this pleasure! I want my husband to be religious about his checkups, as he was not before.
I don't believe I mentioned that 7 years ago he had his first round of sarcoma and had a pelvic exenteration at MDA in which he sacrificed his bladder and prostate as well as other things involved in a pelvic clean-out. As you can see, he has been thorough the wringer.
Thanks again, I will let you know what we do and what happens with the MRI.
Even if you continue with doctor at Sloan Kettering (SKM), ask for a nutrition consult from a dietitian at MD Anderson which can be provided locally and follow the orders of SKM doctor. They can work together. Nutrition support has a BIG impact on healing and survival rates as well as quality of life.
FYI readers, sarcoma is a tumor that grows through connective tissue (muscles, ligaments, tissue) which you have all over your body. Pelvic exenteration is removal of all organs in the pelvic area including male and female reproductive organs, anus, rectum, sigmoid colon and bladder are removed usually due to cancer. When the rectum is removed, an colostomy bag is used to collect feces and an external bladder is used to collect urine.
Sure appreciate the quick reply! MC disease is minimal change disease of the kidneys. His kidneys or the lining of them, I can't remember, were affected by the tumor's presence.
His body weight was up 40 pounds by the time we got to Memorial Sloan Kettering (MSK) Cancer Center. A surgery had been attempted at another hospital and failed. Two months later he was admitted at MSK and spent 4 weeks on albumin IV's with lots of diuretics to get the fluid off so that he would be a safe surgery candidate. His liver has now grown back to almost its full size. So that is a good sign.
I would love for him to have a dietary consult when he goes back, but don't know when that will be. We live in central Texas and he now sees a nephrologist about every month or so. I just don't want him to go backwards and he is frustrated with the whole thing. Thought maybe if he had a dietary plan he would feel involved in his healing which he needs to do. I will let you know. Maybe we can get a consult by mail from MSK when he mails his latest MRI to them this week. Thanks!
Since you are in Texas, contact the nutrition support service at MD Anderson so they can give you and your husband the best local advice. MD Anderson is among the best cancer treatment centers in the U.S and they can collaborate with your husband's doctor at Sloan Kettering. MD Anderson can talk to his doctor at Sloan Kettering for coordinated care as long as your husband gives permission (HIPPA privacy laws in the U.S.). Your husband's nutritional status is complex and I would recommend working with a nutrition support dietitian rather than with a general practitioner.
His abdomen must have been very distended from albumin prior to surgery. Did doctors re-route (shunt) the albumin in his abdomen into his stomach to recycle it back into his body besides giving him IV albumin?
The liver is the most amazing and hard working organ in the body as it does so much besides its ability to regenerate. If he is having MRIs of his liver, the scans must amaze you to see it growing back.
Hey if your husband is getting frustrated it may mean he is getting better. Usually when patients complain about the food it's a good sign that they are getting better. Your husband should be involved in his care as he can take better care of himself than another person because he knows how he feels. Give him an active role based on his available choices within his prescribed nutrition therapy. Do make an appointment to see a dietitian at MD Anderson.
My husband had cancer surgery at Sloan Kettering Hospital. An 8 pound tumor (sarcoma) and 3/4 of his liver were removed at that time. He is doing reasonably well considering the cancer seriously affected his kidneys. He has MC Disease and takes prednisone and Demadex to help this. He has a big problem with fluid retention and is on a 2 gram sodium diet.
His cholesterol is over 300 and he only retains 20 to 30% of his albumin and protein from the things he eats. He is 54 years old and otherwise in good health, at 185 pounds. He was in the hospital for 7 weeks, but had only one very short visit with a dietitian in all that time.
He will eat anything, but does not have a specific diet to follow. His energy level is low and I am worried about the cholesterol, but the doctor does not seem to be. Thank you for advising us.
He needs to eat protein to refuel his albumin which has a half life of about 3 weeks. (In 3 weeks, half a person's albumin in their blood would need to be replaced by their body.) Your husband's need to replenish his albumin is accelerated because his remaining 1/4 liver is trying to do the work of a whole liver and you indicated he had kidney problems. Albumin is returned to the blood by the liver and is retained in the blood by the kidneys. When the liver fails (cirrhosis) or in his case is surgically removed, not all the albumin is returned to the blood and ends up floating around the abdomen. When the kidneys are not working, they leak proteins into the urine. Also, his fluid problem is related to his low albumin because protein is a large molecule and exerts a big influence on fluid being retained in the blood. If blood albumin levels are low, fluid leaks out of the circulatory system into surround tissue. He is experiencing a chain reaction as a result the necessary removal of almost all his liver.
The sodium restriction is probably tied prednisone medication. Prednisone causes fluid retention mostly in the upper torso and face.
He needs to eat and maintain his immunity. Unfortunately when people get cancer, they think "Now I am going to eat healthy" and start eating only low fat or low calorie foods. Quite the opposite is true in that they need sufficient calories to maintain their weight and immune system which is needed to fight cancer. Fat is a good carrier of calories, but when the liver is involved, sometimes fat is kept at healthy amounts of 30% of total calories.
Your husband has been through a lot and of course his energy level is low. He needs rest while his body recovers. His liver can grow back and hopefully he is on the road to recovery.
How was his kidney's affected? Demadex is a diuretic which should help handle some of the fluid retention along with the sodium restricted nutrition therapy.
Considering his complex nutritional needs, I would highly recommend that he make an appointment to see a dietitian at Sloan Kettering (one of the best cancer centers in the world). Unfortunately, patients are discharged more quickly and are sicker when discharged. A dietitian can be called in to see a patient during hospitalization or prior to discharge. Even if your insurance doesn't cover a dietitian's services, it will be money well spent in nutritionally guiding you and your husband during recovery as the hospital dietitian could look at your husband's medical chart which I cannot. He may need liquid meal supplements between meals to keep up with his nutrient and calorie needs.
Sloan Kettering probably has a nutritional support service (team of doctors, nurses and dietitians) that can assess your husband's nutritional status with some physical measurements and periodic blood tests. I was on such a nutritional support service when I worked in a regional hospital. It's impressive what can be done with food, liquid supplements, tube feedings and even IVs short term to provide adequate nutrition and prevent weight loss during recovery.
I stumbled upon your web page looking for some answers for my daughter on her 4 year old girl about ADHD (attention deficit hyperactivity disorder), triglycerides and iron deficiencies. Your articles are very helpful and very detailed.
I've put you in my bookmarks to look up other things as I'm a cancer patient with many years of reoccurrence of breast cancer. I'm still hanging in there and have just recently had to retire because of my health. My quest at this time is to stay in remission and find out how to do that. Your suggestions on cancer are wonderful and I intend to follow your advice. Thank You so very much for all of your information.
Thanks a lot. It is good to hear from you. What spirit you have and with it, I also hope you achieve your quest.
Consider soy foods, especially soy milk and tofu. They contain phytoestrogens which seem to help some breast cancers. First ask your doctor whether your cancer was estrogen driven though as soy may be not recommended. You don't need a lot per day; 4 ounces of soy milk or tofu seem to do the trick. Check out the vegetarian dietitians website.
Otherwise, a healthy eating plan using low fat foods from the My Plate, less than 30% of your calories from fat, 30 minutes of daily exercise and a positive attitude should keep you on the right track.
My father has pancreatic cancer and someone sent me an e-mail saying that vitamin B17 is the cure for cancer, but that the FDA has banned this. Do you know anything about this? Would you please help me?
Or try to send me in the right direction? Thank you in advance for anything you might be able to offer.
I would encourage your dad talk to a registered dietitian who can review his chart and make specific recommendations for pancreatic cancer. Generally, persons with pancreatic cancer need to limit fat and moderate protein as your pancreas makes enzymes that are used in the digestion of these nutrients. It is very important that your dad snack frequently to maintain his weight especially if he is having radiation or chemotherapy.
Unfortunately when people are diagnosed with cancer, they often decide to start eating healthy by cutting out a lot of foods and end up losing weight which is not recommended even for overweight people with cancer. You can best help your immune system by maintaining your weight and eating a variety of foods as long as they are tolerated.
Many thanks for replying so promptly to my enquiry. I have been in contact with a nutrition consultant who is Dip ION MNCA qualified. He has recommended that I eliminate the following things from my diet: tea, coffee, sugar, salt, alcohol and dairy products. I am aware of maintaining a healthy balanced diet.
The supplements I am taking are produced by BioCare and are as follows:
I am confused by two apparently conflicting opinions:
I do not know what a Dip ION MNCA qualified nutrition consultant is as we don't have them in the US where almost all states license who can call themselves a nutritionist. So check the educational credentials of this nutrition consultant yourself and with your doctor. There are registered dietitians in the United Kingdom and you can contact the British Dietetic Association to find a registered dietitian near you.
I checked BioCare's United Kingdom website for information on their supplements. Unfortunately they don't provide nutrient or ingredient information about their supplements online so I can't tell what or how much of any nutrient or herbal is in these supplements. It doesn't appear that BioCare makes Buccalzyme.
The supplement bottle label reflects what is in the bottle which is required in the US by the 1994 Supplement Act. Bring your vitamin and herbal supplement bottles to your next doctor's appointment.
Efamast is gamma linolenic acid, a fatty acid available in the oils from the seeds of evening primrose, borage and blackcurrant. Don't know if this interferes with any medications your doctor prescribed so bring this bottle with to the next cancer doctor's appointment.
I don't see any reason with your history of breast cancer to eliminate salt or dairy products. If you are vomiting due to chemotherapy or radiation, you will be losing salt and will need to make sure you replenish with salt in the foods you eat. Dairy products are an excellent source of calcium and vitamin D. As to whether you eliminate coffee, tea or sugar that is up to you. Alcohol intake would be at your discretion and no more than 1 alcoholic beverage per day would be advised.
Regarding the frequency of getting colds, certain populations have more frequent colds. Infants, the elderly, people with asthma or chronic obstructive pulmonary disease (COPD) or are immunosuppressed like with AIDS would be at higher risk. Unfortunately there are no antiviral drugs that are effective against the common cold. Talk to your doctor about your frequency of colds and your immune system.
I have recently had breast cancer treated with surgery, radiation and now with vitamin and herbal supplements to strengthen my immune system. I have been told that not having colds could be a sign of a weakened immune system. I have had about two colds in the last five years. If this is true, how does the cold virus affect the body if it is not manifested as a cold?
I am puzzled; I would have thought the absence of colds suggested a strong immune system. I look forward to your reply. With thanks.
I would suggest you discuss the relationship between the cold virus, frequency of colds and your immune system with your doctor. Talk to your doctor about vitamin supplements are you taking. Your T-cells and total lymphocyte count best reflect your immune system capability. Have you asked your doctor to assess your immune system before you started trying to strengthen it?
My mother has recently been diagnosed with stage 0 leukemia. The doctors say that there is no treatment done at such a stage, but my sister and I are curious. We both believe that diet can have a positive impact on the growth / development / prevention of cancer. We would like to know the following:
It is true that what you eat or don't eat plays a big role in most cancers as does your heredity, lifestyle and environment. However, with leukemia, what you eat has not been shown to be a factor except in childhood leukemia. One study found that children who eat oranges, orange juice and bananas in the first two years of life have a 50% reduction in the incidence of childhood leukemia between the ages of 2 and 14. The consumption of fruits and fruit juices high in vitamin C and / or potassium may reduce the risk of childhood leukemia. They did not find an association between the consumption of hot dogs or lunchmeats on the incidence of childhood leukemia.
A healthy eating plan with enough vitamins and minerals to meet your mom's Recommended Dietary Allowance is recommended. She should eat a wide variety of foods including fresh and frozen. See the My Plate for more information about recommended number of servings per day for a healthy eating plan. Weight loss at this time would not be recommended and it may negatively impact your mom's immune system.
There is some promising research about low fat vegetarian eating plans that include soybean foods such as soy milk, tofu and other soybean based products. Soy is not specifically recommended for leukemia and is contraindicated in estrogen dependent breast cancers. For information about the food and physical activity cancer connection read this by the American Cancer Society.
It is becoming widely known that yellow and green vegetables and cruciferous veggies contain a number of compounds (such as beta carotene which helps protect from cancers of the aerodigestive tract or chlorophyll which helps protect from cancers that can develop from eating red meats on a frequent basis) that help protect against cancer. Carrots, cauliflower, broccoli, cabbage, Brussels sprouts are a few that belong to these families. I would like to know if other vegetables that haven't gotten as much publicity also contain anti-cancer compounds?
A few such veggies that I'd like to know more about in this regard include: turnips, radishes, corn and potatoes. Thanks for any advice you may have on this matter.
Here is information about the beta carotene and vitamin A content of the vegetables you wanted to know more about:
(A side note, Irish people cook potatoes with cabbage which contains beta carotene (36 mcg) and Vitamin A (60 IU) in a recipe called Colcannon.)
Recent research on anti-oxidant vitamins and minerals (beta carotene, vitamin E and C and selenium) supports their cancer preventative properties of scavenging free radicals in the body. Free radicals are highly associated with tumor formation. Non-smokers especially benefit from including foods with these nutrients (especially vitamin C) in their eating plan. One exception is a study in Finland that showed smokers who took beta carotene supplements actually increased their risk of lung cancer. We don't recommend beta carotene supplements above the RDA (Recommended Dietary Allowances) for people who smoke.
By aerodigestive tract do you mean your mouth, tonsils, nose and larynx or are you also including your esophagus? It is true that the cells that line your mouth, nose and throat are protected by anti-oxidants. The cells that line your gastrointestinal tract, respiratory tract and skin cells are epithelial cells and benefit from anti-oxidant vitamins and minerals.
At the present, there is no research evidence showing chlorophyll as having anti-cancer properties. To my knowledge, there are no nutrient databases that contain chlorophyll nutrient data so how would you identify and quantify foods with chlorophyll other than assuming green foods have chlorophyll which could be an erroneous assumption? In addition, there is no RDA (Recommended Dietary Allowances) for chlorophyll.
Most of the evidence against red meats has been to the fat content. High fat foods are a risk factor for developing cancer. Lean red meat is the best source of iron and Vitamin B12.
There are lots of other foods high in beta carotene like pumpkin, sweet potatoes (but not yams), greens (dandelion, spinach, etc.) and cantaloupe.
Last year, I had surgery for cancer of the throat. My surgery has healed and I've completed a series of radiation treatments.
Since then I have had a very dry "cotton-ball" taste in my mouth that I don't seem to get rid of. Can you suggest some foods that are moist or a diet that would help me?
Any food that has a lot of water in it (beverages, vegetables or fruits) will only provide temporary relief. Either surgery or radiation may be the cause your problem.
First, your surgeon may have had to remove your salivary glands around the base of your mouth. Or second, if they were not removed, your ability to produce saliva may have been destroyed during your radiation treatments, which were necessary to kill any remaining cancer cells.
Patricia Sander, Clinical Instructor with the School of Dental Hygiene at the University of Minnesota used a formula for "Artificial Saliva". Your pharmacist can inexpensively mix it as follows:
Commercially prepared formulas of artificial saliva are now available. Ask your pharmacist to recommend one for you to try.
Your mouth will feel soothed compared to the burning irritation you probably now experience. I have used artificial saliva with patients and they found it to be effective. You will find as time goes on you will only need two drops, three or four times per day.
Also be sure to brush your teeth, gums and tongue frequently during the day. Your taste will be affected by an unbrushed mouth. Visit your dentist regularly as saliva helps prevent dental decay and if you have reduced amounts of saliva, you may experience more cavities than usual.
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