Nutrition Choices

Nutrition Choices for
Breast Cancers



A talk originally given to a Breast Cancer Support Group at UCLA

Diet and Cancer Overview

    The recognized association between and cancer has been acknowledged by the American Cancer Society and the National Cancer Institute. It is estimated that at least 35% of all cancers related to diet; in women this rises to at least 50%. In a similar manner to the link between tobacco and lung cancer, the association is seen most clearly by studying large groups of people, their dietary habits and the incidence of certain cancers. When these groups are studied more closely, the following examples of nutrients from food and the incidence of cancer can be noted. Lung cancer patients eat fewer fruits and vegetables and hence have lower serum levels of beta carotene and other botanical factors. Other key nutrients that are lower in the diet of people eating less than five servings of fruits and vegetables each day include folic acid (also called folate from folio the Latin word for leaf) and Vitamin C. Lung cancer is estimated by the American Cancer Society to become the number one killer of women, beating out heart disease by the year 2000 unless there is significant drop in cigarette smoking particularly among young women. Other cancers associated with diet include breast, colorectal, pancreatic, stomach, esophageal and uterine cancers. Some researchers estimate that when lifestyle is included, the association between diet and cancer rises to as high as 80%. On a more positive note, eating in a more vegetarian manner is consistently associated with a lower risk among all populations.

    Breast Cancer and Diet

    Population studies suggest there is a positive association between a diet high saturated fat and animal protein - which is by definition one low in dietary fiber or roughage. Dietary fiber is only found in foods from the plant kingdom so the more foods such as meat, cheese, milk and eggs are eaten, the fewer fruits, vegetables, grains and beans are consumed. This means that the typical American diet of fast food hamburgers with fries, pizza and turkey sandwiches has very little dietary fiber and is associated with a relatively high incidence of breast cancer. Japanese women have about half the incidence of breast cancer compared with American women but when Japanese women move to the United States and adopt a different diet they begin to get breast cancer as often as women born here.

    Soy and Breast Cancer

    Recently many researchers have been looking at the different elements of a Japanese diet that is higher in foods made from soy beans. Soy is the main source of protein for many Asian women and is a source of various phyto (from the Greek for plant) chemicals in the legume. Genistein, daidzein and the Bowman-Birk inhibitor are three examples of phytochemicals or isoflavones in soy that appear to have anti- breast cancer activity. Genistein is a plant estrogen (phytoestrogen) that binds to breast cell surface receptors that might normally bind the natural hormone circulating in women called estradiol. It has been known for a long time that breast cancer is related to the amount of exposure to estradiol over a woman¹s lifetime. For instance, a woman who has her first period late, has many children and has an early menopause is at a lower risk that a woman who has estradiol circulating in her body more often. Genistein and daidzein also act within the cells to change the activity of certain protein kinases, enzymes that regulate activity within the cells. There may be other mechanisms by which soy isoflavones are protective and researchers are actively investigating soy to see if it is protective against breast cancer.

    Diet and the Breast Cancer Patient

    How can eating tofu or soy protein in the form of a meal replacement soy protein powder make any difference if you have already been diagnosed with breast cancer? Nutrients that protect a woman from breast cancer are just the same as those that protect her from metastasis or spreading of the original tumor. It is particularly important for a woman who has been diagnosed with cancer to eat as many of the protective botanical factors as she can. A plant cannot move away from danger so it relies on powerful chemicals to protect it, chemicals that we can consume and use to protect our own cells from damage to the DNA or cellular information that tells cells when to die and when to continue to grow. Cancer cells typically do not die (apoptosis) and are immortal, dividing and continuing to grow unchecked. Fresh fruits and vegetables are Nature¹s defenders.

    How can I protect my Family?

    New genetic tests may be able to identify those who are at an increased risk for developing breast cancer but we do not yet know how environmental factors such as diet, exercise and tobacco use interact with these genes. It is wise to assume that a healthy diet rich in fruits, vegetables, whole grains, soy and other legumes would be more protective than one that focuses more on animal protein foods such as full fat milk and dairy products, meat and eggs. Exercise is important also as it affects the food choices we make, our metabolism and our general sense of well-being. Tobacco use has already been shown to be a major factor in the development of many cancers in part due to the unregulated amount of pesticides and insecticides sprayed on the leaves. It is prudent to avoid tobacco at all costs. Alcohol intake should also be moderate (1 glass wine per day maximum for women) as this may increase the risk of breast cancer.

    Recommended Supplements For Breast Cancer Patients

    Depending upon the chemotherapy regimen certain important protective botanical factors may be helpful as supplements. Examples include Vitamins C and E (alpha and gamma-pherols) and the antioxidant bioflavonoids (colored botanical factors) such as beta carotene, xanthophylls and ellagic acid. All of these can be consumed by selecting at least ten servings of fruits and vegetables each day. For many people this may be an unrealistic amount so supplements are available. Typical quantities would be 500 milligrams of Vitamin C as Ester-C with bioflavonoids and 2000 milligrams of Vitamin C as ascorbic acid. 400 International Units of Vitamin E as mixed tocopherols.

    Soy protein may be beneficial but the amount required is still controversial. Many legumes may also contain protective phytochemicals and it would be prudent to include many beans of various types in your diet. Black beans, garbanzo beans, red kidney beans, black eyed peas are just some examples of healthy, dietary fiber rich, folate rich sources of plant protein. Eat them often using an enzyme product such as Beano to minimize gas discomfort.

    Most multivitamin and mineral supplements that provide RDA quantities and include antioxidants (typical brands from most pharmacies and good health food stores) are sufficient for most individuals who eat at least five servings of fruits and vegetables and at least six servings of grains or beans

    Coenzyme Q10 is an important part of the release of energy within each cell. This can be lowered as a result of extreme stress such as surgery, chemotherapy or a diagnosis of cancer itself. Supplements of 60-120 milligrams per day of Coenzyme Q10 can be beneficial to breast cancer patients undergoing treatment and is safe at these dosages.

    Selenium is a trace element (one required at quantities of less than one milligram per day) that is important in the regulation of detoxification enzyme activity in the liver and other cells of the body. Supplements of 50-200 micrograms per day can prevent any potential deficiencies that may occur with certain chemotherapy agents. Most multivitamin and mineral products contain sufficient selenium for breast cancer patients without an additional supplement except during chemotherapy itself when it may be prudent to increase the quantity by taking an antioxidant formula that contains an additional 50 micrograms selenium.

    Sulfur amino acids are important in the detoxification process necessary for the liver to remove any chemotherapy agents. We recommend taking an additional antioxidant formula during this time that contains N-acetyl cysteine, the active form of the detoxifying enzyme system known as the cytochrome P450 system. Supplement with 150 milligrams daily. Silymarin (milk thistle) is a valuable herb that is supportive to this liver detoxification process. We recommend taking this during chemotherapy and for at least twenty-one days afterwards.

    Vitamin D3 may also be protective and as it is formed from the action of sunlight on the skin, be sure to go outside at least twenty minutes each day particularly in the early morning or late afternoon when the sun is not as burning. Always protect delicate areas such as the face but allow some action of the sunlight on your arms and legs. A good women¹s formula to protect from osteoporosis should also contain this important vitamin. Oily fish is a good dietary source and we recommend eating oily fish (salmon, trout, tuna, halibut, herring, etc.) at least three times each week. Fish is an excellent source of omega-3 fatty acids that are also beneficial to breast cancer patients as they are anti-inflammatory and supportive to a healthy immune system. For those who don't like fish you can take a supplement of flaxseed oil, borage(starflower) oil, or evening primrose oil. These also contain long chain fatty acids called GLA (gamma linolenic acid) that may assist in regulating female sex hormone levels in the blood.

    Supplement Summary

    • RDA level multivitamin and mineral daily supplement.
    • Antioxidant formula to contain phytonutrients and sulfur amino acids (N-acetyl cysteine or taurine) and selenium.
    • Silymarin (milk thistle) to assist liver detoxification enzymes
    • Other supplements as directed by physician or qualified nutritionist. (The American Dietetic Association and Certification Board of Nutrition Specialists are good resources for nutritionists)

    Remember to drink at least 1 liter (32 fluid ounces) of water each day (non-caffeinated beverages may also make up this quantity of fluid).

    The Last Word

    Have your diet evaluated to ensure that you are getting sufficient of the protective nutrients to support your medical treatment for breast cancer. Your body will thank you!

    More information on optimizing nutrition during cancer treatments can be found in
    The Cancer Nutrition Handbook, covering recommended supplements and more...