Cancer patients have special nutrition needs and issues related to eating. Good nutrition is important at every stage of cancer treatment. Understand this aspect of nutrition during cancer can help you to cope better during the cancer treatment.

Ms Chang Yok Ying, Pharmacy Practice Manager from Outpatient Pharmacy at National Cancer Centre Singapore, gives detailed answers to your questions.

Question by john

I was recommended manuka honey for the dry throat during NPC treatment. Recently, someone told me that Jarrah honey is equally good. Is this true?

What is a 'good diet' for someone currently undergoing both chemo and radiotherapy for cancer treatment.

I was also told never to eat grilled and barbecued food again, because it is carcinogenic. Pls verify. Any other foods that should be avoided?

When my uncle had cancer many years ago, someone told him to eat asparagus and bitter gourd everyday, which he more or less did. Are these especially good for preventing relapse?

Sorry to ask so many questions- would really like to know all this once and for all.

Thanks very very much

Answered by Ms. Chang Yok Ying, Pharmacist from National Cancer Centre Singapore

Honey has antibacterial and antifungal activity which may help in preventing infection. The high osmolality, low pH and hydrogen peroxide in honey contribute to this antibacterial property. The difference between Manuka and Jarah honey lies in the types of flowers from which the bee obtains nectar to make honey. You may try both types to see which is more helpful. Do not take honey in excessive amount due to the sugar content, especially if patient is a diabetic.

A ‘good’ diet would be one that is balanced i.e. contains a good mix and vegetables and meat, avoiding extremely sweet, salty and oily foods. Preferred cooking methods would be steaming ,boiling and stir frying rather than deep frying, grilling, baking.

Subjecting animal protein to high heat during deep frying, grilling, barbequeing, baking, will create heterocyclic amines which is carcinogenic. Minimize eating this foods but allow patient to try a little to ensure enough food intake as his/her taste and smell functions are altered, leading to reduced appetite. Do not be too stringent on food choice during cancer therapies.

Asparagus: In Chinese medicines, asparagus is used orally as a laxative, to treat neuritis ,parasitic diseases and cancer. Fibres from the plant have mutagen-absorbing (cancer-preventing) activity. There is insufficient reliable information about the effectiveness of asparagus.

Bitter gourd: Bitter melon can lower blood glucose levels. There is insufficient information about the anti-cancer property of bitter gourd. However, some studies suggest that people who take a lot of sweet things have higher cancer risks for all cancer types.

The glucose-lowering property of bitter gourd may help in lowering cancer risks.There is insufficient reliable information about the effectiveness of bitter gourd.

Question by rachel

Are there really any 'superfoods' that one should take to cut your risk of cancer? I have heard of veges like brocolli, cauliflowers, etc, and some fruits too. What are they and how do they work? Do they really work? Are they equally good for preventing relapse?

Also, is it true that eating preserved food like sausages, kiam chye, pickles and century egg increases your cancer risk?

Is it okay to use the toaster oven to grill food, or is that also considered not ideal? What about the microwave oven? I know of someone who had cancer, and now never uses the microwave oven for fear of radiation. How true is this?

thanks

Answered by Ms. Chang Yok Ying, Pharmacist from National Cancer Centre Singapore

1. The American institute for cancer research and World cancer research fund have jointly published a report on ‘Food , Nutrition, Physical activity , and the Prevention of cancer’ in 2007. This is an evidence based report on the effect of food on cancer risks.​

Foods that reduce cancer risks are also known to reduce the risk of relapse. Foods that cut cancer risk include a Plant based diet, less red meat, less oil, sugar and salt.

Cruciferous vegetables like broccoli, cauliflowers and cabbage contain plant chemicals that can convert bad estrogens to good estrogens and hence reduce cancer risk.

2. Yes, this is due to the presence of food preservatives like nitrites, which are carcinogenic.
3. ​When animal protein in foods is subjected to high temperature like grilling, baking, barbequeing, deep frying and broiling, heterocyclic amines are generated and these are known to cause cancer.

Question by sieweng55

Hi Ms Chang

We know that a healthy diet is very significant for someone undergoing treatment for cancer and it is a time when there is much demand on the body.

1. So, What are the main nutritional goals for someone living with cancer?
2. What's good to eat during the treatment of chemotherapy and radiation?

Thanks

Answered by Ms. Chang Yok Ying, Pharmacist from National Cancer Centre Singapore

1. It is important for someone undergoing cancer therapy to eat well to maintain good levels of platelets, neutrophils, albumin in the blood in order to receive therapy with minimal breaks. Nausea and changes in taste and smell often happen and cause patients to lose appetite.

Hence the strategy to adopt while patients are on cancer therapy is to serve him his favourite foods without much fuss on fine aspects of ‘healthy diet’. However, it will be good to exercise some restraints on the use of salt, sugar and oil in food preparation.

2. Preferred cooking methods would be steaming, boiling , light stir-frying instead of grilling, broiling and barbequeing. Avoid preserved foods.

Question by Dion

My dad is 68 yrs old n doctor confirmed 90% cancer in pancreas in 4th stage yesterday. Doctor have yet to get tissues @ liver for testing.

I browse thru the website http://www.nutrimaxorganic.com/health_topics/raw_potato_juice.html on benefits of drinking raw potato juice for cancer patients. Please advice is it really true?

Answered by Ms. Chang Yok Ying, Pharmacist from National Cancer Centre Singapore

Orally, raw potato juice is used for gastritis and stomach disorders. There are no evidence-based data on the effect of raw potato juice on cancer

Question by Semaj

I'm a 3+ year survivor. I was advised to take 2 capsules of lingzhi twice a day as anti-oxidant and build up immunity to prevent cancer. Recently a cancer patient advised me not to take lingzhi as it can also cause cancer cells to grow. I'm now very confused.

Answered by Ms. Chang Yok Ying, Pharmacist from National Cancer Centre Singapore

The main biologic compounds in lingzhi, beta-D-glucan and triterpenes, have demonstrated antitumour and immunostimulating activities.

For cancer survivors who have completed all cancer treatment, lingzhi could be a useful supplement.

However, Lingzhi may increase the risk of bleeding in patients undergoing cancer therapy.

So far, there are no published reports stating that lingzhi cures cancer.

Question by majid@sanicarehygiene.com

I have been recently diagnosed to have Protrate Cancer, which has extended to nearby lymph nodes. I am currently undergoing hormone treatment (Zoladex injections every 3 months) as well as Comotheraphy for 8 weeks (currently in 2nd week of treatment). What advice can you give me on the suitable diet and nutrition that I need to consume that will help me in overcoming my current cancer situation?

Answered by Ms. Chang Yok Ying, Pharmacist from National Cancer Centre Singapore

There are many studies on the effect of food and food supplements on the prevention of prostate cancer. However, for prostate cancer patients undergoing cancer therapy, it is not advisable to consume these supplements in big amounts as most are anti-oxidant in nature.

Some foods that are beneficiary for prostate cancer patients undergoing therapy are:

• Tomato concentrates (tomato puree)
• Tomatoes - Brightly pigmented vegetables
• Parsley
• Fish
• Green tea
• Soy foods

During cancer therapy, the patient should eat well to maintain a healthy blood profile. i.e. good levels of platelets, albumin, neutrophils etc and should not be too stringent on the types of foods consumed.

Question by lee

I have had 2 of my siblings - 1 brother and 1 sister get different kinds of cancer - nose and stomach cancer respectively. But my parents did not have cancer. I wonder if it was because of our diet and lifestyle when we were growing up? We were from a poor family and ate a lot of preserved canned food with plain rice. What can I do to prevent myself from getting cancer too? I am quite scared, actually....

Answered by Ms. Chang Yok Ying, Pharmacist from National Cancer Centre Singapore

Cancer is a multi-factorial disease with factors that include genetic predisposition, lifestyle factors, environmental factors, all affecting the risk.

Up to 40% of cancers can be prevented by eating a healthy diet, physical activities and maintaining a healthy body weight. Up to 20% can be prevented by eating vegetables and fruits.

The American Cancer Society recommends the following cancer preventive measures:

1. a plant-based diet, at least 5 servings of fruits and vegetables a day,
2. whole meal foods, less red meat, less fats especially from animals
3. less alcohol
4. be active 30min a day for most days of the week;
5. maintaining an ideal body weight
6. Avoid preserved foods with preservatives, cured meats like bacon, ham, sausages

The main causes of cancer are lifestyle, diet and environmental factors. Being aware of these factors and avoiding them would help bring down cancer risk.

Question by chanyacheng

Hi Ms Chang

My dad has just been diagnosed with advanced liver cancer with max 6 months to live. He also has diabetes and is 72 years old.

I heard that a natural diet with lots of veggies and fruit juices such as carrots, apples and soursop are good for cancer patients. Also read that drinking steeping lemon grass steeped in hot water kills cancer cells. Is that true?

Appreciate if you could advise what foods my dad should take or avoid in his condition.

Thanks Ray

Answered by Ms. Chang Yok Ying, Pharmacist from National Cancer Centre Singapore

Depending on your dad’s outlook in life, he should be given the choice to practice diet intervention or just eat his favourite foods and spend quality time with loved ones, doing his favourite activities. One should respect and support his choice.

If he has stopped all cancer treatment, he may consider the American Cancer Society’s recommendation on healthy lifestyle and diet:

1. a plant-based diet, at least 5 servings of fruits and vegetables a day,
2. whole meal foods, less red meat, less fats especially from animals
3. less alcohol
4. be active 30min a day for most days of the week;
5. maintaining an ideal body weight
6. Avoid preserved foods with preservatives, cured meats like bacon, ham, sausages

Question by loga

I have been diagnosed with breast cancer and currently I am under going chemotheraphy. One of the side effect of the chemotheraphy is diarrhoea. I did consult a Naturepath and I was advised to take Vitamin C Crystals and Probiotic Defense. My question, is it alright to take the above supplements while I am undergoing chemotheraphy?

Answered by Ms. Chang Yok Ying, Pharmacist from National Cancer Centre Singapore

One needs to be cautious not to consume mega doses of vitamin C due to its antioxidant property which may affect the outcome of chemotherapy. How antioxidants affect chemotherapy is still a grey area. High dose vitamin C may cause diarrhea for some individuals.

As for probiotic preparations like acidophilus, which can alter the nature of faecal material as well as the condition of the inner lining of intestines, one should also exercise caution so that the intake of this probiotics does not work against the chemotherapeutic effect of drugs.

Question by janelim

My aunt is going for her chemo very soon. I am wonderfing what kind of food, fruits and drinks (muruku honey, juices ?) she can consume during these period of time?

What is good beofre and after the chemo?

Can she take supplements? If can take Vitamin C, how much is needed? the doasge?

Is there any food she really need to avoid? some folks are saying avoid chicken, mushroom, coconuts?

Is it adviseable to go for TCM and TCM meidcation like lingzi a fews day before or after the chemo session?

What can she eat is she have coldsore at her mouth area?

What can she take when she encounter dryness of skin and throat? Thank you.

Answered by Ms. Chang Yok Ying, Pharmacist from National Cancer Centre Singapore

1. ​I am wondering what kind of food, fruits and drinks (muruku honey, juices?)

she can consume during these period of time? During chemotherapy, encourage her to eat well, not worrying too much about restricting her diet to ‘healthy foods’. This will enable her to maintain a good blood profile with adequate platelets, albumin, neutrophils etc….that will help her undergo her treatment with minimal breaks.

2. Can she take supplements? If can take Vitamin C, how much is needed? the dosage?

Try to obtain vitamins like vitamin C from whole foods. e.g. fruits. This is to prevent overdose of Vitamin C which may affect the efficacy of the chemo drug. If she wants to take a supplement, she may want to chose a multivitamin with vitamins not more than 100% of Recommended Daily Allowance (RDA).

3. Is there any food she really need to avoid? some folks are saying avoid chicken, mushroom, coconuts?

Avoiding chicken could be a Chinese medicine concept. There are no evidence based reports that recommend not to take chicken. No problem with mushroom and coconut. She may do well to limit the intake of oily foods as there are studies that show that restricting oil / fat intake reduce the risk of recurrence of the cancer and increases survival and success of treatment among breast cancer patients undergoing therapy.

4. Is it advisable to go for TCM and TCM medication like ling-zi a few days before or after the chemo session?

Taking lingzhi during chemotherapy may increase the risk of bleeding. After patient has completed all cancer therapy, she may take lingzhi as a health supplement as lingzhi is known to have antitumour effect.

5. What can she eat is she have cold sore at her mouth area?

Foods that are soft, neither too hot or too cold. Avoid spicy and oily foods.

6. What can she take when she encounter dryness of skin and throat?

For dry throat,increase the intake of water. The most effective way of managing dry skin is to use a mild skin moisturizer.

Question by janey

I have 2 friends who had cancer. During that time when they were undergoing treatment, someone recommended them to buy the special 'juicer' for fruits and vegetables that claims to extract the best and all the nutrition, enzymes etc out, for better nutrition. She bought it and is using it.

I want to know - do those things really work? It was really expensive ( over $1000), but of course, since she already bought it, I didn't want to say anything.

Also, there is the water purifier. Another expensive item. Is this effective in helping and/or preventing relapse?

Answered by Ms. Chang Yok Ying, Pharmacist from National Cancer Centre Singapore

There are no evidence based reports on the benefits of certain makes of juicers or water purifier. Some manufacturer of juicer claims that their machine generates the least heat and hence preserves the enzymes in vegetables and fruits.

Since they have bought these equipments, just make good use of them.

Question by jess

More often than not when someone received their diagnosis, they received advices from ex-cancer patients, loved ones what to eat and what not eat during their treatment even right after they have gone onto remission. These expression of care and concern do come helpful to support individuals to come to term with their health conditions; however it can be add stress to patients not know how to choose their meals.

Hence my subsequent questions are: What are things we need to be cautious(beside hygiene) select meal for are patients with cancer ? Is there really link between cancer and sugar? Is it true that there specific nutrition patients need to take/and food need to avoid while under chemotherapy and radiation therapy? Should a cancer patients diet be alter accordingly to stage of the cancer? Would you recommend specific diet regiment to a person Stage 2 cancer and another to someone with much advance stages to boost their immunity? Given the fact the more advance cancer are the weaker the patients would be.

Thanks for taking time off the answers questions aforementioned.

Answered by Ms. Chang Yok Ying, Pharmacist from National Cancer Centre Singapore

Please see answer in question 1, 3 and 10.​

Ref: V10