The new dangers of fructose

Yesterday, I read an article on Reuters about a study showing that some cancers (particularly pancreatic) "feed" on fructose, growing faster when given more of it. Because eating less sugar is recommended for cancer (and cancer recurrence) prevention, this was not too surprising. However, the article distinguished between fructose--problematic--and glucose--less so. Of course, high-fructose corn syrup was mentioned: because it so permeates industrial food production, could it be accelerating cancers?

Today, salon.com has a terrific piece examining the issue. My favorite part: the Marion Nestle quote comparing sugar content in various sweeteners:

[Both corn syrup and] table sugar ... are about 50% fructose and are about equal in their effects. So is honey. Agave has even more.

Again, it's all about perspective. Let's eat less sugar--we'll be healthier. But I'm seeing several media outlets jumping on the "corn syrup is evil" bandwagon, and really--not helpful, guys.

The LA Times today mentions a study by USC researchers that found green tea to block the effects of a specific kind of chemo agent used on multiple myeloma and a couple of other cancers--not breast cancer, though. Green tea is an antioxidant (perhaps it would be more precise to say it contains antioxidants) that are effective at preventing breast cancer, and it may even aid in the treatment of breast cancer. Although some very conservative oncologists, such as the local practice near where I live, don't want their patients using green tea or other antioxidants during chemo, I found a substantial amount of research showing that green tea actually aided the effects of chemo. It may help chemotherapy target cancer cells better, while protecting non-cancer cells and thus easing the damaging effects on the body. (Note that I am linking to a layperson-friendly page, not to one of the studies, but a quick Google search will get you the real research.)

I'm very happy to say that I was treated at USC, which--this study notwithstanding--seems more open to green tea; I wasn't treated at the local practice.

Just wanted to share!

What I Eat

I've promised many times to post my post-cancer diet. "Diet" is right and wrong; eating this way helped me lose almost 40 pounds (so far), but it's not about dieting the way our society tends to think of it, and it's not about being thin for vanity's sake. It's about a lifelong way of approaching food and nutrition so that these things are part of making me healthy (being thinner so that I don't have fat as a risk factor; exercising for even more risk reduction). It's about a changed relationship to food.

First and foremost, the idea is to eat as close to nature as possible. We hear all the time about the crazy toxins and contaminants in food. Even if you eat stuff right out of the garden, of course, who knows what jet fuels and refinery emissions have settled on your zucchini. So (as I ponder just below) no, there is no absolute control. However, we can do a whole lot by cutting down on overly processed foods, with their extra chemicals; and we can shift things so that most of the calories come from real nutrition, rather than from fillers or corn syrup.

The second major principle (really a cluster of principles) is about evidence-based practices--that is, using food in ways that solid research has shown to reduce cancer risk, specifically. Low fat (10-20% of calories only), high fiber (30-35g per day), lots of antioxidants (green tea, cinnamon, turmeric, cruciferous vegetables)--all of these have a central role.

It's funny, because at first it was enormously difficult for me to eat this way. Then it became a way of life. Then I kind of backslid, while teaching, out of laziness and a reversion to the "comfort foods" of old habit. Since my class ended, I've been pretty strict again (I tell Noah I'm "hitting the reset button") and it has been ridiculously easy. So it can be tough to start this kind of habit, but it's really not tough to maintain. (My comrade-in-cancer, though, who just finished chemo, utterly refused the nutritional oncology approach. As a trained chef, she has too much value for butter. I can certainly understand priorities. Who knows how long we have, and perhaps for some people a butter-less life is not as worth living!)

In any case, at long last, here's the basic outline. I'm skipping a lot of detail because the specifics of the diet are copyrighted by Rachel Beller, my nutritionist, but this will still tell you a lot.

Breakfast:
3/4 c bran cereal (Nature's Path Smart Bran is my favorite; Fiber One has the most fiber)
3/4 c almond milk
OR
1 c greek yogurt (fat free) w/1/2 t cinnamon
1 mini bran muffin

Snack:
something like fruit (1/2 banana, some blueberries, etc.)

Lunch:
vegetables (e.g., salad) and lean protein (e.g., fish)
For example: large (3-4c lettuce + other veggies) salad with salmon, using plain balsamic vinegar as a dressing; or perhaps using a locally-made dressing called Galeo's miso caesar, which tastes amazing and is super low-fat. (Commercial nonfat dressings are a no-no because of chemicals.)

Snack:
tomato soup (no cream) or gazpacho, raw veggies, etc.

Dinner:
vegetables, lean protein, salad, soup
For example: 2-3 lbs grilled veggies (asparagus, broccoli, chard), grilled halibut, side salad and miso soup

Snack:
yogurt, popcorn, or something else

It's pretty plain when written out like this, but it really leaves a lot of flexibility in terms of preparations, seasonings; I can have Indian or Mexican or Italian or Chinese food this way, as long as I watch out for the fats and privilege veggies and fish above bread or cheese.

Anyway, at long last there is the basic diet, and I hope it is somewhat helpful for someone out there!

Role Models and Broken Records

I was really surprised, and then really happy, to see that Christina Applegate is being so open about her response to her breast cancer. In case you've been on a desert island for the past few days--her mom struggled with breast cancer, surviving it twice, and Christina tested positive for the BRCA-1 gene. This puts her at high risk for getting breast cancer again in the future, so she opted for a double mastectomy, and then went on a morning talk show to tell the world about it.

As a starlet prized for her appearance, this has to be tough, but her attitude is great. And I just love the message it sends to all women who face the reduction or removal of breasts as a result of this disease: You don't have to be ashamed, you don't have to feel invalidated, and your life is far more important than your boobs. Oh, and along with those other women rushing out to buy fake ones anyway, remember you'll have perky ones in the nursing home.

It's no less traumatic to face a mastectomy, I'm sure, just because a celebrity has talked about hers. But it's just one more area of life in which we don't have to be silent, to hide in shame; we can speak out and own our experience, and know that we are still worthwhile and valuable even though something has been taken from us. Damn right!

Finally, I've said it before and I will keep hollering about it: We can cut our risk enormously by just watching what we eat and really exercising. Apparently most Americans already know this, and yet we're still not doing it. Watch a slightly fluffy treatment of the topic by CNN's Sanjay Gupta:

(It's looking like the embed might not be working; if not, here's the link.)



Now, I know it's hard. After losing 37 pounds post-treatment, I recently gained 6 of them back, and now I am having to watch my food strictly once more. (Exercise I have covered, with beach volleyball--go USA!!--at least 6 hours a week.) As I forego bread and use balsamic vinegar in place of salad dressing, I feel some pain. But a) eating healthfully is a lot more fun than going through chemo; and b) my life is too important not to do it!

Edited to add: I've already gotten rid of 3 of the 6, in just a few days. Yay.

Good eats

Much silence from me lately! This reflects both good news (trip to Europe, getting work done, playing lots of volleyball) and not so good news (I'm feeling resentful about my involuntary association with the world of cancer, partly because of its effect on my own life, and partly because someone very close in my social circle--and younger than me--has just been diagnosed and is being dragged into this world herself).

I break my silence with little to say about my own life. But the NY Times strikes again with another great piece on nutrition. This is just a general "what you should eat" article, but most of these items are on my nutritional oncologist's list of things to eat every day.

Bon appetit!

More problems--and one solution!

I'm sure everyone has been following the latest bad news about Nalgene and baby bottles? The regulatory focus has been on baby products, since the chemical in question--bisphenol A--poses risks to development. But the chemical is also implicated in breast cancer (see the end of the article). I'm glad to see that Nalgene is changing its plastic, and that there are tips available to minimize BPA exposure. But as a longtime drinker from Nalgene bottles (and eater of canned foods), I also wish this information had come out earlier.

Now onto the good news. I've been complaining (even more off-blog than on) about the fact that modern corporate farming and food distribution has led to less-nutritious, less-tasty food that poses greater health risks. I've been wishing that I had the time to grow my own food, or that we had a direct line to people who farm organically and could get us fresh produce, not stuff picked a few weeks ago and left to ripen in a dark truck.

Well, it doesn't take much internet sleuthing to find that this is entirely possible. Community-supported agriculture may be a relatively new movement, but it's well organized! I've found 2 potentially good farms in my area. The costs are higher than at the grocery store, I think--and that stinks, because again, healthy food should not be something available only to rich people. But for us, the costs are pretty manageable, and I'll be looking into this more. Just think--peaches and tomatoes that really taste like peaches and tomatoes. Keep you posted!

Clip'n'Save list of Cancer-Fighting Foods :-)

Boy, I gotta say--the information is certainly out there if you want it. Why didn't I pay attention earlier? It's not like this list of good cancer-fighting foods is boring or yucky. It even includes chocolate!

Another good reason to play volleyball

From Ode Magazine, a quick note on the benefits of Vitamin D (maximized through sun exposure) for a variety of ills, including breast cancer. :-)

Oh yeah, my in-house portrait photographer keeps reminding me I need to post the latest, for those of you who haven't seen me with hair lately. Here ya go!

More nutrition news

Before you ask, my back has felt better this week. Lots better. So, so far I am not calling back for an MRI. I'll let you know if that changes.

Now--the LA Times today has a really terrific article about nutrition and cancer. It talks at length about foods purported to lower cancer (or recurrence) risk, and the strengths and flaws in various studies. I'm happy to see many of the recommendations of my nutritional oncologist, Rachel Beller, validated in the article. She really seems to base her approach on solid research and evidence, which of course appeals to me.

Among the key points for me:

• In one study, breast cancer survivors who ate 5 servings of fruits/veggies a day and exercised regularly achieved a 44% decrease in the rate of recurrence. That's great! Those who only ate the veggies, OR who only exercised, did not get any benefit.
• Cruciferous vegetables (broccoli, kale, brussels sprouts), tomatoes, spinach, apples, and blueberries are among the key foods that have been shown beneficial.
  
• The benefits come from the whole foods themselves, not supplements of just one nutrient or chemical at a time.
• Excess weight is the #2 risk factor for cancer, behind only smoking.
  
• A scary factoid: for Americans, 52% of "vegetable" consumption comes from just 3 sources: iceberg lettuce, potatoes, and canned tomatoes. Yikes!

So, Rachel has me getting the vast majority of my calories these days from veggies and fish (or tofu), with fruit and yogurt close behind--and the items on the list are definitely staples. And I'm playing volleyball for hours a week, and walking Kibble as well (though less than he'd like). Everything is as organic as possible, so that there aren't toxins and chemicals competing with the positive effects of the food. I'm almost down to my goal weight, which removes that as a risk factor.

It is hopeful and amazing to think that there could be a cell sitting inside me, with the potential of turning into another tumor (or of starting a cascade of cells tumbling in metastatic unison to become something really ugly), but what I'm doing could stop it. It's like Schrodinger's cat: I do one thing, and I get cancer. But I do another thing--perhaps the thing I'm doing by following Rachel's advice--and I live 50 more years cancer-free. That cell just sits there, and thinks about it, and then shrugs and stays healthy.

Anyway, everyone: Lose weight if you need to lose it, eat good things, and move your body! Let's all give the giant middle finger to cancer!

Another 3-month check today

Hello, and long time!

No news is good news, in my case. I have celebrated my summer-after-cancer by travelling to Europe, tending the garden, playing with my dog, and having fun with Noah. I have played hours and hours of volleyball--generally with more energy and skill than before treatment. Basically, I feel great.

Of course, cancer is evil. I could be feeling this great and still have something wrong. Today, I had my latest 3-month check (and it's a year since I ended chemo!!). The physical exam was clear. I haven't yet gotten results of my blood test, but I'm sure I would have heard if they were bad. There's just one little thing: I've had a nagging lower-back pain for about the last month. It could be travel, different beds, volleyball, our own wearing-out bed, or even the way I slump as I sit here in the computer. But once you've had cancer, everything is cancer.

So the oncologist has a "one-month rule": if a pain persists for a month, we take it seriously. We do an MRI and check it out. Well, I'm almost at a month with my back, but it's felt better for a couple of days. Metastases don't get better, so if the pain goes away (or even eases a lot), then it's unlikely to be a metastasis. But if I am still feeling like this in a week, I'm supposed to call back, and we'll be doing an MRI.

I'm not too worried, but it's all relative. I'll be paying attention to my back for the next week, and trying hard not to be a hypochondriac at the same time. A good friend of my sister-in-law's was just diagnosed with metastatic melanoma in his spine. Started as a backache. He had it checked out, and now things are pretty serious for him. So it's easy to freak out a bit.

Otherwise--there have been some interesting cancer stories in the news lately. Many people have asked for my reaction to the news that a high-vegetable diet does not help prevent recurrence. My diet (which I'll post here soon) is not that. It's a basic high-fiber, low-fat diet that tends to have lots of veggies, but only prescribes the standard RDA kind of approach.

(I saw my nutritional oncologist yesterday, too, by the way. I'm back strictly on the plan for a while, to lose a little more weight and be more disciplined after our European culinary free-for-all.)

And I really found this piece, in the NY Times, poignant. Also scary. It's written by a guy (a cancer survivor) visiting an ex-girlfriend and former fellow survivor, now terminal patient. While searching for the link for that, by the way, I also encountered this somewhat treacly story (though, to be fair, I actually agree with it) about finding the positives from a cancer experience.

OK--I'll be sure to update y'all with the verdict this next week!