Nutrition is as much a part of an oncology patient's recovery as the cancer treatment itself.
For oncology patients, whose typical ailments include inflammation and blood sugar control, nutritionist Danielle Kalbfleisch and naturopathic oncologist Markian Babij, both of Alaska Cancer Treatment Center, recommend staying away from refined foods as a general rule. Beyond that, they work with patients to develop tailored diets: some will become lactose intolerant or develop food allergies. "Chemo is wrecking your gut," Babij said. Learning a patient's symptoms, side-effects and lifestyle helps Kalbfleisch and Babij to create custom meal plans and identify supplements that will alleviate, nourish and heal. Avoiding refined carbohydrates and sugars, in addition to getting adequate sleep and plenty of water, are the only rules they employ.
"Let's not put you on a diet," Babij tells his patients. "Let's put you in a lifestyle place. Let's break the rules once in awhile."
A bend in the rules comes in the form of what Babij calls "transitional foods." For example, Babij has a recipe for vegan cheesecake that he says is wonderful, if not calorie-free, and Kalbfleisch suggests zucchini or black bean brownies as an alternative to less wholesome recipes. These foods are a part of their plan to transition patients from high calorie, low-nutrient diets to high-nutrient, low calorie ones.
To help patients get there, they suggest some grocery cart staples and basic meals and supplements to get started.
Your grocery cart
Getting enough protein is fundamental, Kalbfleish said, suggesting less inflammatory sources such as fish, organic beef and legume-based proteins. In addition, since a patient's gut is often compromised, protein powders for smoothies are another good option, she said. Add to your proteins a variety of cruciferous vegetables, and those should make up the majority of your food staples.
Kalbfleisch also encourages maintaining a snack supply to include olives, organic beef jerky, nuts, seeds, applesauce and protein bars (with less than five grams of sugar, at least 10 grams of protein and plenty of fiber). She said green tea is great not only for hydration but for its antioxidants, and dark chocolate even gets an okay for the same reason.
While Kalbfleish recommends buying organic products all around, she suggests choosing organic animal products if you need to prioritize based on your budget.
Your go-to meals
Stir-fries are a simple way to incorporate the proteins and produce from your newly stocked kitchen into your diet, Kalbfleisch said. Choose an organic meat, fish or tofu; add some broccoli or bok choy; stir fry in olive or coconut oil, and season with turmeric powder, an anti-inflammatory. Keeping a bag of vegetables from Costco in the freezer makes this meal even quicker and easier, she added.
One of Babij's favorites is a warm bowl of porridge. For maximum nutrients, he recommends steel-cut oats cooked in a dense milk and substantiated with your choice of almond butter, maple syrup, cinnamon, sunflower seeds, pumpkin seeds and berries.
Another breakfast option or meal replacement is Kalbfleisch's smoothie: She suggests using a protein powder of your choice, canned coconut milk for extra calories and energy, adding additional fiber with flax or chia seeds, an avocado or banana to add creamy texture, berries to sweeten, and water to thin to desired consistency.
For a snack or dessert, both are fans of chia pudding. The recipe has only two ingredients—coconut milk and chia seeds—and its preparation is as simple as letting them sit together overnight in the fridge. With virtually no calories and lots of fiber, it's a comfort food and nutrient-rich.
Your social strategy
A common question patients will ask is, "What do I do when I go out socially?" Babij said.
He recommends cooked foods, such as steamed or sautéed vegetables, that are easier on the stomach, noting that some oncology doctors will tell patients to stay away from salad as it is more difficult to digest.
Naturally, both recommended staying away from additional toxins, including alcohol, though the antioxidants found in coffee and tea make an Arnold Palmer or after dinner cappuccino great beverage alternatives.
Your supplements
Everybody benefits from supplements, Babij said, stating that a multivitamin, fish oil and vitamin D are several standard supplements that anyone should consider incorporating into their diet. He added that cancer preventive supplements, including cacao, grapeseed extract and green tea extract for their antioxidants, and turmeric for its strong anti-inflammatory properties are all good choices for patients.
When selecting groceries and supplements alike, Kalbfleisch and Babij remind patients to read and dissect labels—looking at the number of servings before the number of calories and reading not only the ingredients, but the order in which they are listed.
It's a lot to take in, but relying on a support system for encouragement and help in dispersing the tasks involved in treatment and recovery is vital.
"After treatment is the most difficult part of treatment," Babij said. It's a time when patients are not only recovering, but trying to establish new habits and perhaps adapt to a new lifestyle. The Alaska Cancer Treatment Center has developed a survivorship program—continued care for oncology patients—which includes post-treatment counsel regarding diet, supplements, exercise, sleep patterns, gut health and lab monitoring.
Treatment and recovery is a process that requires patience, consistency and establishing new dietary habits. "Everything in life is cumulative," Babij said referring to patients who get frustrated with themselves over a diet backstep. He encourages them to give themselves a break and remember that no one changes their lifestyle overnight.
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This article first appeared in the 2015 edition of Alaska Pulse magazine. Contact Pulse editor Jamie Gonzales at jgonzales@alaskadispatch.com.