Making healthy food choices before, during, and after cancer treatment can help you feel better and stay stronger. In fact, people living with cancer who eat well and keep or achieve a healthy weight usually manage treatment side effects better. Eating well also helps the body replace blood cells and healthy tissues that may be damaged as a result of treatment.
According to The Leukemia & Lymphoma Society’s (LLS) Information Resource Center team of master’s level oncology social workers, nurses and health educators, cancer research related to nutrition is still in its early stages, and it may be hard to find truthful and honest advice because of the myths and misinformation about this subject. To provide some clarity, we spoke with LLS’s Information Specialists who provided the following tips:
1. Choose Healthy Foods
Many nutritionists agree that eating a variety of foods is the best way to ensure intake of all the nutrients that the body requires. A healthy eating pattern includes a combination of food groups and a calorie intake level that maintains a healthy body weight. A healthy diet includes a balance of:
Fruits and vegetables
Whole grains and legumes
A variety of protein, including fish, lean meats and poultry
Fat-free or low-fat dairy, including milk, yogurt and cheese
Oils including olive oil and canola oil for cooking and salad dressings
2. Maintain a Healthy Lifestyle
In addition to eating well, it is important to:
Maintain or achieve a healthy weight
Drink enough fluid
Exercise. Consult your doctor first, and start with low-risk activities like short daily walks.
Get enough sleep (7 to 9 hours for adults)
Do not use tobacco or abuse drugs and limit or avoid alcohol.
3. Talk to Your Doctor About Foods to Avoid
Certain foods may cause a bad reaction with some of the therapies that are used to treat cancer. Members of your treatment team should tell you which foods to avoid.
When you begin a new treatment or start using a new drug, it is a good idea to tell your doctor about any food allergies you have and all vitamin and herbal supplements you are taking. You should also ask the following questions:
Will I have any special nutritional needs while taking this medication?
Do I need to take this medication with food or should I take it without food?
Are there any known foods that I shouldn’t eat during this treatment?
4. Try to Eat, Even If You Don't Have an Appetite
Your cancer and the treatment for it may increase your body’s need for calories and protein. Chemotherapy, certain other drug therapies and radiation therapy create a need for more calories and protein. The following nutrition tips can help you to get the most nutrition out of each bite of food when decreased appetite is a problem:
Eat small meals or snacks frequently throughout the day.
Keep prepared snacks or small meals on hand and be sure to take them with you when you will be away from home.
Try high calorie liquids such as juices, soups or shakes if eating solid foods is a problem.
5. Get Enough to Drink
Certain cancer therapies, including chemotherapy, other drug therapies and radiation therapy can increase risk for dehydration. Some side effects of treatment, such as diarrhea and vomiting, increase the need for more fluids.
Sipping even small amounts of liquids at regular intervals will help if that is all you can manage. Your treatment team may recommend liquids, such as broths or sports drinks—these can restore the body’s electrolyte balance. Electrolytes, such as sodium and potassium, have many important functions in the body. Vomiting and diarrhea increase your body’s loss of electrolytes. Check with your treatment team to see if you need extra help in keeping your body’s fluid in balance by drinking liquids that contain electrolytes.
The Information Resource Center is a team of master's level oncology social workers, nurses and health educators, who assist patients through cancer treatment. To speak one-on-one with a LLS Information Specialist call (800) 955-4572 or go to www.lls.org/irc.
At age 39, Jody was working full time, volunteering, and raising four children, when her life was suddenly interrupted.
In January 2009, she landed in the hospital with a diagnosis of Philadelphia chromosome positive acute lymphoblastic leukemia. It was the start of a long journey through many hospital rooms. Five months after her diagnosis, Jody had a bone marrow transplant and went into remission. In 2011, the leukemia was back. Despite a poor prognosis, Jody again beat the odds through a successful stem cell transplant.
Today, she is still in remission. For the rest of her life, Jody needs to take a daily oral pill called dasatinib, a targeted therapy advanced with LLS support that works by inhibiting the mutation that causes cancer cells to proliferate. When she went to pick up her first dose at the pharmacy, Jody was shocked to learn how much that life-saving drug would cost her: $5,640 for the first month alone.
It was not long before Jody’s medical bills ate through her family’s savings. Everything that she and her husband had put away for their children’s college educations went to pay for the treatments and medications keeping Jody alive. The payments soon added up to more than $60,000 in out-of-pocket expenses.
Unfortunately, these high out-of-pocket costs are all too familiar for cancer patients. For the last several years, health plans have been shifting a greater portion of the cost of care onto patients, like Jody. This is done through a combination of cost-sharing techniques, including:
Deductibles: The amount that a consumer must pay upfront before his or her health plan will begin to cover the cost of care.
Coinsurance: As in Jody’s case, coinsurance requires a patient to cover a percentage of the total cost of a benefit or service instead of paying a flat co-pay.
Especially for patients who rely on specialty medications, these cost-sharing techniques can result in out-of-pocket costs that run into thousands of dollars in just a single month. This nearly eliminates access to care for the many patients whose families simply cannot afford such high costs.
Through its nationwide grassroots network of more than 100,000 volunteer advocates, The Leukemia & Lymphoma Society (LLS) is working to change that by advocating for policies at the state and federal level to limit out-of-pocket costs for patients.
Patients could benefit greatly if cost-sharing for medications was limited to more reasonable amounts. According to an analysis commissioned by LLS in 2015, health plans could adopt such limits with little-to-no impact to premiums. The analysis was developed by Milliman, a consulting company with expertise in insurance coverage.
LLS recently commissioned a follow-up analysis from Milliman to understand how these cost-sharing limits would affect premiums under current marketplace trends. For this report, Milliman based the analysis on a silver plan, since this plan type is popular among consumers.
As a specific cost-sharing limit, Milliman tested a pre-deductible limit of $150 for a one-month supply of any prescription drug. In this case, pre-deductible means that a patient would not have to meet a deductible before the $150 limit would apply at the pharmacy counter.
The findings? Looking out over a three-year period, the latest analysis projects a monthly premium increase of less than 1% each year. Furthermore, that impact could be reduced to less than 0.5% if a plan were to make small (for example, $1 to $5) increases in cost sharing for other benefits or services.
While these findings are extremely important to a patient’s wallet, they are also important to overall health and wellness. Data shows that when cost becomes a barrier to accessing medications, patients do not use their medications appropriately, skipping doses in order to save money or abandoning a treatment all together.
By strengthening the case that limiting cost-sharing for medications is indeed feasible, these analyses will help inform public policy. LLS’s Office of Public Policy will deliver these findings through strategic advocacy at the federal and state levels, along with input from patients, like Jody, to help improve access to care and accelerate cures.
As the voice for all blood cancer patients, LLS’s Office of Public Policy has achieved groundbreaking results for patients, such as advocating for oral parity legislation which has been signed into law in 42 states, and helping to drive forward the 21st Century Cures Act. To learn more about those efforts or help in LLS’s advocacy efforts, click here.
The U.S. Food and Drug Administration (FDA) approved an immunotherapy for adults and children with classical Hodgkin lymphoma who were not benefiting from existing treatments. The Leukemia & Lymphoma Society (LLS) applauds this approval as an important step forward in ultimately finding a cure for these patients.
While Hodgkin lymphoma is now considered one of the most curable forms of cancer – with a more than 88 percent five-year-survival rate overall – this therapy is for patients who have relapsed after being treated with current therapies, and otherwise have limited treatment options.
The approved therapy, pembrolizumab (Keytruda ®), is among a class of drugs known as immune checkpoint inhibitors, which work by removing the brakes that stop the immune system from attacking cancer.
The body’s immune system has T-cells that patrol the body constantly looking for signs of infection or foreign cells (such as cancer cells). Certain proteins on cells indicate if it is healthy or cancerous – and if it is cancerous, the T-cell will attack it. Sometimes the T-cells are unable to recognize the cancer cells because they carry “checkpoint” proteins that act like masks, helping the cancer cells blend in with normal cells.
In this case, the “mask” is a protein called PD-L1, which interacts with another protein, PD-1, allowing cancer cells to evade attack from immune T-cells. The newly approved drug, pembrolizumab, targets PD-1, unleashing the patient’s immune system to fight the cancer. This marks the second FDA approval of a PD-1 checkpoint inhibitor for Hodgkin lymphoma patients, with nivolumab (Opdivo ®) approved in May 2016.
FDA based the approval of pembrolizumab on data from a clinical trial of 210 patients who were not benefiting from previous treatment. Within the trial, 69 percent of patients responded positively and 22 percent showed no detectable sign of cancer.
The approval reinforces the hope that immunotherapy will prove useful for a wide variety of cancers, as the drug was previously approved for head and neck cancer, non-small cell lung cancer and melanoma.
Furthermore, LLS is currently funding research studying the benefits of pembrolizumab or nivolumab for patients with non-Hodgkin lymphoma. Stephen Ansell, M.D., Ph.D., Mayo Clinic, Margret Shipp, M.D., Dana-Farber Cancer Institute, and Sattva Neelapu, M.D., MD Anderson Cancer Center, are leading these research efforts.