Antioxidants and Vegan Diets: The Role of a Cancer Center Dietitian

Each Monday this month, we’re looking at the UVA Cancer Center’s Integrative Medicine Program.

How would you react if you found out the 4.5-centimeter lump on your breast was cancer?  What if you were just 31 years old, otherwise healthy and a busy student working towards a PhD?

My reaction would probably be to scream, cry and curse my body for its betrayal. And then I might eat half a pepperoni pizza or a pint of ice cream. If my body couldn’t stop cancer, why bother continuing to feed it well?

So I was impressed when I met Jennifer LaFleur, a 31-year-old University of Virginia graduate student, and learned how she responded: she cut way back on meat and dairy consumption and began eating a mostly vegan diet.

LaFleur read “The China Study,” which examined a link between consuming animal protein and cancer cell growth. But she thinks the diet was a way to control her situation.

“At that stage, there’s nothing you can do but wait,” she says. “Even when you’re undergoing the treatment, there’s nothing you can do … except try to rest and eat well.”

LaFleur had some questions, though. Her cancer was estrogen-receptor positive, which means the cells depend on estrogen to multiply. Many vegans consume soy as a protein source, but soy is chemically similar to estrogen. Could a vegan diet actually impede her hormone therapy treatments?

Getting Answers

Fortunately, cancer treatment at UVA isn’t just radiation, chemotherapy and surgery. The UVA Cancer Center has a full-time dietitian to address patients’ nutrition concerns.

This is part of the Integrative Medicine Program, which looks at the mind, body and spirit of cancer patients to help them get through their treatment.

Dietitian Carole Havrila can answer any questions related to nutrition during cancer treatment. She also works with patients at risk for breast and ovarian cancer who want to beat their odds.

Havrila first found LaFleur during a chemotherapy session. Many Cancer Center patients travel 100 miles or more for appointments, so Havrila often meets with them during treatment so they don’t have to make a special trip just to see her.

When LaFleur began asking questions about veganism, Havrila did some research and came back a few minutes later with recipes and a vegan food pyramid.

“Carole was very supportive of my decision to go vegan, which I loved,” LaFleur said.

Havrila suggested LaFleur also get protein from beans and leafy green vegetables; research also showed a minimal amount of whole soy foods would not interfere with LaFleur’s treatment.

In fact, LaFleur’s diet isn’t too different from American Institute for Cancer Research nutrition guidelines, which recommend limiting processed foods and red meat and eating mostly plant foods.

Dietary Supplements = Cancer Prevention? 

LaFleur’s concerns and interest in prevention aren’t uncommon. Havrila sees a lot of patients, particularly through UVA’s High-Risk Breast and Ovarian Cancer Program, who want to know what they can eat to help cure their cancer — or avoid cancer altogether.

Her patients sometimes bring her bags full of supplements, including:

• Antioxidants
• Vitamins and minerals, particularly Vitamin D
• Mushrooms
• Green tea

One patient was chewing apricot pits to extract laetrile, a compound rumored to prevent cancer. Havrila says research shows the practice is ineffective and dangerous.

“People say things like, ‘My friend told me about somebody he knew who did this and his cancer went away,’” Havrila says. “A lot of patients don’t want to tell their physicians these things, because there’s this perception that it’s way out in left field and their physician won’t approve. But they’ll tell me.”

Havrila recommends Vitamin D for breast cancer patients, who face an increased risk of osteoporosis because chemotherapy can lead to early menopause. But in general, “There’s just so many supplements and so little science.”

She researches supplements to ensure they won’t interfere with treatments. Generally, if a supplement is safe but ineffective, she shares her findings with her patients to let them make their own decisions.

Food is Medicine

Then there are the patients who struggle to get enough calories. Chemotherapy and radiation can:

• Eliminate appetite
• Cause nausea and vomiting
• Leave the patient too exhausted to prepare food
• Alter the sense of taste

“Chemotherapy can affect taste buds, and it can make things taste really weird, either like metal or cardboard,” Havrila says.  Radiation to the head and neck causes similar taste bud interference.

A dieter might be thrilled if food suddenly started tasting bad. But cancer patients need to maintain their weight, and some may need extra protein or calories. “Patients worry if they lose weight, they’ll have to miss a treatment or stop treatment,” Havrila says.

She tells her patients to avoid using metal silverware and use sweeteners to avoid metallic tastes. If everything just tastes blah, she encourages using sea salt, vinegar and acids.

“There’s a fair amount of cheerleading involved,” she says. “I tell patients that they’re going to get through it, but they have to view food as medicine for that period and push through it.”

Positive Prognosis

LaFleur finished chemotherapy in November and had a lumpectomy and axillary lymph node dissection a few weeks later. While she no longer had the disease in her breast or lymph nodes, her ducts contained cancerous cells. To eliminate those, she’ll have a second lumpectomy this month.

She’s optimistic, though, that she won’t need a mastectomy. She was also pleased when Havrila recently connected her with an exercise physiologist to discuss getting back to being more active.

The diagnosis forced her to slow down her graduate studies, but she’s planning to spend more time on it in the spring and hopes to eventually get her PhD in classics from UVA.

Will she stick with the mostly vegan diet?

Time will tell. LaFleur allowed herself occasional servings of meat and dairy during her treatment and found she didn’t miss it as much as she thought she would. She’d like to continue to enjoy it once in awhile, particularly as a treat. She’s also influenced her parents to try more vegan recipes.