Overview

Blood-cancer and treatment for the same can take its toll on the patient. Radiation-therapy and chemotherapy can deplete the person’s strength, induce fatigue and bring in several side-effects. Anaemia and the risk of infections create new challenges. It is important for blood-cancer patients to eat a nutritious, yet balanced diet to maximize the effectiveness of medication or therapy, and improve recovery. This article covers guidelines on eating right, tips on overcoming side-effects, and specific foods to avoid.

The role of Diet and Nutrition in Cancer treatment

It is important to understand that leukaemia is a complex condition and cannot be cured by merely consuming a nutritious diet, or consuming specific foods. Medication and therapy play a big role in limiting the spread of cancer and effectively destroying tumours or cancerous-cells. However, the right diet and adequate nutrition can create the right pathological conditions in the body that help improve recovery rates and manage side-effects better.

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Also Read: Causes, Symptoms and Treatment of Acute Myeloid Leukaemia

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Proteins and Calories

A diet rich in lean meat such as poultry and fish are preferred over red-meats. So also, nuts, legumes, beans, seeds, milk and dairy products, and eggs are rich sources of protein. Healthy fats such as ghee, olive oil and almond oil are preferred. High-calorie foods include mayonnaise, honey, cream, butter, ice-cream and jams. Consuming a high-protein, high-calorie diet has the following benefits:

Before treatment

• Helps you stay strong when you commence treatment
• Prevents body tissues from breaking down
• Helps rebuild body tissues
• Effectively fights infection
• Manages side-effects of treatment better

During treatment

• Replaces older, affected blood-cells with new and healthy ones
• Helps the patient feel fit and energized
• Helps maintain body-weight
• Helps replenish the body’s store of nutrients
• Helps withstand treatment and its side-effects better
• Reduces the risk of infection
• Helps in quick repair, healing and recovery

Fresh fruits and vegetables

Fresh fruits and vegetables in all colours must be consumed. These are rich in vitamins, minerals, phytonutrients and anti-oxidants. All these compounds help fight cancer-cells. An adult leukaemia patient must get 5 to 10 servings of fresh fruits and vegetables per day (where one serving is equal to half a cup). Vegetables are good either raw, cooked or steamed, in the form of salads, curries (sambhar), sprinklings and garnishing on curries on in soups (rasam).

Specific compounds in food

There are specific compounds in plant produce that are useful while treating cancer due to specific properties in them.

• Curcumin found in turmeric and mango-ginger target different cell-signalling pathways such as cytokines and growth factors. This helps prevent the growth, spread or recurrence of cancer. However, curcumin absorption can be maximized only when consumed along with black pepper.
• Ursolic acid reduces tumour growth by regulating the function of mitochondria through metabolic pathways. Ursolic acid is found in rosemary, apple, basil and cranberry.
• Glucosinolates and sulphorophane: These are found in cruciferous vegetables like cabbage, knol khol, bok choy, cauliflower, broccoli and brussels sprouts. Glucosinolates help prevent cancer development and recurrence. However, these are very effective in cancers of the prostate, breast, colon and lung. Research is ongoing with respect to their efficacy in blood-cancer treatment. Sulphorophane is known to delay the spread of certain types of leukaemia.
• Ginsenosides: These are found in ginseng. Some lab-studies have shown that this compound has anti-tumour properties.

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Also Read: The different Stages of Hodgkin’s Lymphoma and the Survival Rate

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Neutropenic diet

One of the side-effects of chemotherapy for blood-cancer is a drop in the number of neutrophils, a type of white-blood-cells. They help fight infection, so their low levels heighten the risk of infection. To overcome this risk, the doctor will recommend a neutropenic diet that will reduce exposure to bacteria. This involves avoiding:

• raw or undercooked meat, whether red or white
• raw or undercooked seafood, which includes undercooked shellfish, sushi and sashimi
• unpasteurized foods which include raw milk, fresh fruit juice, raw-milk yogurt and soft cheese made from unpasteurized milk
• uncooked or undercooked eggs, and foods that contain them
• refrigerated and preserved deli meats, such as dry-cured, uncooked salami
• some raw sprouts such as alfalfa sprouts
• fruits and vegetables that are not washed properly before eating
• food served in salad bars or salads served in buffets
• well-water that has not been boiled or heated

Combating anaemia

One of the symptoms of leukaemia is iron-deficiency anaemia which causes weakness and fatigue. This can be overcome by consuming iron through food. This includes all types of meat (lean and red), grains, legumes and vegetables. Vitamin C increases the absorption of dietary iron, so this must also be consumed. It is found in cruciferous vegetables, bell-peppers and citrus fruits.

Combating vitamin deficiencies

A rare type of anaemia called megaloblastic anaemia, which is found in people with certain types of blood-cancer, is caused by a deficiency of Vitamin B12 and folic acid.

• Vitamin B12 is found in beef, chicken, salmon, tuna, clams, eggs, fortified cereal and nutritional yeast.
• Folic acid is found in cruciferous vegetables, spinach, asparagus, avocado, fortified cereal and black-eyed peas.

Reducing the risk of kidney damage

Some patients of leukaemia develop kidney damage. In such a case, the doctor will recommend limiting foods rich in phosphorus, sodium and potassium.

• Phosphorus-rich foods include, cheese, nuts and seeds, peanut-butter and wheat-bread
• Sodium-rich foods are basically salty foods like deep-fried snacks, packaged and ready-to-eat foods, condiments and salad dressings
• Potassium-rich foods include bananas, oranges, peaches, spinach, potatoes and zucchini

Fibre

Fibre is found in fresh fruits and vegetables, nuts and seeds, beans and whole-grains. They aid in proper digestion of food, managing healthy lipids, promoting healthy gut-bacteria and effective glycaemic control. All these factors prevent cancer symptoms from aggravating.

Vitamin D

Some of the symptoms of blood-cancer include heightened risk of infection, and weakened bones. Vitamin D helps boost the immune system, which can fight infections. It also helps in better absorption of calcium that can strengthen the bones. While sunshine helps the body make Vitamin D, it can also be absorbed from food sources such as kale, soyabeans, salmon, sardines and fortified – cereal, milk and orange juice.

Hydration

Water is required by the body for several functions. Adequate hydration relieves some of the symptoms of blood-cancer while promoting overall-health which boosts the immune system. Patients of blood-cancer should consume plenty of plain water, along with soups (rasam) and fresh juices. They should avoid sugary drinks, sodas, canned juices, and limit alcoholic drinks and caffeinated drinks.  The latter two cause dehydration. Further, coffee and tea reduce iron-absorption when consumed along with food.

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Also Read: The different tests required for detecting blood-cancer

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Overcoming Side-effects of Cancer treatment

Nausea, vomiting, diarrhoea, constipation, mouth-ulcers and sore-throat are some of the side-effects of cancer-treatment. They cause difficulty in chewing and swallowing, poor appetite, weight-loss and malnutrition. Some treatments also cause weight-gain. Over time, doctors, researchers and the patient-community have come up with tips and tricks to overcome side-effects and improve patient comfort.

Overcoming Nausea and Vomiting

The patient should eat frequently, in small meals or portions, every 3 hours of his/her waking time. Food should be eaten slowly and chewed well. Low-fat, bland and salty foods (such as Ven pongal) are preferable, while oily, fried and spicy foods are best avoided. An empty stomach and foods with a strong smell should be avoided. Dry foods such as chips and rusk are good to eat. Easy to digest foods like curds and vegetable/rice/millets broth (congee) are preferable.

Overcoming Diarrhoea

The patient should consume plenty of plain-water, fresh juices, soups, porridges (payasam), broth (rasam), gruel (congee), all of them at room temperature preferably. Oily and greasy foods must be avoided. High-fibre foods like whole grains, millets, fresh fruits and vegetables must be avoided, in favour of refined grains, refined flour (maida), and cooked vegetables in small portions (like in sambhar).

Overcoming Constipation

The patient must eat a diet high in fibre such as fresh fruits and vegetables, whole grains and millets, nuts and seeds, beans and legumes. He/she should drink plenty of plain water and avoid caffeinated drinks. Daily exercise and good sleep also help relieve constipation.

Overcoming low appetite

Low appetite causes low food-intake and hence malnutrition. To prevent this, the patient must consume foods in small portions every 3 hours of his/her waking time. He/she can eat his/her favourite foods and must consume a high-calorie diet. Snacking between meals is allowed. Food should be made to look good, smell good, and meal-time must be pleasant.

Overcoming taste-changes

The patient must avoid red-meats and consume more of lean meat. He/she should consume foods at near room temperature, and preferably foods that are a little sour (containing lemon, tamarind, vinegar, raw mango and sour curds, as they help restore taste). It’s important to follow good oral hygiene (brushing teeth, tongue and flossing).

Overcoming sore throat and difficulty in chewing or swallowing

The patient should consume meals frequently in smaller portions. He/she should avoid solid food and large chunks of food, in favour of more semi-solid and liquid foods. This includes mashed vegetables, small pieces of cooked vegetable, soups (rasam), broths (congee), porridges (payasam), fresh fruit juices, sauces, gravies (sambhar), milk, buttermilk and plain water. A straw can be used.

Overcoming mouth-ulcers

The patient must consume bland food that is low on salt and spice (like Ven Pongal or upma). He/she should avoid more of solid food, in favour of semi-solid and liquid foods. The doctor may also recommend Vitamin B tablets.

Avoiding foods that interfere with medication

Some foods contain compounds that can interfere with cancer medication. These should be avoided throughout the treatment phase. Else, they can delay treatment and, in the process, worsen the condition.

• John’s wort: Extract made from this herb is used to treat depression. It reduces the effectiveness of imatinib, a drug used for treating certain types of blood-cancer.
• Green tea: Popular with people fighting digestive issues or weight-gain. It can reduce the effects of bortezomib, a drug used for treating certain types of blood-cancer.

Other factors

In addition to Diet-related factors,

• Following a high level of food-safety helps prevent infections that can be worsened due to blood-cancer.
• Exercise has a positive impact on the mental-health of the person, along with restoring appetite and in healthy weight-management. Patients who exercise regularly are also less likely to indulge in substance-abuse, to combat depression or anxiety brought on by blood-cancer.

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