Tuesday, January 31, 2012

A Dietitian's Cancer Story Newsletter: Fall 2005

Fall 2005 Greetings from Diana Dyer, MS, RD, author of A Dietitian's Cancer Story


During October 1995, ten years ago, I had an appointment with my oncologist for my first post-chemo check up. I asked him what I thought was a simple question, “Now that chemo is over, what can I do to help myself recover? His initial silence was both deafening and disheartening. I politely told him I would be back with a better answer than that as I left his office that day feeling very alone.
His lack of an answer ultimately led me to write my book, A Dietitian’s Cancer Story, which I wrote to be exactly what I wish my own cancer center would have had available to hand me when I asked that “simple question”. I was looking for a short, motivational, and easy to read guide containing reliable information about nutrition and lifestyle changes that could help a cancer survivor potentially tip the scales in favor of both extension of life and improvement of the quality of life.
Several years later, my oncologist shared with me his observation that “the oncology community didn’t even know there was a ballgame in town to have dropped the ball regarding the various concerns of cancer survivorship.” While many aspects of cancer survivorship receive more attention in 2005 compared to 1995, there is no standard of practice, and much more still needs to be done to optimize medical care and life after cancer. His earlier observation has recently been verified in an important new report just published, 10 years after I asked my original question.
On November 7, 2005, The Institute of Medicine of the National Academies released its new report From Cancer Patient to Cancer Survivor: Lost in Transition. This report addresses the many issues facing adult cancer survivors once they have completed treatment, and yes, it does include recommendations for nutrition and lifestyle counseling among many other aspects of important follow-up care.
I urge you to read this report (at least the summary) and ask your oncologist how survivorship concerns will be addressed at your cancer treatment facility. More can be read at the following web sites:
http://www.iom.edu/report.asp?id=30869
http://www.canceradvocacy.org/news/iom.aspx
This report is a direct result of grassroots efforts, with many cancer survivors speaking out to help pave the path so the recovery journey will be less difficult for those millions of cancer survivors still to follow.

In this season of giving and thankfulness, I would like to thank all those survivors and health care professionals in the oncology community who shared their personal experience, gave their time, expertise, heart, advocacy, and service to develop this report. I also thank all of my readers who continue to be supportive for patients, friends, family, or colleagues with a cancer diagnosis.
I could not help but smile with understanding as I recently heard one of Shirley Chisolm’s most notable quotations: “Service is the rent we pay for living on this earth.” How true, but please don’t think that service needs to be advocating at the national level. Emily Dickenson reminds us of the benefits from local service with her well-known poem:
If I can stop one heart from breaking,
I shall not live in vain.
If I can ease one life the aching,
Or cool one pain,
Or help one fainting robin
Unto his nest again,
I shall not live in vain
I send you all my best wishes for this holiday season and 2006 - may they be filled with hope, health, happiness, and service.
Diana Dyer, MS, RD
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Newsletter Contents:
I. Tidbits of Helpful Information
II. Clinical Trials for Cancer Survivors
III. Research Updates
IV. Book Ordering Information

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I. Tidbits of Helpful Information
A. It was with great sadness to hear of the passing of Steve Dunn, a long-term cancer survivor and advocate, who founded the very helpful web sitehttp://www.cancerguide.org. A friend told me about the following web sitehttp://www.gratefulness.org/candles/enter.cfm where I lit a candle in Steve’s honor. I now use this web site to light candles of hope for my friends who are experiencing the uncertainties of a cancer diagnosis and therapy.
B. The Department of Health and Human Services (HHS) recently launched a new breast cancer site, http://www.hhs.gov/breastcancer/ , which helps patients understand their disease, its treatment, and gives them tools to help deal with the challenges that the disease creates in their lives.
C. 30 manageable steps to take with the new “MyPyramid for a Healthier You!” Get started! http://lancaster.unl.edu/food/ftnov-dec05.htm Great ideas for those New Year’s Resolutions!
D. Please read and sign the petition for a "CHILDHOOD CANCER AWARENESS POSTAGE STAMP."
http://www.thepetitionsite.com/takeaction/928701473

E. The American Institute for Cancer Research (AICR) has added a new feature to their web site. The AICR Nutrition Hotline can now be accessed most easily by going to http://www.aicr.org/hotline/ and clicking on “submit a question.” An email response from an AICR registered dietitian (RD) will be received within 3 working days. As in the past, questions can also be submitted by dialing 1-800-843-8114 from 9 to 5 EST Monday through Friday and asking for the Nutrition Hotline.
F. I’ve highlighted http://www.CancerNutritionInfo.com in the past. This web site just keeps better and better. Much of the excellent content is available free of charge. However, the research analyses are the real strength of the web site’s content and are well worth the annual cost of $15.00. A free trial subscription is available.
G. A helpful booklet called A Low-fat Dietary Guide to Aid in the Management of Skin Cancer by Homer S. Black, PhD and Suzanne Jaax, MS, RD can be downloaded and printed off from http://www.homersblack.com.
Dr. Black conducted a clinical trial several years ago (N Engl J Med. 5;330(18):1272-5, 1994), which showed that following a 20% low-fat diet decreased the incidence of actinic keratoses (pre-malignant skin lesions) in people who had already had one occurrence of basal cell skin cancer. The control group (those people following their usual high fat diet) had nearly 5 times the number of these lesions develop during the two years of the study.
Dr. Black does not know if a diet with higher fat content primarily coming from the healthful monounsaturated fats like those contained in olive oil will be as effective as this low fat diet (personal communication). However, the booklet is very helpful in teaching people how to calculate their approximate calorie needs, fat requirements when limiting intake to 20%, and the fat content of many foods. 
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II. Clinical Trials

A. A second call for all long-term survivors of colorectal, prostate, and breast cancers to participate in the RENEW Study (Reach out to Enhance Wellness in Older Survivors)
What: A diet and exercise program for long-term cancer survivors funded by National Institutes of Health - led by Dr. Wendy Demark-Wahnefried (Winner of the 2003 Komen Professor of Survivorship Award from the Susan G. Komen Breast Cancer Foundation)
1. At Duke University, Durham, NC
2. You do not need to have had cancer treatment at Duke
3. You will not need to travel to Duke
4. All materials will be mailed to you
5. Health counseling will be done by telephone

Eligibility requirements:
1. Anyone with a diagnosis of colorectal, prostate, or breast cancer at least five (5) or more years ago.
2. At least age 65
3. Must be overweight

Contact Information:
1. Call Denise Snyder at 1-877-239-1054 (toll-free) or,
2. Send Email to RENEW@geri.duke.edu

This is an important and popular study. Call soon.
B. Phase III Randomized Chemoprevention Study of Selenium in Participants with Previously Resected Stage I Non-small cell Lung Cancer (NSCLC)
In this study, researchers are investigating the ability of selenium to prevent the development of secondary lung tumors in patients with surgically removed, early-stage NSCLC. Selenium is an essential dietary mineral that has been shown in animal studies to inhibit the growth of tumors. It is also associated with reduced cancer incidence in some animal populations.
The following web site will review the study, give entry criteria, and study locations throughout the country.
http://www.cancer.gov/clinicaltrials/ft-ECOG-5597
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III. Research Updates
A. Dietary Genistein Reduces Metastasis in a Post surgical Orthotopic Breast Cancer Model, SA Vantyghem et al., Cancer Research 65, 3396-3403, 2005.
Metastatic spread, not primary tumor burden, is the leading cause of breast cancer deaths. A mouse model of breast cancer metastasis was developed where an implanted primary breast tumor was grown for 5 weeks and then was removed by surgical resection before systemic adjuvant treatment. Mice were then randomized into two diet groups: control soy-free diet versus genistein-supplemented diet. Five weeks later, metastatic burden was assessed. Genistein reduced the percent metastatic burden in the lungs by 10-fold.
Conclusion: These results indicate that dietary intervention following cancer surgery can affect the outgrowth of seeded tumor cells.
My comments: This innovative study adds to some additional cell culture evidence that consumption of genistein (at least in this mouse model) may actually be beneficial in reducing the spread of breast cancer, a significant advance in the potential treatment of this disease. However, controversy continues regarding the consumption of soy foods and the isoflavone genistein (available as both a dietary supplement and also added to some foods) for women who have a history of or are at high risk for developing breast cancer. Much more research needs to be done to understand how much genistein, for how long, etc, etc, may produce this beneficial effect. (See below.)
B. Mammalian lignans enterolactone and enterodiol, alone and in combination with the isoflavone genistein, do not promote the growth of MCF-7 xenografts in ovariectomized athymic nude mice, Power, KA, Saarinen, NM, Chen, JM, Thompson, LU, Int J Cancer. 2005 Sep 8; [published online, ahead of print]
This study determined the effect of various dietary phytoestrogens (the mammalian lignans from flaxseed called enterolactone (ENL) and enterodiol (END) alone and in combination with the isoflavone genistein (GEN) from soybeans) on the growth of breast (MCF-7) tumors in ovariectomized nude mice. The mice with established estrogen sensitive breast tumors were all fed a basal diet and divided into 5 groups that received daily subcutaneous injections ENL, END, GEN, a mixture of these compounds (MIX), or vehicle as a negative control for 22 weeks. In the ENL- and END-treated mice, palpable tumors regressed significantly by 91 and 83%, respectively, resulting in final tumors that were similar to the negative control tumors. Tumor cell apoptosis (programmed cell death) was significantly enhanced by the lignans. In the GEN-treated mice, tumors initially regressed significantly by 64% but regression ceased following prolonged treatment, resulting in final tumors that were significantly larger compared to negative control, ENL-, and END-treated mice, in part by increasing tumor cell proliferation. The MIX treatment significantly regressed palpable tumors by 87% similar to negative control group, with no effects on tumor cell apoptosis or proliferation.
Conclusions: the isoflavone GEN alone promoted the growth of established MCF-7 human breast cancer xenografts after prolonged treatment, while the mammalian lignans ENL and END did not. When these phytoestrogens were given in combination, no tumor growth-promoting effects were observed.
My comments: This research shows why the controversy regarding the effects of genistein on breast cancer cells continues. However, the interesting aspect of this study is that the mixture of flaxseed lignans (available in the whole or ground seed) and the isolated soy isoflavone called genistein showed no tumor promoting activity for these implanted estrogen sensitive breast cancer cells.
While it is important to understand this was not a diet study (the animals received all these phytoestrogens by injection), the mixture of the flaxseed and soy phytoestrogens showed tumor regression in this model. The benefits from combining foods (called food synergy) are receiving more and more attention in the research community. After all, this same model is used within the oncology community with multi-drug chemotherapy regimens and also combining types of therapy such as chemo and radiation.
In any case, it is interesting for me to think about the results of this study in light of the fact that I have been combining soy foods with flaxseeds in my soy shake recipes for 10+ years without a recurrence of my estrogen positive breast cancer. 
C. Tea and circulating estrogen levels in postmenopausal Chinese women in Singapore, Wu, AH et al, Carcinogenesis May 2005;26(5):976-80.
This study investigated the relationship between tea intake and plasma estrogen and androstenedione (a hormone that is a precursor for testosterone) levels in healthy postmenopausal Chinese women in Singapore. Some limited evidence has suggested that green tea may decrease circulating sex-steroid hormones, whereas black tea may increase these hormones. In this group of 130 women, 84 were non or irregular (less than once a week) tea drinkers, 27 were regular (weekly/daily) green tea drinkers and 19 were regular (weekly/daily) black tea drinkers. Relative to plasma estrone levels in non- or irregular tea drinkers (29.5 pg/ml) the levels were 13% lower in regular green tea drinkers (25.8 pg/ml) and 19% higher in regular black tea drinkers (35.0 pg/ml). These differences in estrone levels were statistically significant (P = 0.03) in spite of adjusting for age, body mass index, intake of soy, and other covariates. A similar pattern of differences between tea intake, and plasma levels of estradiol (P = 0.08) and androstenedione (P = 0.14) were found. Larger studies are needed to confirm these results and to better understand the potentially differing effect of black and green tea on circulating estrogen levels and ultimately on the risk of breast cancer.
My comments: This is a small observational study that has shown differences in hormone levels of potential interest to those studying reasons why there is a lower incidence of breast cancer in Asian countries. It was most interesting to see the increased hormone levels in women who consumed black versus green tea. I continue to carry my own green tea when traveling, as it is still the unusual restaurant, airline, or conference that has it available.
D. Antioxidant vitamin and mineral supplementation and prostate cancer prevention in the SU.VI.MAX trial, Meyer, F et al, Int J Cancer. 2005 Aug 20;116(2):182-6
The Supplementation en Vitamines et Mineraux Antioxydants (SU.VI.MAX) study is a randomized, double-blind, placebo-controlled primary prevention trial evaluating antioxidant supplementation on the risk of cardiovascular disease and cancer. A total of 13,017 French adults (7876 women aged 35-60 years and 5141 men aged 45-60 years) were included. All participants took a single daily capsule of a combination of 120 mg of ascorbic acid, 30 mg of vitamin E, 6 mg of beta-carotene, 100 micrograms of selenium, and 20 mg of zinc, or a placebo and were followed for 8 years.
Overall, there was a moderate non-significant reduction in prostate cancer rate associated with the supplementation. However, the most notable results were the striking differences seen between men who had a normal PSA versus those who started the study with levels higher than 3. Among men with normal PSA, there was a statistically significant 48% reduction in the rate of prostate cancer for men receiving the supplements. In men with higher PSA levels at baseline, the supplementation was associated with a 54% increased incidence of prostate cancer.
My comments: Whew, talk about controversy and complexity. Nothing is ever simple when it involves cancer and antioxidants. The increase in prostate cancer with the antioxidant supplementation was only of borderline statistical significance, but I would highly recommend knowing your baseline PSA prior to taking antioxidants hoping to prevent prostate cancer. In addition, I always recommend having your diet reviewed by a registered dietitian (RD) for individualized advice in order to optimize the healthfulness of your diet to reduce the risk of or treat all diseases for which you may be at high risk. Finally, always discuss the introduction or use of all dietary supplements with both your doctor and RD to help evaluate the pros and cons based on current research.
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IV - Both editions of A Dietitian's Cancer Story (English version ISBN 096672383X) and Historia De Cáncer De Una Dietista (Spanish version ISBN 0966723821) can be ordered from any bookstore, library, Amazon.com, and directly from the American Institute for Cancer Research (AICR) by calling 1-800-843-8114 or going to AICR’s web site <http://www.aicr.org>.
Discounts for orders of 10 or more copies are available for both editions by calling AICR at 1-800-843-8114 - asking to speak to Candis Navarette. Many cancer centers, health care professional offices, and places of worship have ordered books in larger quantities to have available to give as educational and support information or to resell.
Bookstores and libraries may order directly from the book wholesalers Ingram or Baker & Taylor.
Personally autographed copies of A Dietitian's Cancer Story are now readily available through Nicola's Books in Ann Arbor, Michigan. It's easy to order the book directly from this full service independent bookstore at their web site,http://www.nicolasbooks.com which has a space to indicate how you would like the book inscribed. They will happily mail the book anywhere in the world.
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I send my best wishes to all of you for health, healing, and hope!
Diana
--
Diana Grant Dyer, MS, RD - Author
A Dietitian's Cancer Story (English and Spanish translation)
Available from AICR (call 1-800-843-8114)

"Information and inspiration for cancer survivors"
Proceeds donated to the Diana Dyer Cancer Survivors'
Nutrition and Cancer Research Endowment at the
American Institute for Cancer Research (AICR)






 


Monday, January 30, 2012

A Dietitian's Cancer Story Newsletter: Summer 2005

Greetings from Diana Dyer, MS, RD, author of A Dietitian's Cancer Story

I would like to take this opportunity to thank all of you who responded to my request in the Spring Newsletter to write your US Senators and House Representative asking for their support and sponsorship of The Medical Nutrition Therapy Act of 2005 (Senate Bill 604 and House Bill 1582). Support for this legislation continues to grow. As of July 26, 2005, there are now 19 sponsors in the Senate and 36 House sponsors.

This bill, which has bipartisan support and is considered “revenue neutral”, is a necessary step in order to increase the inclusion of professional services by Registered Dietitians (RD), which is called medical nutrition therapy or MNT, into true comprehensive cancer care.
More information about this bill can be found on my web site at http://www.cancerrd.com/faqs/faq74.htm along with links to web sites where you can find the names and contact information for your senators and representative and even a sample letter to thank or ask for their support of this important bill.
I recently read this Chinese proverb:
“When a question is asked ceremoniously, the universe responds”

As ceremoniously as possible via an Email newsletter, I ask you for two things:
(1) Please write your senators and representative in Washington today expressing your support for The Medical Nutrition Therapy Act of 2005 and asking or thanking them for theirs

(2) Please send me a short email message at newsletter2@CancerRD.com (put MNT in Cancer Centers as your subject) describing a situation in which professional services from an RD helped with the outcome of your cancer treatment and/or recovery or if such professional expertise was not included as a component of your cancer care and how you believe nutrition services would have been of benefit to your cancer care.
I think this proverb means when someone “really” asks, we “really” respond.
Thank you for “really”, i.e. wholeheartedly, responding to my request!
Diana Dyer, MS, RD
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Newsletter Contents:
I. Autographed books and past newsletters
II. Spanish edition of my book
III. Tidbits of helpful information
IV. New clinical trial for people with chemotherapy-induced nausea
V. Research Updates
VI. Book Ordering Information
VII. Newsletter forwarding guidelines
VIII Newsletter sign-up instructions
IX. Removal Instructions

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I. Autographed books and past newsletters
Just as a reminder, personally autographed copies of my book A Dietitian’s Cancer Story are now available through Nicola’s Books in Ann Arbor, Michigan. It’s easy to order the book directly from her web site at http://www.nicolasbooks.com, which has a space to indicate how you would like the book inscribed. They will mail the book anywhere in the world. It has been fun to see where all the books have been sent.
All previous newsletters are now archived on my web site. Just click the Newsletter button on the Homepage to find them. Of special interest, all the information contained in these newsletters is also searchable with the search function available to use on my web site.
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II. Spanish edition of my book – Historia De Cáncer De Una Dietista
"This book is so helpful and inspirational that I volunteered to translate it into Spanish in order to share this valuable information with the Spanish-speaking community." – Maria Duarte-Gardea, PhD, RD, LD, Assistant Professor Texas Tech University Health Sciences Center at El Paso, El Paso, TX, USA
The estimated Hispanic population of the United States is nearly 40 million people, with the following states having the highest proportions of these Spanish-speaking communities: California, Texas, New York, Florida, Illinois, Arizona, New Mexico, and New Jersey.
No matter where you live, please consider ordering the Spanish edition of my book to donate to your cancer center’s patient library or resource center, or your local public library. Copies may be ordered from any bookstore, Amazon.com, or directly from AICR by calling 1-800-843-8114.
Please help me reach this population of cancer survivors with both “information and inspiration”. I appreciate your help. Thanks very much!
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III. Tidbits of Information
(A) Recurrent Cancer – The National Cancer Institute is developing a new booklet to address questions and concerns of people with recurrent cancer. They would like to hear your reactions to the booklet.
If you have been diagnosed with recurrent cancer within the last year, and would be willing to read the booklet and then spend about 30 minutes on the phone to let NCI know your opinions, please call NCI toll-free at 1-888-249-0029. All eligible participants will be paid for their time, and this study will only involve a total of 1-2 hours.
(B) Cancer survivor movie - http://www.thesurvivormovie.com/ Don’t plan to whip through this short movie or read your mail at the same time. Make yourself a cup of green tea to sip while watching this brief tribute to cancer survivorship. You’ll be glad you gave yourself the opportunity to pause and reflect on what you have accomplished thus far, still have to do, or appreciate the significance of the journey being taken by your friends, loved ones, or patients.
(C) The NCI Cancer Advocates E-News – an Email newsletter for cancer advocates and the general public interested in cancer news from NCI and other federal agencies, clinical trials and new treatment updates, NIH video casts, press releases, and opportunities to become involved. The newsletter comes every other week. To subscribe: send an Email to listserv@list.nih.gov, type the following command in the body of the message: subscribe cancer-advocates.
(D) Zonya’s Health Bites: The Show for Food, Fitness, and Fun – My own PBS television station is finally going to start airing the new 30 minute show called Zonya’s Health Bites: The Show for Food, Fitness, and Fun by Zonya Foco, RD, CSP. You can check her web site at http://www.zonya.com/healthbites.htm to see if your local PBS station has it in their line-up. If not, call the station to request it!
(E) New book – Over 140 Things you need to know about your Autologous Bone Marrow or Stem Cell Transplant by Mark Patton, MGC Publications, Bayside, Wisconsin, ©2005. Ordering information is at www.BMTresources.org, and a portion of the proceeds are donated to the Bone Marrow Foundation to help patients in need of financial assistance for their transplants. A wealth of practical advice from a very experienced patient. I especially liked Tip #74 – utilize the expertise of the transplant centers “outstanding dietitians”.
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IV. New Clinical Trial
A new clinical trial funded by the NCI and National Center for Complementary Medicine is comparing different doses of ginger in patients with chemotherapy-induced nausea and vomiting. The study is currently recruiting patients. Study sites are in Michigan, New York, Indiana, and Puerto Rico. Further information regarding the study design and objectives, eligibility, and study sites contact names and phone numbers can be found at the following web site:http://www.cancer.gov/clinicaltrials/CCUM-0201
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V. Research Updates
(A) Women’s Intervention Nutrition Study (WINS) was finally presented at The American Society of Clinical Oncology’s annual meeting in May 2005. Further information can be found at the following web site:http://www.cancer.gov/clinicaltrials/results/low-fat-diet0505
In a nutshell, this large research study showed that post-menopausal breast cancer patients given intensive nutrition education and on-going support from a Registered Dietitian (RD) in order to achieve and maintain a low-fat diet (target was 15%, actual intake ~20%) had a lower rate of breast cancer recurrence than women who were asked to follow their regular diet. The overall risk reduction for recurrence was 24% but the subgroup of women with ER-negative tumors had a 42% risk reduction for recurrence during the 5 year follow up time period.
This research has not yet been published, and combing the data with a fine-tooth comb may still show that other factors also helped reduce the risk of recurrence, such as weight loss, increased exercise, increased consumption of fruits and/or vegetables, etc, even though these lifestyle changes were not the primary interventions or variables being studied.
Take home message – If you are a breast cancer survivor (either in treatment or after treatment completion), don’t wait for your oncologist or surgeon to suggest that you see an RD as part of your comprehensive cancer care. Ask for a referral today for the RD at your cancer center or seek out the professional expertise of an RD in private practice in your locality by going to the web site for the American Dietetic Association (http://www.eatright.org) and typing in your zip code. Look for an RD with expertise in oncology and/or weight management.
(B) Two recently published studies show that patients who received concurrent individualized dietary counseling while undergoing radiation therapy for either colorectal cancer or head and neck cancer had improved nutritional and quality of life outcomes. These well-designed research studies will likely prove to be classic, landmark studies leading to the increased provision of proactive nutritional care for cancer patients.
1. Dietary counseling improves patient outcomes: a prospective, randomized, controlled trial in colorectal cancer patients undergoing radiotherapy. Ravasco P, et al., J Clin Oncol. 2005 Mar 1;23(7):1431-8.
This study compared three groups of colorectal cancer patients, all undergoing radiation therapy: (1) the first group received individualized dietary counseling as directed by their food preferences and symptoms of the disease or radiation side effects, (2) the second group did not receive any counseling but received 2 cans/day of a high protein and calorie liquid supplement to drink in addition to their usual food intake, and (3) a third group consumed only their usual food intake the best as possible during radiation therapy without any counseling or liquid dietary supplements.
The results showed that individualized dietary counseling was the most effective means leading to improved nutritional intake, nutritional status, and quality of life during radiation, at the end of radiation, and particularly 3 month after radiation therapy had been complete.
2. Impact of nutrition on outcome: A prospective randomized controlled trial in patients with head and neck cancer undergoing radiotherapy. Ravasco P, et al., Head Neck. 2005 May 26;27(8):659-668.
With an identical study design to the colorectal study already mentioned, again, only the group of head/neck cancer patients who received the individualized dietary counseling during radiation therapy had the most improved nutritional intake, nutritional status, and quality of life indicators at both the end of radiation therapy and even more significantly 3 months after radiation was complete, even overcoming the usual nutritional deterioration seen with radiation therapy for head/neck cancer.
Quality of life outcomes like physical and cognitive functioning have traditionally been considered *soft* results by the research community. However, these authors state that they should be the “gold standard” in any clinical trial. Ask any cancer survivor if quality of life is important, and even as important as the more commonly used endpoints that involve some measurement of tumor response.
Which group would you want to be in? The time is rapidly approaching, if not already here, when patients at high risk of nutritional decline during cancer therapy plus those for whom nutritional intervention may impact disease progression will benefit by receiving medical nutrition therapy from RDs as a proactive component of comprehensive cancer care.
Take home message from both of these studies – speak up and insist on having an RD be part of your oncology health care team in a proactive role (i.e., not just receiving a consult after you have lost or gained 30#). I have heard from cancer survivors across the country that “shopped around” to find a cancer treatment team that included an RD. Ask up front and express your desires (do I dare say requirements?) One last note: don’t assume a center does not have an RD on staff, as some progressive cancer treatment facilities have figured out ways of including their expertise as part of the complete cancer care package.
(C) Two recent flaxseed studies from Dr. Lilian Thompson’s lab in Toronto will be encouraging for those who have had concerns that the most active component of flaxseed, a phytoestrogen abbreviated SDG, may promote estrogen responsive tumors or even interfere with the anti-estrogen drug Tamoxifen.
(1) Dietary flaxseed enhances the inhibitory effect of Tamoxifen on the growth of estrogen-dependent human breast cancer (mcf-7) in nude mice. Chen J, Hui E, Ip T, Thompson LU, Clin Cancer Res. 2004 Nov 15;10(22):7703-11.
This mouse study clearly showed that dietary flaxseed given in an amount equivalent to the human intake of 25-50 gm per day (25 gm = approx. 2 Tbsp) inhibited the growth of human estrogen-dependent breast cancer and also increased the tumor-inhibitory effect of Tamoxifen at both low and high level of estrogen levels. The mechanism(s) for this effect is not yet clear but is likely multi-factorial in nature involving several non-hormonal pathways.
In general, ground flaxseed showed more positive effects in the mouse study than the use of flaxseed oil.
An additional important finding was that while Tamoxifen increased the weight of the uterus 39% in the low estrogen group (indicating an estrogenic effect) compared to the control, flaxseed alone had no effect on weight of the uterus.
Note: Many women who now take another anti-estrogen drug called an aromatase inhibitor (AI) will wonder if there are data to evaluate how flaxseed might interact with the action of aromatase inhibitors. No comparable study has yet been published but additional recently published in vitro work by Dr. Thompson has shown that the active components produced from flaxseed (and also the active component of soy) greatly reduce the activity of the aromatase enzyme in estrogen-dependent breast cancer cells grown in cell culture. Further research is warranted, but these results are encouraging. (J Steroid Biochem Mol Biol. 2005 Apr;94(5):461-7)
(2) Dietary flaxseed alters tumor biological markers in postmenopausal breast cancer, Thompson LU, Chen JM, Li T, Strasser-Weippl K, Goss PE, Clin Cancer Res. 2005 May 15;11(10):3828-35.
Publication of this study has been long awaited. Post-menopausal women who had a breast biopsy positive for breast cancer consumed either a muffin containing 25 grams of flaxseed or a control (placebo) muffin daily during the time frame between the biopsy and breast cancer surgery with various tumor biological markers measured at the time of biopsy and later surgery.
This human study very clearly showed that dietary flaxseed favorably impacted existing both ER-positive and ER-negative breast tumor cells in a short time period (32 days) by showing reduction in tumor cell proliferation markers, increased cell death (apoptosis index), decreased expression of the aggressive HER2 gene (c-erbB2 score), and the total intake of flaxseed correlated with the changes seen for both the c-erbB2 score and the apoptosis index.
The author states that these results suggest that the dietary intake of flaxseed has the potential to reduce the growth and invasiveness of breast cancer. Additional research is needed, but again, these results are very encouraging.
Take home message from these flaxseed research reports: Dietary flaxseed in reasonable amounts looks to be very promising as adjunctive therapy for both ER-positive breast cancer and ER-negative breast cancer.
The amount used in the muffin study and the comparable amount used in the mouse study is easily achievable. One to two Tbsp. of whole flaxseed can be obtained by consuming my soy shake recipe on a daily basis (http://www.cancerrd.com/Recipes/supersoy1.htm).
Other recipes on my web site that contain flaxseed as an ingredient include:
* Banana Walnut Flaxseed Muffinshttp://www.cancerrd.com/recipes/banana_walnut_flax_muffins1.htm

* Flaxseed Pesto 
http://www.cancerrd.com/recipes/flaxseedpesto1.htm

* Rice Pudding 
http://www.cancerrd.com/recipes/ricepudding1.htm

* Granola with Soy and Flaxseedhttp://www.cancerrd.com/recipes/granola_soy_flaxseed1.htm
Sprinkle ground flaxseed on cereal or yogurt, mix it into veggie burgers, tuna or egg salad, pancake or waffle batter, etc, etc. Please write and tell me your favorite way to eat flaxseed. Send a message to newsletter2@cancerrd.com and put Flaxseed in the subject line. I’ll put some more ideas into my next newsletter along with an update about an additional study published by Dr. Thompson.
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VI - Book Ordering Information
Both editions of A Dietitian's Cancer Story, the updated and revised 2002 edition (ISBN 096672383X) and the Spanish edition published in 2000 (ISBN 0966723821) can be ordered from any bookstore, library, Amazon.com, and directly from the American Institute for Cancer Research (AICR) by calling 1-800-843-8114 or going to their web site <http://www.aicr.org>.
Discounts for orders of 10 or more copies are available for both editions by calling AICR at 1-800-843-8114 - asking to speak to Candis Navarette. Many cancer centers, health care professional offices, and places of worship have ordered books in larger quantities to have available to give as educational and support information or to resell.
Bookstores and libraries may order directly from the book wholesaler Ingram.
***************************


I send my best wishes to all of you for health, healing, and hope!
Diana
--
Diana Grant Dyer, MS, RD - Author
A Dietitian's Cancer Story (English and Spanish translation)
Available from AICR (call 1-800-843-8114)

"Information and inspiration for cancer survivors"
Proceeds donated to the Diana Dyer Cancer Survivors'
Nutrition and Cancer Research Endowment at the
American Institute for Cancer Research (AICR)





 


Sunday, January 29, 2012

A Dietitian's Cancer Story Newsletter: Spring 2005



Spring 2005 Greetings from Diana Dyer, MS, RD, author of A Dietitian's Cancer Story.


On April 8, 1997, The Detroit Free Press published an article in which I was interviewed about the impact of nutrition on cancer recovery. It was the first time I had spoken to a reporter, and I thought it would a little article buried in a big newspaper. In a nutshell, I never could have foreseen the multiple opportunities that would subsequently come my way to help other people with their cancer recovery journey after that article was published.


From that “little article”, I recently had the opportunity to speak at The American Society of Breast Surgeons’ annual meeting in Los Angeles. It was an awesome opportunity (in the true sense of the word) to be able to speak to and potentially influence the practice of 1000+ breast surgeons in this country about the importance of nutrition for their patients.


I recently came across this meaningful quotation:
 No one could make a greater mistake than he who
did nothing because he could do only a little.
• Edmund Burke (1729 - 1797)
We never know how far the ripples of our small actions will spread, but spread they will, just like the ripples that result from throwing a pebble into a lake.


I urge you all to do something “little”, not knowing where it will lead, hoping only that your actions will help someone else with some aspect of their life.


Diana Dyer


**********************
Newsletter Contents:
I.Autographed books now available
II.Past newsletters now available
III.Action Alert – legislation needs your support now
IV.Research Update
V.New Books to Suggest
VI.New Clinical Trial for Cancer Survivors
VII.Tidbits of Helpful Information
VIII.Book Ordering Information

**********************
I. Autographed books now available! Many of you have written to me asking how to obtain a personally autographed book either for yourself or to send to someone you care about. There is now any easy way to do this. By going to the web site forNicola’s Books in Ann Arbor, Michigan, you may order my book through that web site indicating how you would like the book signed. They will call me, I drive to the store to sign the book as soon as I am available, and they mail the book to the address specified.
I am very pleased to provide this new personalized service. They have already shipped a book to Australia! (Special note: sometimes I am out of town and cannot accommodate rush requests. Please allow at least a week for me to sign the book and Nicola’s Books to ship it out.)


**********************
II. All previous newsletters are now archived on my web site. Again, so many of you wrote me asking for access to these older newsletters. They are now all posted up on my web site; just click the Newsletter button on the Homepage to find them. Of special interest, all the information contained in these newsletters is also searchable with the search function available to use on my web site. I have enjoyed re-reading them myself!


***********************
III. Action Alert – since I developed this web site in 1998, the most frequently asked question I have received each year has been “Why isn’t nutrition included with my cancer care?” I have responded to this question in the past but have recently updated the answer on my web site to include information about a new bill that has been introduced into Congress this year called The Medical Nutrition Therapy Act of 2005. www.CancerRD.com/faqs/faq74.htm
In a nutshell, this bill would ultimately permit Medical Nutrition Therapy (MNT or professional services of a Registered Dietitian) to be a covered expense by Medicare for disease conditions like cancer when scientific evidence shows the intervention to be both beneficial and cost effective (private insurance companies usually follow Medicare guidelines).
For this bill to be passed (either alone or as an amendment onto another bill), your Senators and Representative in Washington, DC, need to hear from you now so they know this bill is important to patient care, particularly so that nutrition can become a component of comprehensive cancer care for all people diagnosed with cancer.
I have put a copy of the letter I wrote to my Senators and Representative on my web site at www.CancerRD.com/faqs/faq74.htm . Feel free to copy it, inserting your own comments, and send it off by Email or fax to your Senators and Representative.
Most people I meet who have not had personal experience with cancer are astounded to hear that nutrition services from Registered Dietitians is often not included as a component of comprehensive cancer care. Please write or call your Senators and Representative soon. You will be helping yourself and those millions of patients still coming to have better cancer care.


***********************
IV. Research Updates – New cancer drug side effects noted
(A) Bisphosphonates linked to osteonecrosis of the jaw.
Although causality has not yet been established, research reports have recently shown an increased incidence of a serious condition known as osteonecrosis of the jaw (ONJ) in some people receiving the bisphosphonate drugs zolendronic acid injection (Zometa) and pamidronate sodium injection (Aredia), both made by Novartis.
Symptoms include the following:
 Pain, swelling, or infection of the gums
Loosening of teeth
Poor healing of the gums
Poor healing after dental procedures
Numbness or the feeling of heaviness in the jaw
The drugs' labels now advise doctors who prescribe these drugs to consider having patients undergo dental evaluation and necessary preventive and noninvasive dental care before they start receiving Zometa or Aredia treatment.
Novartis is recommending that while receiving these drugs, patients should avoid invasive dental procedures if possible. If patients do develop osteonecrosis of the jaw while receiving bisphosphonate therapy, they should avoid dental surgery.
According to the FDA: "If patients on bisphosphonates do require dental procedures, there are no data available on whether stopping the drugs reduces the risk of osteonecrosis of the jaw. The clinical judgment of the physician should guide each patient's management, based on an assessment of benefits and risks."
Take home message: If you are already receiving either of these medications, maintain excellent oral hygiene. If you experience any symptoms or any dental procedures are needed, make sure that your dentist or oral surgeon knows of your increased risk for development of ONJ so that all symptoms and/or risks and benefits of a procedure can be evaluated taking this potentially very serious condition into consideration.
Additional information can be found at the following web sites:
http://www.myeloma.org/main.jsp?type=article&tab_id=1&menu_id=0&id=1259
http://www.sciencedaily.com/releases/2004/12/041203100220.htm
http://www.ada.org/prof/resources/pubs/adanews/adanewsarticle.asp?articleid=1185

(B) Tamoxifen may show decreased efficacy when prescribed along with SSRI anti-depressant medications such as Paxil in some women
A recent article in the January 2005 issue of The Journal of the National Cancer Institute reported that, depending on their genotype, women receiving tamoxifen may have a decreased level of one of tamoxifen’s most effective metabolites (endoxifen) if also taking an SSRI antidepressant drug.
This research showed two main outcomes: (1) individual genes and variants were identified and demonstrated to have an effect on how tamoxifen is metabolized, and (2) different antidepressant drugs in combination with those various genes result in varying levels of tamoxifen metabolites.
Without genotype analysis for each woman, it is not known if one has the genes that produce the enzymes to promote maximum or reduced response when taking tamoxifen. However the study did show that certain SSRI drugs were more potent at reducing the level of the desired tamoxifen metabolites. The authors point out that the most potent inhibitor of the enzymes that optimize tamoxifen metabolism was paroxetine (Paxil), followed by fluoxetine (Prozac), sertraline (Zoloft), and citalopram (Celexa). Venlafaxine (Effexor) was the least potent inhibitor. In fact, the authors found that venlafaxine had very little effect on plasma endoxifen concentration, the important metabolite of tamoxifen produced by the genes being measured in this study.
The lead author of this study, Dr. David Flockhart at Indiana University in Indianapolis, notes, "Patients should NOT stop taking tamoxifen or their anti-depressant medications, but they might want to talk about the research with their doctor. These data suggest that women taking tamoxifen should avoid potent inhibitors of this enzyme, including paroxetine and fluoxetine."
“Before his group can make wider recommendations regarding genotype analysis or measurement of metabolite levels, they must await results of ongoing studies analyzing mortality outcomes and breast cancer recurrence rates,” Dr. Flockhart added.
Full article citation:
Jin Y, Desta Z, Stearns V, Ward B, et al. CYP2D6 Genotype, Antidepressant Use, and Tamoxifen Metabolism During Adjuvant Breast Cancer Treatment .J Natl Cancer Inst 2005; 97: 30-39.

Additional information:
http://www.nci.nih.gov/ncicancerbulletin/NCI_Cancer_Bulletin_011105/page2
http://health.yahoo.com/news/54082


***********************
V. New Books
I have two new books to suggest purchasing. They are both beautiful books with recipes focusing on healthy ingredients to optimize either cancer prevention (The New American Plate) or recovering from a cancer diagnosis (One Bite at a Time). I love them both and am working my way through their delicious recipes.
A. The New American Plate Cookbook: Recipes for a Healthy Weight and a Healthy Life, The American Institute for Cancer Research, University of California Press, 2005.
B. One Bite at a Time: Nourishing Recipes for People with Cancer, Survivors, and their Caregivers, Rebecca Katz, Celestial Arts, Berkeley, CA, 2004.


***********************
VI. New Clinical Trial for Cancer Survivors
Calling all long-term survivors of colorectal, prostate, and breast cancers to participate in the RENEW Study (Reach out to Enhance Wellness in Older Survivors)!
What: A diet and exercise program for long-term cancer survivors funded by National Institutes of Health – led by Dr. Wendy Demark-Wahnefried
1. At Duke University, Durham, NC
2. You do not need to have had cancer treatment at Duke
3. You will not need to travel to Duke
4. All materials will be mailed to you
5. Health counseling will be done by telephone



Eligibility requirements:
1. Anyone with a diagnosis of colorectal, prostate, or breast cancer at least five (5) or more years ago.
2. At least age 65
3. Must be overweight

Contact Information:
1. Call Denise Synder at 1-877-239-1054 (toll-free) or,
2. Send Email to RENEW@geri.duke.edu

This will be a popular study. Call soon. The pilot study conducted earlier in the year filled up almost immediately.


**********************
VII. Tidbits of helpful information
A. New TV show on Public Television
A new TV series called Zonya’s Health Bites, featuring Zonya Foco, RD, is available nationally on PBS starting in April. In a country plagued with heart disease, cancer and obesity, Zonya offers realistic lifestyle solutions for the whole family. Each show features segments in the grocery store, kitchen and fitness area. Zonya uses her dynamic motivational keynote presentations to begin and end each show, which carry the theme of her health message. By watching Zonya’s Health Bites, you’ll learn quick and easy ways to keep you motivated and on the right track for staying high energy and healthy!


B. New web sites:
1. http://ncilistens.cancer.gov/ - NCI Listens and Learns is a pilot forum for NCI. This pilot program is structured to facilitate dialogue between NCI and two distinct segments of the community: registered cancer advocacy organizations and members of the general public. The pilot forum was designed, and is being overseen, by the NCI's Director's Consumer Liaison Group (DCLG). One area of input being requested is how to prioritize the recommendations of the President’s Cancer Panel issued in 2004. Take a look and send in your ideas.
2. Web site www.plwc.org (ASCO’s People Living With Cancer) The American Society of Clinical Oncology (ASCO) is increasing its focus on cancer survivorship issues with its new Survivorship Task Force, which will manage initiatives designed to improve the lives of cancer survivors from long-term physical, emotional, and practical perspectives.
The ASCO task force will operate in several spheres including education, research, and advocacy. They aim to enhance oncologists’ confidence in their own ability to provide appropriate long-term survivor care by making survivorship a key component in the Society’s updated Core Curriculum for medical oncology.
ASCO will also develop clinical practice guidelines on topics like late effects of cancer treatments, secondary malignancy, and the psychosocial issues of survivorship.
The will start by looking at the most promising prevention strategies among those survivors at high risk of second cancers such as female survivors of Hodgkins’ disease who received radiation therapy to the chest and now have a 35% cumulative incidence of breast cancer 20-25 years after treatment.


C. New restaurant
If you are lucky enough to live in Maine or Massachusetts, give this new restaurant chain a try and let me know how you liked the menu and the food. O’Naturals, now with four locations, was founded by the folks that also started Stonyfield Farm, a producer of organic yogurt. Menu items range from Asian soups to sandwiches with wild Alaskan salmon. It also has a kid’s menu to appeal to the entire family.www.onaturals.com/

**********************
VIII - Book Ordering Information
Both editions of A Dietitian's Cancer Story, the updated and revised 2002 edition (ISBN 096672383X) and the Spanish edition published in 2000 (ISBN 0966723821) can be ordered from any bookstore, library, Amazon.com, and directly from the American Institute for Cancer Research (AICR) by calling 1-800-843-8114 or going to their web site.
Discounts for orders of 10 or more copies are available for both editions by calling AICR at 1-800-843-8114 - asking to speak to Candis Navarette. Many cancer centers, health care professional offices, and places of worship have ordered books in larger quantities to have available to give as educational and
support information or to resell.

Bookstores and libraries may order directly from the book wholesaler Ingram.


**********************


I send my best wishes to all of you for health, healing, and hope!


Diana
--
Diana Grant Dyer, MS, RD - Author
A Dietitian's Cancer Story (English and Spanish translation)
Available from AICR (call 1-800-843-8114)

"Information and inspiration for cancer survivors"
Proceeds donated to the Diana Dyer Cancer Survivors'
Nutrition and Cancer Research Endowment at the
American Institute for Cancer Research (AICR)

Tuesday, January 24, 2012

A Dietitian's Cancer Story Newsletter: Winter 2005

A Dietitian's Cancer Story Newsletter: Winter 2005
Greetings from Diana Dyer, MS, RD, author of A Dietitian's Cancer Story.
As winter starts to give way to spring, I had the pleasure of visiting the Frederick Meijer Gardens in Grand Rapids, Michigan, where the largest temporary indoor butterfly exhibit in the US will open on March 1st. Because I was fortunate to be there early (before the throngs of happy school children, teachers, and families will fill the pathways throughout the exhibit), I was able to focus on more details of the plantings in the conservatory.


I was admiring a large stand of bamboo when I noticed a small plaque with this saying, It is quite possible to live without meat but not without bamboo, attributed to the 11th century Chinese poet Su Shih. Yes, it is possible to live without meat. In fact the translation for tofu is meat without bones, and parts of the bamboo plant are used in multiple aspects of Chinese life.


Of special interest to me however is bamboo being considered the Chinese symbol of spiritual fortitude, compromise, and survival as it gracefully bends without breaking. In addition, even more meaningful to me is the beautiful image the bamboo plant conveys for cancer survivors, with our spirits bending but not breaking as we seek and find our individual path on this journey of cancer survivorship to emerge with newly found spiritual fortitude and wisdom.


March 2005 will be the 10-year anniversary of surviving my second breast cancer. As I wait for spring to finally arrive here in the snowy Midwest, I am going to celebrate by growing a bamboo plant indoors, an ever-green symbol of my survival, but even more importantly, my spiritual growth, fortitude, and wisdom.


My hope is that you will also gracefully bend without breaking during the stormy times of your cancer survivorship journey to emerge renewed with life,


Diana Dyer, MS, RD
********************************


Newsletter Contents:
I. New Book to Suggest
II. Helpful Websites
III. New Clinical Trial
IV. Research Updates
V. Book Ordering Information

********************************
I. New Book to Suggest


From Asparagus to Zucchini: A Guide to Farm-Fresh Seasonal Produce, Madison Area Community Supported Agriculture Coalition, Jones Books, Madison, WI, 2004. Reading the new 3rd edition of this cookbook is even more exciting and satisfying than browsing through a seed catalog in January. The 300 mouth-watering recipes for 50 vegetables and herbs make this book simply feel delicious. Don't wait until your local Farmers Market opens to purchase this book. I simply love vegetables can you tell? More information about ordering this book can be found at the website for the Madison Area Community Supported Agriculture Coalition http://www.macsac.org/foodbk.php.


Now is a good time to consider joining a Community Supported Agriculture (CSA) farm in your location. All the ones that I know are small family farmers committed to organic farming. The following web site will help you find the CSAs in your state:http://www.nal.usda.gov/afsic/csa/csastate.htm. Also ask about the availability of CSAs at your local natural foods store and farmers market. Enjoy your locally produced, scrumptious, healthy foods while also supporting your local economy.


********************************
II. Helpful Websites


A. http://www.ChemoCountCards.com - A set of meaningful but also light-hearted cards to send to a friend undergoing chemotherapy for breast cancer. A portion of the proceeds is donated to the Young Survival Coalition, an organization dedicated to supporting women with breast cancer who are under age 40
B. http://www.votenote.com - Sign up at this web site for weekly notification of how your representatives in Washington are voting on bills of interest to you
C. http://www.whyorganic.org - A UK site dedicated to explaining benefits of organic food and farming
D. http://nat.crgq.com - Nutritional Analysis Tools at the University of Illinois a web site where you can analyze your own recipes for nutrient content
E. http://hin.nhlbi.nih.gov/portion/ - Understand portion distortion and learn about portions vs. serving sizes
F. http://www.hhs.gov/familyhistory/ - The Family History Initiative, launched by former Health and Human Services Secretary Tommy Thompson, a new computer-enabled program enables consumers to organize their own health information and enter family health or medical history details that could identify near- or long-term risks of developing certain conditions or diseases.


********************************
III. Clinical Trial


A. Study to Examine Memory Problems in Breast Cancer Survivors
SHINE CARES (Chemotherapy and Radiation Effects Study) is a study being led by Kris Kaemingk, Ph.D., Associate Professor at the Steele Memorial Children's Research Center and member of the Arizona Cancer Center to help understand the impact of cancer treatment on the brain, learning, and memory.


Breast cancer is the second most common cancer in women. Fortunately, the likelihood of survival has dramatically increased in recent years, but many women experience unwanted side effects from breast cancer treatments. Breast cancer survivors who have been treated with chemotherapy complain of changes in memory, attention, and other cognitive functions.


This study is recruiting women between the ages of 20 and 75 who have been diagnosed with Stage 1, Stage 2, or Stage 3 breast cancer two or more years ago, and have received local therapy and/or chemotherapy.


Study participants will answer questions about their breast cancer and medical history; complete questionnaires about coping, personality, mood, and memory; have an MRI scan (a safe way to take pictures of the brain and its structures); and complete an assessment of memory and other skills.


Eligible participants will be compensated for their time.
Recruitment of 150 women will take place during the next two years. It is not necessary to have had your cancer treatment at the Arizona Health Sciences Center in Tucson, AZ, but you will need to travel there to be included as a participant in the study.


This study is supported by the Susan G. Komen Breast Cancer Foundation.
For more information, or to inquire about eligibility to participate in the study, please contact Tara Patton at 520-318-7281. http://www.shinecares.ahsc.arizona.edu
********************************


IV. Research Updates - Recent articles about the role of green tea and cancer


A. Tea and circulating estrogen levels in postmenopausal Chinese women in Singapore. Wu AH, et al, Carcinogenesis. 2005 Jan 20.
Increased intake of green tea was correlated with reduced levels of plasma estrogen levels in healthy post-menopausal women in Singapore. Of special interest, increased intake of black tea showed statistically increased levels of this same hormone, increasing risk of breast cancer.


B. Molecular and cellular effects of green tea on oral cells of smokers: a pilot study, Schwartz JL, et al, Mol Nutr Food Res. 2005 Jan;49(1):43-51.
A small pilot study that showed drinking 5 cups of green tea daily for 4 weeks reduced the numbers of damaged cells in the mouth that are commonly seen in smokers as high risk indicators of oral cancer.


C. Green tea consumption enhances survival of epithelial ovarian cancer, Zhang M, et al, Int J Cancer. 2004 Nov 10;112(3):465-9.
A prospective study in China showed increased consumption of green tea was associated with increased survival from epithelial ovarian cancer. At the 3-year mark, 77% of the tea drinkers were still alive compared to 48% of the non-tea drinkers. Survival odds were also enhanced related to amount of green tea consumed (i.e., daily versus weekly consumption).


D. Analysis of catechin content of commercial green tea products, Manning J, Roberts J, J Herb Pharmacother. 2003;3(3):19-32.
Analysis of content of various green tea products (capsules and tea bags) for their catechin content (the active ingredient for anti-cancer effects) showed wide variability compared to label claims. All products had significantly lower levels than claimed (9-48%).


(Note: I use loose-leaf green tea when possible, which I purchase at Asian grocery stores or a local specialty shop. Taste is far superior to most bagged green tea. Remember to steep in water that is just below the boiling point for the best flavor. I do drink about 1 quart of green tea daily, either warm or cool.)

********************************
V - Book Ordering Information


Both editions of A Dietitian's Cancer Story, the 2002 edition (ISBN 096672383X) and the Spanish edition published in 2000 (ISBN 0966723821), can be ordered from any bookstore, library, Amazon.com, and directly from the American Institute for Cancer Research (AICR) by calling 1-800-843-8114 or going to their web site,http://www.aicr.org.


Discounts for orders of 10 or more copies are available for both editions by calling AICR at 1-800-843-8114 - asking to speak to Candis Navarette. Many cancer centers, health care professional offices, and places of worship have ordered books in larger quantities to have available to give as educational and support information or to resell.


Bookstores and libraries may order directly from the book wholesalers Ingram.


I send my best wishes to all of you for health, healing, and hope!


Diana
--
Diana Grant Dyer, MS, RD - Author
A Dietitian's Cancer Story (English and Spanish translation)
Available from AICR (call 1-800-843-8114)

"Information and inspiration for cancer survivors"
Proceeds donated to the Diana Dyer Cancer Survivors'
Nutrition and Cancer Research Endowment at the
American Institute for Cancer Research (AICR)




A Dietitian's Cancer Story Newsletter: Fall 2004

A Dietitian's Cancer Story Newsletter: Fall 2004


Fall Greetings from Diana Dyer, MS, RD, author of A Dietitian's Cancer Story.
I am writing this Fall newsletter the week prior to Thanksgiving. Although I do not remember the exact date, I had the surgery for my first breast cancer the day before Thanksgiving in November 1984. Thus, this year when we share those things for which we are thankful at the Thanksgiving meal, I will feel heartfelt gratefulness for the past 20 years of life plus the many opportunities those years have brought me to help others along their cancer recovery journey.


I recently read a synopsis of the book Reinventing Fundraising: Realizing the Potential of Women’s Philanthropy by Sondra Shaw-Hardy and Martha Taylor (1995, Jossey-Bass), which described the 6 C's underlying women's giving:

• Create - finding new solutions to old problems
• Change - making a positive impact
• Connect - building relationships
• Collaborate - working within a larger effort
• Commit - working for an organization or cause you care about
• Celebrate – feeling the joy of accomplishment



Most of my readers know that I donate a substantial portion of the proceeds from my book, A Dietitian's Cancer Story, to the American Institute for Cancer Research (AICR) in order to fund research projects focused on nutritional strategies after a cancer diagnosis to help enhance the odds for long-term survival. As I read through the themes listed about regarding why women are involved in philanthropy, I could see myself in all of the 6 C's with this effort.


I have helped to fund four research projects since my endowment was established at AICR (see below for an up to date list of projects funded so far). On the surface, helping to fund four research projects sounds significant, and I do celebrate that accomplishment. However, the need for more nutrition research for cancer survivors is sooo great and the need is sooo urgent that four projects seems like a spit in the wind to me.


Therefore, I am asking each of my readers to consider joining me in this cause. I will offer a reduced price during the holiday season for orders of 5 or more copies of my book (instead of the usual price break at 10 books) when ordered through AICR. In the spirit of both thankfulness and giving, please consider purchasing five (5) or more copies to give to friends, relatives, or colleagues with cancer, all of your various cancer doctors, each branch of your local library (Spanish editions also), several copies for your cancer center's patient resource library and/or your community's cancer resource center like Gilda's Club, your own support group, your minister, etc. You get the idea. This special offer will be in effect through December 31, 2004. 

Orders of 5-19 books will be $10 each instead of $12 (even lower prices for higher totals) plus s/h charges and are easily handled by the staff at AICR. Please call ACIR at 1-800-843-8114. Ask to speak to Candi Navarette. Thank you for your support of this effort. Together we can move mountains! :-)



At this year's Thanksgiving gathering, I will also be giving thanks for all the support and strength my readers have given me. Although I am not Jewish, I would like to share with all of you a traditional Jewish blessing extended to me by a new web site visitor from Juneau, Alaska:


May you always go from strength to strength,


Diana Dyer, MS, RD


********************************
Newsletter Contents:
I. Books to Suggest
II. New Recipes
III. New Foods
IV. New Websites
V. Research Updates
VI. Tidbits
VII. Book Ordering Information

********************************
I. Books to Suggest


A. Canyon Ranch Cooking, Jeanne Jones, Harper Collins, New York, 1998 – more delicious-looking recipes than I could ever make in a lifetime. Not a vegetarian cookbook, but I love the use of beans and whole grains, even tofu, in these recipes. However, I would never use the corn oil or corn oil margarine suggested in some recipes; instead substitute canola, olive oil or some trans-fat free margarine. This book also has an abundance of dessert recipes, made as healthfully as possible with the extra bonus of smart serving sizes to use for those special occasions!


B. Meatless Meals for Working People: Quick and Easy Vegetarian Recipes (4th edition), Wasserman and Stahler, Vegetarian Resource Group, Baltimore, MD, 2004. A great starter book for a new vegetarian or a review for people who simply need new ideas of how to combine vegetarianism with a fast-paced life in the real working world. Includes menus, recipes, and suggestions for restaurant eating.


C. Making the Breast of It: A Cancer Survivor Talks about Reconstructing Her Life with Resilience, Resolve, and a Robust Sense of Humor, Laurie Lindsay, RD, LD, Purple Pepper Press, Alexandria, VA, 2004. A small book that makes a delightful gift for a woman newly diagnosed with breast cancer. Order from the author's web sitehttp://www.laurieaomari.com/.


********************************
II. New Recipes


I have posted a few new recipes on my web site over the past couple of months. Be sure to check them out to enjoy some ultra-healthy eating.
Tempeh Sandwich Spread
Pumpkin Bread
Raspberry Sauce
Pizza with Thai Peanut Sauce
Salmon with Thai Peanut Sauce



In addition, I look for inspiration for new recipes from two weekly updates I receive by Email:


A. Health-e-Recipes from AICR. You will receive a recipe by email once per week. In general, they are fairly easy to prepare and have cancer protective ingredients. Just go to AICR's homepage at www.aicr.org to sign up.
B. The Splendid Table's Weeknight Kitchen Recipe. Again, a weekly email with an interesting recipe. Not all of these recipes are vegetarian, but I might see a great sauce recipe that would also work with tofu, tempeh, or even salmon instead of pork chops. Sign up at http://splendidtable.publicradio.org/.


********************************


III. New Food Items


A. Larabar - a delicious bar that is made from real (yes, only real!) food like fruit and nuts. These are a little pricey but so good that they are worth looking for. The web site http://www.larabar.com shows where they can be purchased in each state. They are available at Wild Oats, so Whole Foods can't be far behind.


B. Raw Energy Bar, made by Fabe's All Natural Bakery. Again, a bar made from only real food (organic dates, walnuts, raisins, coconut, almonds, poppy seeds, oranges) that is absolutely delicious. Their web site mentions both Wild Oats and Whole Foods as their *Friends*, so check to see if you can find these in your area.http://www.fabesnatural.com/

********************************


IV. New Web sites
A. Turkey tips, just in time for the holidays -http://lancaster.unl.edu/food/foodsafety.htm#turkey
B. For those who will enjoy Tofuky instead of or along side a turkey for a holiday meal - http://www.tofurky.com/

********************************


V. Research Updates
A. Flor-Essence® herbal tonic does not inhibit mammary tumor development, Breast Cancer Research and Treatment 88 (1):87-93, 2004, LM Bennett, JL Montgomery, SM, Steinberg, KS Kulp.
This research showed that the commonly consumed commercially available form of Essiac tea called Flor-Essence® did not inhibit, stop, or reverse the growth of estrogen-receptive breast cancer in mice. In fact, the data actually show that the consumption of this product caused more and larger tumors to form in the mice given the Flor-essence® to drink before they were injected with the substance that induces breast cancer. This study was not designed to show the effect of Flor-essence® in mice who had already developed breast cancer, which would have more comparable to *real life*. However, the results are worrisome and should give one pause at this time before choosing to recommend or use this product as part of a treatment plan for a breast cancer diagnosis.


B. Improvement of Metabolism among Obese Breast Cancer Survivors in Differing Weight Loss Regimens, K-L C Jen, et al., Obesity Research 12(2):306-312, 2004.
Obese post-menopausal women are at increased risk of developing breast cancer and having a poorer prognosis. While it is not yet known if losing weight after a breast cancer diagnosis will improve the cancer prognosis, weight loss has other health and quality of life benefits (decreases blood pressure, blood lipids, insulin, and leptin levels, increases insulin sensitivity). This small study involving 48 women demonstrated that a weight loss protocol combining individualized sessions with a Registered Dietitian along with the group support from weekly Weight Watchers meetings produced the best overall results, including the largest amount of sustained weight loss over a 3 year time period. The women randomized to this comprehensive protocol also showed the largest reduction in body fat percentage, total blood cholesterol, LDL-cholesterol, and leptin levels, while HDL-cholesterol levels increased significantly in this group also. These results are expected to reduce the risk of cardiovascular disease and may also reduce the risk of breast cancer. 


********************************
VI. Tidbits of Information


A. People from 125 countries have now visited my web site. To help them read my web site, Google.com can translate its content from English to five languages: French, Spanish, German, Portuguese, and Italian.


B. Update of projects funded at AICR by donations to the Diana Dyer Cancer Survivors' Nutrition and Cancer Research Endowment. These are all considered small pilot projects that will hopefully provide data leading to larger and more comprehensive studies that ultimately guide advice and clinical practice regarding the optimal nutritional choices after a cancer diagnosis. For example, results from the small project funded in 2001 helped lead to a multi-center clinical trial currently underway and funded by National Cancer Institute.
• 2001 - A Potential Role for Ascorbic Acid as a Chemosensitizing Agent in Multiple Myeloma, J. Grad McCafferty, PhD, University of Miami School of Medicine, Miami, FL
• 2002 - Antioxidant and Oxidative Status of Children on Treatment for Acute Lymphoblastic Leukemia (ALL), K. Kelly, MD, College of Physicians and Surgeons, Columbia University, New York, NY
• 2003 - Chronobiological Principles to Maximize Efficacy of Alternative Dietary Therapeutics, J. Burton, MD, Center for Molecular Medicine and Immunology, Belleville, NJ
• 2004 - Cooked Meat, DNA Repair Genes and Breast Cancer Risk, Recurrence, and Survival, Susan Steck-Scott, PhD, University of North Carolina, Chapel Hill, NC

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VII - Book Ordering Information
Both editions of A Dietitian's Cancer Story, the updated and revised 2002 edition published in April 2002 (new ISBN is 096672383X) and the Spanish edition published in 2000 (ISBN 0966723821), can be ordered from any bookstore, library, Amazon.com, and directly from the American Institute for Cancer Research (AICR) by calling 1-800-843-8114 or going to their web site, http://www.aicr.org.
Discounts for orders of 10 or more copies are available for both editions by calling AICR at 1-800-843-8114 - asking to speak to Candis Navarette. Many cancer centers, health care professional offices, and places of worship have ordered books in larger quantities to have available to give as educational and support information or to resell.
Bookstores and libraries may order directly from the book wholesalers Ingram.
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I send my best wishes to all of you for health, healing, and hope!
Diana
--
Diana Grant Dyer, MS, RD - Author
A Dietitian's Cancer Story (English and Spanish translation)
Available from AICR (call 1-800-843-8114)

"Information and inspiration for cancer survivors"
Proceeds donated to the Diana Dyer Cancer Survivors'
Nutrition and Cancer Research Endowment at the
American Institute for Cancer Research (AICR).