A Dietitian's Cancer Story Newsletter: Fall 2006

It is hard for me to believe that I am quickly approaching the 10-year anniversary of writing and independently publishing my book, A Dietitian’s Cancer Story. Some of you may even have a copy of that 1st edition, which was stapled together at my local Kinko’s in June 1997. I only printed 300 copies at that time, knowing I would have no trouble giving that number away to friends, relatives, and colleagues. Instead, the first printing sold out in 3 weeks! With that vote of confidence, I next printed 500 copies, which sold in 3 months, and on and on and on. Now I print 5,000 books each year. It seems like the blink of an eye, but nearly 10 years have now gone by. I very quickly realized that I wanted to do more than provide information and inspiration to individual readers but to also make a difference by funding research that would give cancer survivors better guidance about which nutritional strategies could improve their odds for long-term survival. That desire led me to develop a relationship with The American Institute for Cancer Research (AICR) in Washington, DC. I had known of AICR’s dedicated commitment to fostering research on diet and cancer prevention for many years, and AICR has enthusiastically embraced the need for and opportunity to support nutrition research that fosters cancer survivorship also. Proceeds from the sale of my books are donated into the Diana Dyer Cancer Survivors’ Nutrition and Cancer Research Endowment that I have established at AICR specifically to fund nutrition research to optimize cancer survivorship. I have helped to fund six (6) projects since the endowment was established in the year 2000. However, high quality research is very expensive, and currently my endowment can only help to partially fund these projects. My dream is to have my endowment funded to a level at which one full research grant can be awarded every year that will be exclusively focused on researching nutritional strategies to optimize cancer survivorship. In order to do that, my endowment needs to be funded at a level of $2 million (yes, million). Whew, that is a LOT of books to sell, so I am looking for alternative ideas and help to achieve that goal. Currently my endowment is funded at a level of approximately $110,000, which has come primarily from my donations. Some additional people have made contributions, also, and I extend my deepest gratitude to them for sharing and supporting my vision with their gifts. However, sometimes I admit to feeling discouraged when I see that my endowment (and what it can do) is still so small after all the effort I have put forth during these past 10 years. I want my endowment to be more than a “political statement”, so I have decided that it is time to both “re-think and reach out” for new ways and help in order to increase the endowment’s funding and ability to support the research that is so necessary (and even urgent) for cancer survivors. Thus, I am offering all of my readers who share my dream an opportunity to be involved in a meaningful way by investing in the future and hopes of all cancer survivors. There are several ways you may choose to become involved: (1) Of course you may order more books. In fact, you may choose to purchase a large number to donate to your local cancer center, clinic, or doctor’s office, to give to your own patients, local libraries, support groups, place of worship, etc. Quantity discounts are available when ordering 10 or more copies from AICR. Please call 1-800-843-8114 and ask to speak to Candis Navarrete. (2) You may wish to hold a fund-raising event in your own community such as a golf-outing, bike-a-thon, silent auction, etc, etc, with proceeds donated to The Diana Dyer Endowment at AICR. Ideas and information about fund-raising for AICR are available on their web site at http://www.aicr.org, then click on “How can I help?” (3) In addition, I would be honored if you chose to make a direct contribution to the Diana Dyer Endowment at AICR. A donation of any size can now easily be contributed directly to my endowment on AICR’s web site athttp://www.aicr.org/DianaDyer or mailed to AICR, 1759 R Street - NW, Washington, DC 20009. If mailing a donation, be sure to put Diana Dyer Endowment on the memo line. In addition, check to see if your employer will match any direct donations; AICR always gets the paperwork filed promptly to receive these matching funds. AICR is eager to help you with all of these options. Please feel free to contact Heather Morgan, Director of Development, at 1-800-843-8114 or by Email toh.morgan@aicr.org for additional information and assistance with local fund-raising events or more in-depth discussions about donations. I have been very blessed with the opportunity to help others have a cancer survivorship journey that has been less difficult than mine. Indeed, although I could not foresee this path when I was struggling with chemotherapy and recovery in 1995, sharing my journey with all of you has become a way of life for me. Many great voices have expressed an understanding of this blessing in different ways over the ages, so I will end with their words: A man makes a living by what he gets; he makes a life by what he gives. – Sir Winston Churchill My life is my message. – Gandhi Your work is to discover your life and with all your heart give yourself to it. – Buddha With continued best wishes to all of you for both life and hope, Diana Diana Dyer, MS, RD Newsletter Contents: I. The Oncology Nutrition Dietetic Practice Group Updates II. New Recipes and New Foods to Try III. Information on Cancer Prevention IV. Survivorship Info – Holiday Gift Ideas V. Cancer Treatment Improvement Study - Participants Wanted VI. Research Updates VII. Website Updates – Holiday Eating FAQ VIII. Book ordering information *************************** I. The Oncology Nutrition Dietetic Practice Group Updates The Oncology Nutrition Dietetic Practice Group (ON DPG) of The American Dietetic Association achieved many major milestones this year. A. ON DPG developed and published their Standards of Practice and Standards of Professional Performance for Registered Dietitians working with oncology nutrition care at the generalist, specialty, and advanced practice levels. (Robien K, Levin R, Pritchett E, Otto M; J Am Diet Assoc. 2006 Jun;106(6):946-51) B. ON DPG petitioned the Commission on Dietetic Registration (CDR) to approve a new board specialty certification in oncology nutrition and received full approval in September 2006. The exam should be ready by the end of 2007. The new credential, Certified Specialist, Oncology (CSO©) will help to enhance public protection and will serve as an important documentation of RDs' specialized skills and expertise in oncology nutrition. C. Two articles have been published that will help oncology practices achieve more reimbursement for oncology nutrition services: 1. Improving Reimbursement for Oncology Nutrition Services, Ganzer, H and C Selle, Oncology Issues, Sept/Oct 2006, pp 34-37. 2. Seeking reimbursement for oncology nutrition, Ganzer, H and C Selle, Oncology Nutrition Connection, Spring 2006 Volume 14(6). D. Publication of The Clinical Guide to Oncology Nutrition – 2nd edition by the Oncology Nutrition Dietetic Practice Group; L Elliott, L Molseed, P Davis McCallum, B Grant, ©2006, American Dietetic Association. Representing the most current oncology nutrition research, this new edition is the clinician's guide to understanding the nutritional needs and risks of cancer patients and to anticipating and responding with appropriate nutrition care. This guide explores the fundamentals--from nutrition screening to therapy protocols to pharmacological management--with new chapters devoted to ACS survivor guidelines, reimbursement guidelines, and outcomes research. Non-ADA member Price: $66.00 + shipping and handling Member Price: $50.50 + shipping and handling Available at the ADA web site http://www.eatright.org and http://www.Amazon.com E. Seven members of ON DPG attended the Inaugural Lance Armstrong Foundation’s Cancer Survivorship Summit where the unmet needs of cancer survivors were identified, discussed, and initial plans developed to provide programs and services to fill these unmet needs at the local, state, and national levels. F. ON DPG’s membership continues to increase and currently has an all time high of 1500 Registered Dietitians who have a special interest in the many aspects of oncology nutrition, including prevention, treatment, survivorship, hospice, research, and advocacy. Much still needs to be done in order to provide proactive and individualized oncology nutrition care to all patients diagnosed with cancer, but these accomplishments will help accelerate the inclusion of nutrition as part of true comprehensive cancer care. I’m proud of everything that the board and members of ON DPG have accomplished and look forward to many more efforts from this passionate group of dietitians dedicated to providing and improving oncology nutrition care. *************************** II. New Recipes and New Foods to Try A. I did a lot of traveling in 2006 and was always glad to come home to my own cooking and plant-based diet. I saw the following two quotations during my trips this year. Both brought a smile to my face as I whole-heartedly agree and abide by these words of wisdom spoken by men who were clearly ahead of their time! To lengthen thy life, lessen thy meals – Ben Franklin I have lived temperately, eating little animal food, and that not as an aliment, so much as a condiment for the vegetables, which constitute my principal diet – Thomas Jefferson B. I have posted many new recipes on my website during the past few months. Some were even developed by my husband! I hope you’ll try a few of them: Bean “Burgers” Bean and herb patties Pasta w/veggies and caponata Stuffed cabbage rolls Gingery cole slaw Apple butter acorn squash Crustless pasties Black bean brownies Chocolate chip (and bean!) cookies Halvah C. Some new food items to look for and try: Organic green tea, which is also a fair-trade product, by Equal Exchange – I found this in my regular grocery store. More info at the company’s web sitewww.equalexchange.com Trail Blaze Bake-at-Home Oatmeal Energy Bars by Matisse & Jack’s – My favorite flavor of an “energy bar” that contained both soy and flaxseed was discontinued, so I have been on the hunt to find another one containing these healthy food ingredients that is not too sweet for my tastes. I am in the process of developing a recipe for a bar to make at home, but in the meantime, I have found this very good mix that is delicious and healthy. More info at the company’s web sitewww.MatisseandJacks.com. *************************** III. Information on Cancer Prevention Although I usually focus this newsletter on information to enhance cancer survivorship, I want to highlight some information that I found informative and important on primary prevention of cancer, too. A. The Cancer Decisions web site will be starting a cancer prevention focused Email newsletter called Wellbeing in which they plan to “reshape the debate on cancer and serve as a forum for new ideas and new strategies in the individual and social struggle against cancer.” Sign up for this newsletter athttp://www.cancerdecisions.com B. The National Institute of Environmental Health Sciences, a component of the National Institutes of Health, held its third annual Early Environmental Exposures Meeting in Berkeley, California on Nov 2-3, 2006. The meeting included presentations on the basic biology of breast development, environmental exposures that influence the early onset of puberty (a risk factor for breast cancer), and public health communication of the risks associated with these exposures. The purpose of the meeting is to promote the latest scientific findings from the Institute's four Breast Cancer and Environment Research Centers (BCERCs) -- University of California, San Francisco, Fox Chase Cancer Center in Philadelphia, Michigan State University in East Lansing, and the University of Cincinnati. Funded jointly by the NIEHS and the National Cancer Institute, the centers are investigating the influence of early-life exposures on mammary gland development and the potential of these exposures to alter the risk of breast cancer in later life. The program and poster abstracts can be found athttp://www.bcerc.org/2006mtg/index.htm The four BCERCs are enrolling 1,200 girls aged 6-8 to examine relationships between breast development, age at first menses, & factors such as hormonal changes, diet, exercise, obesity, family medical history, psychosocial stressors, environmental exposures, & genetic characteristics & biomarkers. In parallel, using rat & mouse models, they are conducting animal studies to characterize the molecular features of the mammary gland over the lifespan & determine how exposure to potential carcinogens during these times influences cancer risk. Breast cancer advocates have been instrumental in the formation and work of these centers. I commend their persistent efforts to increase the awareness of these concerns along with the urgent need for research funding for these centers. Additional information can be found at www.bcerc.org . The research conducted by these centers will most certainly apply to other cancers types, too. C. Information about pesticides and ways to reduce our exposure to them can be found at the web site for the Northwest Coalition for Alternative to pesticides (NCAP) at http://www.pesticide.org/default.htm. D. "Things You Can Do to Decrease Your Toxic Exposures and Protect Your Health” is a very practical booklet written by Laurine Brown, PhD, MPH. If you are not able to find a copy, I suggest that you take the time to read a series of articles that Dr. Brown has also written to increase awareness of the role that environmental toxins may play in our health with thoughtful and practical guidance for individual actions. They are available to read at the following web site:http://www.iwu.edu/~wellness/environment_folder/sparchive.htm *************************** IV. Survivorship Info – Holiday Gift Ideas A. The 2007 Colondar -- Young Cancer Survivors Show Scars to Save Lives I must admit that while I was aware that young women in their twenties and even teens have been diagnosed with breast cancer, I had no idea that both young women and men in these same young age groups have been diagnosed with colon cancer. Sales of the 2007 Colondar benefit The Colon Club, a nonprofit organization dedicated to educating young people about colorectal cancer. The Colon Club is best known for creating the Colossal Colon®, a 40-foot long replica of the human colon that has traveled across the country since 2002. I’ll have to look for this! B. Cancer Awareness Jewelry A portion of the proceeds from the jewelry purchased at this web site is donated to multiple causes plus products can be purchased to assist with your own fund raising efforts. C. Steps For Living Foundation This is the only organization addressing cancer survivorship from both a consumer perspective and culturally through music and the arts. They work to embolden (I love that word!) survivors to express themselves creatively and become vigilant self-advocates who can make informed decisions and take conscientious steps for living the survivorship lifestyle. Founded by Matthew Zachary, a brain tumor survivor and concert pianist. Told he would likely never perform again, Matthew is now a “cancertainer” and donates proceeds from the sale of his CD’s to his foundation. D. Moving Beyond Breast Cancer (DVD/Video) This 23-minute educational video (available in DVD or VHS format) was developed to help women who are completing breast cancer treatment and entering the post-treatment phase. This can be a particularly difficult time for cancer survivors, as they lose the focus of treatment and the security of frequent doctor's visits. This is often a time when the support of friends and family can drift off, many of whom think that when you are done with treatment, things are back to normal. Well, any survivor can tell you; this is far from the truth. This video features the stories of several women post treatment. They are real survivors, discussing issues of body changes, emotions, fears, relationships, & new outlooks on life. No video can take away the emotions and feelings survivors deal with, but this one helps the viewers see that they are not alone, and gives them ideas for handling their "new normal". The video also features Dr. Susan Love, a breast cancer surgeon, whose thoughtful insight adds another perspective to these topics. Although the women featured on the video are survivors of breast cancer, this video would be useful for any woman completing cancer treatment. The video is available free of charge from the NCI. To obtain a copy, visit www.cancer.gov or call 1-800-4-CANCER *************************** V. Cancer Treatment Improvement Study - Participants Wanted Inflexxion, Inc, a behavioral research company based out of Newton, MA, is developing a telephone-based system that will help cancer patients learn to deal with their pain and symptoms. To make the system as helpful as possible, they are looking for cancer patients that are willing to review this telephone-based system from their home and then complete some brief questionnaires. To be eligible, participants must be at least 18 years of age and have a current diagnosis of lung, prostate, breast & or colon cancer. Completion time will vary from between 45 minutes to 2 hours depending on which group you may be randomly assigned to. For taking the time to help us you will be paid between $40 and $120, depending on which group you are assigned to. The National Cancer Institute and Inflexxion, Inc sponsor this study. For more information or to sign-up, please contact Luis Ponce at (800) 848-3895 ext. 278 or go to www.studiesforcancer.com *************************** VI. Research updates A. Whole sesame seed is as rich a source of mammalian lignan precursors as whole flaxseed (Nutr Cancer 52(2): 156-165, 2005). The molecules called mammalian lignans (enterolactone and enterodiol), which are produced by the microflora in the colon of humans and animals from precursors in foods such as flaxseeds, may have anticancer effects. This study is the first to demonstrate in healthy, post-menopausal women that consumption of 25 grams of unground flaxseed produced the same amount of these important molecules as 25 grams of ground flaxseed. In addition, the study showed equal production of these mammalian lignans from both flaxseed and sesame seed. ^*^*^*^*^*^ Take Home Message ^*^*^*^*^*^ 1. Don’t fret too much about the use of ground vs. unground flaxseeds. 2. Enjoy sesame seeds too! Use of tahini (sesame seed paste) in Hummus and the dessert recipe Halvah may also boost your intake of these cancer-fighting molecules. (make links to these recipes from my web site) ^*^*^*^*^*^ ^*^*^*^*^*^ ^*^*^*^*^*^ ^*^*^*^*^*^ B. Phytosterol composition of nuts and seeds commonly consumed in the United States (J Agric Food Chem 53(24):9436-45, 2005) Phytosterols are a component of plant fats found in varying concentrations in all plant foods (particularly nuts and seeds) that inhibit cholesterol absorption in the GI tract, reducing a risk factor for heart disease by lowering blood cholesterol levels (a good thing for all cancer survivors!). Phytosterols also enhance the immune system and may reduce the risk of several types of cancer. Thus again, research continues to show multiple benefits from eating a plant-based diet. This study is the most comprehensive to date evaluating the phytosterol content of nuts and seeds in our typical diet. Sesame seeds, wheat germ, and pistachio nuts showed the highest concentration of phytosterols of the 27 foods tested. ^*^*^*^*^*^ Take Home Message ^*^*^*^*^*^ 1. Strive for consuming a variety of plant foods on a daily basis that contain phytosterols for their multiple health benefits. 2. Increasing consumption of sesame seeds and sesame seed paste (tahini) will allow you to “double-dip” as you consume both health-promoting phytosterols and lignans (see recipe ideas above). 3. Regularly including wheat germ in various recipes, including all my soy shake recipes, is an easy way to increase consumption of phytosterols. ^*^*^*^*^*^ ^*^*^*^*^*^ ^*^*^*^*^*^ ^*^*^*^*^*^ C. Randomized controlled trial of weight training and lymphedema in breast cancer survivors (J Clin Oncol 24(18):2765-72, 2006) Breast cancer survivors who completed treatments were randomly assigned to a weight-training group (n=42) or a control group (n=43). After six months of participating in a specified weight-training program, there was no difference in various measurements or self-reports of symptoms related to lymphedema between the two groups. ^*^*^*^*^*^ Take Home Message ^*^*^*^*^*^ 1. This is the largest and longest study to date to measure effects of upper body weight-training on the occurrence and/or worsening of lymphedema in the upper arms of breast cancer patients. 2. Although this study seems to indicate that weight-training is safe for breast cancer survivors, obtain your physician’s approval before starting any exercise program. ^*^*^*^*^*^ ^*^*^*^*^*^ ^*^*^*^*^*^ ^*^*^*^*^*^ *************************** VII. Website Updates – Holiday Eating FAQ I began responding to questions from web site viewers, researching and posting my answers “waaaay back” in 1998, when my web site first was put up on the Internet. After much thought, I have started the process of slowly cutting back, simplifying my life, and shifting how I spend my time and energy. Thus, I will no longer be responding to individual questions on my web site. However, I will continue to review my web site and post new information that I believe will be helpful to cancer survivors seeking reliable information about nutrition and lifestyle changes that will optimize their odds for long-term success from both cancer and overall health and wellness. So, please take a look at the newest FAQ I have posted on my web site that providestips for getting through our holidays and still maintaining your commitment to a healthy lifestyle. ^*^*^*^*^*^ Special Notes ^*^*^*^*^*^ To inquire about having me speak to your group, please contact Barbara Christenson at The Speak Well Being Group (Barbara@speakwellbeing.com, (503) 699-5031). Health care professionals and media may still feel free to contact me through thecontact page of my web site. Students – Many professors give assignments that ask you to contact a Registered Dietitian with a web site, so I have posted answers to many of your common questions on my web site . During my recent efforts to simplify and “downsize”, I sorted through piles and files of letters and cards that readers have sent me since I wrote the first edition of my book in 1997. I thought I could throw them away after re-reading them. Wrong! I remembered receiving every single one of them; you have all touched my heart in a very deep place. I still love receiving your thoughtful cards and letters, so if you are moved to do so, please feel free to continue sending them to me at PO Box 130221, Ann Arbor, MI 48113. *************************** VIII. Book Ordering Information Both editions of A Dietitian's Cancer Story (English version ISBN 096672383X) and the 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. 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 and have already sent copies with personalized autographs as far away as Australia and England. *************************** Those who choose to remain on this list can be assured that I will never share or sell your name or Email address to anyone. 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)