Our Conversations Webinar Series is an opportunity to link national experts in colorectal cancer and other related fields to you, right in the comfort of your own home. The programs are designed to empower you to play a leading role in your healthcare management.
Last month, our webinar focused on questions of proper diet and oncological nutrition after a colorectal cancer diagnosis. To answer your questions, we brought in Terri Taylor, Registered Dietitian and Board Certified Specialist in Oncology Nutrition from the Virginia G. Piper Cancer Center at HonorHealth Scottsdale, Arizona.
Q: Is there any application to help design menus after CRC treatment that you know of? How can I design menus upon my restrictions?
A: I am not aware of any specific apps and am unsure of your individual diet restrictions. I recommend meeting and working with a Registered Dietitian who specializes in oncology to develop an individualized nutrition plan. The Academy of Nutrition and Dietetics website: www.eatright.org can help you locate a dietitian who is Board Certified in Oncology Nutrition in your area.
Q: What meat do you suggest for smooth digestion into the colon and out the stoma?
A: I would say most of your skinned poultry is going to be easiest; things that are leaner are going to be much better, meaning lower in fat. Red meats may be harder to digest. Some of your white fishes would be fine as protein sources from animal sources.
Q: What are some suggestions for cooked fruits and vegetables? I am a stage III B CRC recent survivor.
A: In our cooking class last week we actually made a fruit compote with peeled pears and peeled apples, put some seasonings in there, a little bit of butter and just cooked them and the bowl was empty at the end of the class! So peeling pears and apples and cooking them is very delicious. Also, if you are going to do something like oatmeal where you can add peaches, and cook them together, you can use canned peaches. You don't want to use any dried fruits as they are much more gassy and hard to tolerate, but pears, peaches, apples, all very good for cooking.
Q: Any specific foods to help with the long term side effects of neuropathy and improving kidney function?
A: When we are looking at neuropathy, some of the foods that may be helpful are foods that have Omega 3 fat in them. That would be your fattier fish, or if you can tolerate some of the plant sources like flax seed or chia or walnuts, but I would say the fattier fish. Some of the B Complex vitamin foods, like your grains and some things with Folate. So it may be some cooked greens, some citrus in there, those are going to be your main food sources to help with the neuropathy and again the addition of the L-glutamine powder which is a supplement and another way to work with the peripheral neuropathy. And as far as kidney concerns, I would really need to know a little bit more about what you are discussing, like are you having kidney dysfunction, because that would determine how much protein you would use, and fluid and potassium and sodium, so that is more of an individual concern.
Q: Who nowadays is recommending coffee as cancer preventive? How much coffee per day is acceptable?
A: The American Institute for Cancer Research in partnership with the World Cancer Research Fund publishes their International Continuous Update Report. This report reviews many studies regarding cancer prevention and survivorship. Studies are finding that coffee (not high in fat/sugar) may reduce the risk of colorectal, liver and endometrial cancers. In a study published in the April 2016 issue of Cancer Epidemiology Biomarkers and Prevention, coffee consumption was associated with lower risk of colorectal cancer development. They compared non-coffee drinkers (less than 1 serving per day) to coffee drinkers (up to more than 2.5 servings per day). The protective benefits in coffee appear to be chlorogenic acid, caffeoylquinic acid and ligans. These compounds are thought to act as antioxidants to deactivate cancer-causing substances and to reduce inflammation and insulin resistance.
Q: How can nutrition help hand/foot syndrome from xelodam (maintenance chemo)?
A: The only nutritional suggestion that I am aware of for hand/foot syndrome is supplementing with 50-150 milligrams of vitamin B6 daily to reduce the pain. Of course, you would want to discuss adding this supplement with your healthcare providers before starting it. Otherwise, the environmental suggestions of avoiding hot water, using ice packs and moisturizing lotions may help relieve some of the discomfort.
Q: I'm currently receiving chemo and have a lot of problems eating\drinking a few days after chemo. What's the best thing to do?
A: Good question. We want you to maintain your hydration, and primarily after cancer treatment. So really pushing those fluids in small amounts throughout the meals, and having the fluids in between your meals rather risk with your meals. First, focus on foods that sound good and taste good and second, foods that might be a bit lighter. So again use small frequent feedings, foods a bit lower in fat and high in carbohydrates, things easier on you like toast or chicken noodle soup which may be easier to digest those first few days. And other fluids can be things like popsicles, or jello or soups, all those would count as fluids as well.
Q: I am a Rectal Cancer Stage 3c survivor and had surgery that removed the rectum and entire sigmoid colon. At 4 years after surgery I can get severe diarrhea without warning. So I don't ever eat if I will be out or not near a bathroom. I've tried the food journal but my episodes are not consistent with food intake. I take up to 8 Imodium a day but can still have these symptoms. Raw fruits and vegetables also cause diarrhea for me. What are some alternatives?
A: It may be helpful to try eating at least ½ cup rice congee daily (mix 1 cup long grain white rice with 6-7 cups of water and a little salt or 6-7 cups broth in a saucepan and cook on the stove top for 40 minutes); and take a psyllium fiber supplement daily. It sounds like you may tolerate cooked vegetables and canned and cooked fruits better than raw; and perhaps limiting the lactose and fat may help.
Q: I'm 7 years post-CRC- stage 2. My anastomosis is very low, and I had a hysterectomy at the same time. I still have lots of dietary challenges. Some of my meds (for other health issues) slow my metabolism. So, I've gained 15 pounds in the past 7 yrs and am struggling because most 'diet choices' aren't possible. (Dairy is out, salads are out, raw fruits & veggies are out. Is this a common issue? Any advice?
A: I would encourage you to be working specifically with a dietician and an exercise physiologist on a plan that is tailored to you, and your food choices and activity level. Specifically if you have a cancer center nearby where you can meet with an oncology dietician and exercise physiologist that is very important. In general, higher proteins, lower carbohydrate can sometimes help with weight control, so eliminate some of the red and processed meats and avoid dairy as you don't tolerate it. Getting that protein early in the morning is important for weight management. Adding to your breakfast an egg, or creamy nut butter can add protein. For carbs, cooked vegetables can be very low in calories and usually are tolerated. Some fruits can be peeled apples or applesauce or things canned without sugar added. I also encourage you to lose empty nutrients and high calorie things like high sugar foods and sugar sweetened beverages. I also encourage you to think about your first goal being not gaining any weight. Oftentimes we look at cancer survivorship knowing some of the medications may result in weight gain, and we are just focused on weight loss. But let’s put our health first and consider that a success.
Q: Why do certain foods that never bothered me before give me very painful stomach cramps (for example apples)? Eventually my stomach will go and I'll throw up. Afterwards my stomach will be sore but I'll feel better.
A: If you had surgery it may be affecting the way you are digesting food. There may be some residual effects of the treatment itself or other medications you are on. Some things I would suggest may be the way you are eating apples. Apples can be very gassy in particular, so using some anti gas products might be appropriate for you. If you want apples, you could peel them and bake them, and use them in applesauce. If that doesn't work with you, try fruits and vegetables that are higher in soluble fiber, this might be of some help. Also, some of the cramping may be the foods you are combining with those apples. For instance if you are using something with lactose, that could provide more cramping, or are you using some other types of grains that are contributing to cramping. Is gluten an issue with you? These are many things that need to be evaluated and maybe keeping a food log and figure out the biggest triggers and see if you can see a pattern.
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