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A conversation with Dr. Kim Robien on living with lymphoma - a guide to nutrition

Following on from the current spring edition of LRF's Research Report which features an article from Dr. Kim Robien, PhD, RD, CSO, George Washington University, School of Public Health and Health Services, we asked Dr. Robien to share some of the most common questions that she is asked by patients on nutrition and managing a lymphoma diagnosis.

Can diet treat or slow the progression of my lymphoma?

"I really, truly wish this was possible, but unfortunately, no, there are no dietary treatments for lymphoma. Being well nourished (not over-nourished or under-nourished, but appropriately nourished) will help your body respond better to treatment, and will help you recover more quickly after treatment has ended. Being appropriately nourished means working towards or maintaining a healthy weight and eating five or more servings of fruits and vegetables each day, and minimizing your intake of alcohol, salt and processed meats."

"Being under-nourished (underweight and/or deficient in certain nutrients) can increase the risk of treatment-related complications, and slow recovery after treatment. Being over-nourished (usually the result of overeating or taking large amounts of dietary supplements) can sometimes interfere with the effectiveness of your cancer treatment."

Dr. Robien recommends the National Heart and Blood Institutes website to calculate your body mass index (BMI). To access, click here.

Are there dietary supplements that can boost my immune function?

"Again, unfortunately, the answer is no. We do know that people who are malnourished are at higher risk of experiencing infections. So, if you are not able to eat well, and are losing weight, talk with your health care team about strategies for improving your dietary intake. Dietary supplements are great at correcting nutrient deficiencies, but too much of certain nutrients can be harmful. Your medical team will alert you if your blood tests show that you are deficient in a nutrient, or at risk for deficiency."

Does sugar cause cancer?

"This phrase is a significant over-simplification of a number of physiologic processes. In general, dietary sugar does not feed cancer cells. All cells do run on glucose, a type of sugar molecule, a small amount of which does come directly from the diet. But, most blood glucose is synthesized in the liver. The amount of glucose that we have circulating in our blood supply (and thus available to the cancer cells) is tightly regulated under normal circumstances, and is a balance between the amount of sugar produced by the liver and the amount of sugar taken up by the cells through a mechanism that involves the hormone insulin. Cancer cells grow and multiply by taking more of their fair share of nutrients from the blood stream, and by tricking the liver into producing more glucose to fuel their growth. Blood glucose, rather than dietary sugar, should be the focus for people trying to decrease their risk of cancer or cancer recurrence."

"We are starting to understand that there are a lot of connections between diabetes and cancer. People who are overweight are at increased risk of having high blood sugars (and Type II diabetes) because chemical messengers produced by adipose (fat) tissue interfere with the function of the insulin receptors, thus depriving cells of normal cells of the sugar they need. Maintaining a healthy body weight through a combination of regular exercise and avoiding over-eating is recommended for managing Type II diabetes, and has also been shown in study after study to be associated with lower risk of cancer recurrence and improved survival after a cancer diagnosis. If you are overweight, and eat a lot of sugary foods, it would be wise to cut back on sweets as one component of a healthy weight loss plan – not because the sugar is feeding the cancer."

Is there anything that lymphoma patients specifically should be aware of in terms of nutrition advice?

"Following good food safety practices is always important, but food safety is especially important while going through cancer treatment. Chemotherapy, radiation, blood or marrow transplantation, or removal of the spleen can make people more susceptible to food borne illnesses. Foodsafety.gov is a great website to learn how to keep your food safe and to receive notification of food product recalls."

Dr. Kim Robien speaking at LRF's 17th Annual North American Educational Forum on Lymphoma, Manhattan Beach, California in November.

To view the latest edition of the Research Report and the feature from Dr. Robien, click here.