About Lymphoma | Advocacy | Art | CAM | Clinical trials | Doctors - Experts - Centers | Guidelines at Diagnosis | News
Risk Factors | Side Effects | Statistics | Support | Symptoms | Tests | Treatments | Types of Lymphoma

Find trials: by AGENT | by TYPE of LYMPHOMA AND treatment status | of INTEREST

   Search Site | Ask Question | Sign Guest book |  How to Help!

Patients Against Lymphoma

 

CAM & Life Style > Diet & Exercise

Last update: 03/09/2014

Diet Topics
General Guidelines to Support Good Health and Fitness  | Exercise and Fitness
 Resources | Research News
Treatment-specific:
Diet for Immune Suppressed  | Fighting Nausea Tips | Nausea Shopping Guide | Resources
Is it likely that a change in diet can have a treatment effect?

See also Exercise Topics below

MYTHS

Can diet influence the progression of lymphomas? 

Unfortunately, there is no evidence from animal or human studies that dietary changes are likely to change the growth and survival of lymphoma cells -- which are driven to grow and survive because of mutations in the DNA of the abnormal cells.
 

Can diet influence the low blood counts that are caused by lymphomas ?

A healthful diet will provide the building blocks for the immune system to "build" new blood cells - but only if the underlying cause of the low counts is address by therapy. 

Can diet affect other cancers?

Yes, for some cancers, diet appears to have some influence on the growth rate, such as fats on prostate cancer cells, but this is specific to the type of cancer cell.

See for example: Webmd.com, which dispels the myth that conventional medicine will not provide such information when there is evidence to support it.
 

 

In the News

bullet
Cancer Nutrition Consortium:
Nutritional Guidance & Support http://bit.ly/18qPw28
 
bullet Important - Expert-developed for CA Cancer J Clin 2012:

Nutrition and physical activity guidelines for cancer survivors 

PDF version - printable

 
 
bullet
* Stanford Dietitian
 Discusses Nutrition and Cancer Myths and Legends 

There are many myths circulating about diet and cancer. 
 
bullet Nutrition - Medscape: Uncertainty About Nutrition and the Malnourished Cancer Patient

“There are guidelines on the nutritional management of malnourished patients with cancer from the American Dietetic Association, the American Society for Parenteral and Enteral Nutrition, and the Dietitians Association of Australia, among others. They all support the use of nutritional intervention. However, as the study authors point out, "these guidelines and recommendations rely heavily on consensus statements and good practice points in the absence of good-quality randomized controlled trial evidence."
 
bullet

Can diet can have a treatment effect? 
 

bullet University of Leicester: Public ignorant about key messages concerning diet and cancer

The general dietary guidelines on this page do not take into account individual needs and sensitivities.  Please consult with a qualified medical professional.

A healthful diet and being physically active can help the cancer patient achieve a better quality of life and combat the side effects of treatment. Many cancer patients feel that taking steps to optimize their survival chances is empowering, and  provides a valuable sense of control.  

Your dietary needs can change depending on your health status and other factors. For example, you may need a special type of diet to help build up strength and recover from treatment; or, you may have trouble eating while receiving chemotherapy. It's essential that your diet contains a balance of nutrients that promotes the health and and provides the nutrients needed to maintain or restore good health. Ideally, you should consult a nutritional expert who has the information about your specific health, diagnosis, and treatment at hand.

Evidence suggests that life style and diet can influence the risk of developing some types of cancers. Therefore, it seems reasonable for the cancer patient, who is particularly susceptible to developing secondary cancers to eat well and remain active - to promote general health.

It's important to distinguish between diet as a risk factor for lymphomas, versus diet as a therapeutic factor.

While some dietary factors are associated with a modest increased risk of lymphoma (such as red meats), restricting red meats will not influence the growth rate of an existing lymphoma.

Similarly, if you stop smoking, a lung cancer that is caused by smoking cancer is not expected to go away. 

External factors more likely to influence the growth of lymphoma cells would be antigens (something that doesn't belong in your body), such as virus, bacteria, auto-immunity ... a chronic antigen stimulus, that would be impossible with current technologies to identify, and could be unique to each person. 

The growth rate of lymphomas is also determined by the genetic defects within the abnormal cells, which can vary even within the same diagnostic subtype .. which might account for why one indolent lymphoma never needs treatment, and another needs frequent therapy.

Anyhow, if in future a dietary practice is found to limit the growth of lymphomas it will be big news ... something everyone will be made aware of. 

General Life Style and Diet Guidelines 

Source:
Nutrition and physical activity guidelines for cancer survivors

Excerpt from report:
 

bullet

Survivors should ask their health care provider for a referral to see an RD, preferably an RD who is also a CSO, if they experience nutrition-related challenges.

bullet

Consuming enough calories to prevent additional weight loss for survivors at risk of unintentional weight loss, such as those who are already malnourished or those who receive anticancer treatments affecting the gastrointestinal tract

bullet

Nutritional assessment for survivors should begin as soon after diagnosis as possible and should take into consideration treatment goals (curative, control, or palliation) while focusing on

current nutritional status and
anticipated nutrition-related symptoms

bullet

During active cancer treatment, the overall goals of nutritional care for survivors should be to

prevent or resolve nutrient deficiencies,
achieve or maintain a healthy weight,
preserve lean body mass,
minimize nutrition-related side effects, and
maximize quality of life.

bullet

For survivors experiencing anorexia (low body weight) or early satiety, and who are at risk of becoming underweight,

consuming smaller, more frequent meals with minimal liquids consumed during meals can help to increase food intake.

Liquids can and should be consumed in between meals to avoid dehydration.

bullet

For survivors who cannot meet their nutritional needs through foods alone, fortified, commercially prepared or homemade nutrient-dense beverages or foods can improve the intake of energy and nutrients.

bullet

For survivors who are unable to meet their nutritional needs through above measures and who are at risk of becoming malnourished, other means of nutritional support may be needed, such as

pharmacotherapy using appetite stimulants,
enteral nutrition via tube feeding, or
intravenous parenteral nutrition.

bullet

With compelling evidence against the use of select supplements in certain oncology populations, health care professionals and survivors need to proceed with caution.25

If interested in supplementation, individuals should
- first assess whether they are nutrient deficient,
- avoid ingesting supplements that exceed more than 100% of the Daily Value, and
- consider limiting dietary supplement use to therapeutic interventions for chronic conditions such as osteoporosis and macular degeneration, for which scientific evidence supports the likelihood of benefits and low risk of harm.

bullet

An increasing number of studies have examined the therapeutic value of exercise during primary cancer treatment.26, 27

Existing evidence strongly suggests that exercise is not only safe and feasible during cancer treatment, but that it can also improve physical functioning, fatigue, and multiple aspects of quality of life

bullet

Persons receiving chemotherapy and/or radiation therapy who are already on an exercise program

may need to exercise at a lower intensity and/or for a shorter duration during their treatment, but the principal goal should be to maintain activity as much as possible.

Some clinicians advise certain survivors to wait to determine their extent of side effects with chemotherapy before beginning an exercise program.

For those who were sedentary before diagnosis,

low-intensity activities such as stretching and brief, slow walks should be adopted and slowly advanced.

For older individuals and those with bone metastases or osteoporosis, or significant impairments such as arthritis or peripheral neuropathy, careful attention should be given to balance and safety to reduce the risk of falls and injuries.

bullet

Adequate protein intake is essential during all stages of cancer treatment, recovery, long-term survival, and living with advanced disease.

The best choices to meet protein needs are foods that are also low in saturated fat (eg, fish, lean meat, skinless poultry, eggs, nonfat and low-fat dairy products, nuts, seeds, and legumes).

bullet

High sugar intake has not been shown to increase the risk or progression of cancer.

However, sugars (including honey, raw sugar, brown sugar, high-fructose corn syrup, and molasses) and beverages that are major sources of these sugars (such as soft drinks and many fruit-flavored drinks) add substantial amounts of calories to the diet and thus can promote weight gain.

In addition, most foods that are high in added sugar do not contribute many nutrients to the diet and often replace more nutritious food choices. Therefore, limiting the consumption of products with added sugar is recommended.

bullet

Evidence from both observational studies and clinical trials suggests that dietary supplements are not likely to improve prognosis or overall survival after the diagnosis of cancer, and may actually increase mortality.

bullet

Before supplements are prescribed or taken, all attempts should be made to obtain needed nutrients through dietary sources

Supplements should be considered only if a nutrient deficiency is either biochemically (eg, low plasma vitamin D levels, B12 deficiency) or clinically (eg, low bone density) demonstrated.

bullet

Supplements should be considered if nutrient intakes fall persistently below two-thirds of the recommended intake levels.

Such a determination should be made by a registered dietitian, who is most qualified to assess the nutrient adequacy of the diet, especially in view of emerging data suggesting that higher nutrient intakes, especially through sources other than foods, may be harmful rather than helpful.

bullet

Food safety is of special concern for cancer survivors, especially during episodes of treatment-related immune-suppression that can occur with certain cancer treatment regimens.

Survivors can become susceptible to developing infections due to treatment-induced leukopenia and neutropenia (low blood counts).

During any immunosuppressive cancer treatment, survivors should take extra precautions to prevent infection, and they should be particularly careful to avoid eating foods that may contain unsafe levels of pathogenic microorganisms.

• Wash hands with soap and water thoroughly before eating.

• Keep all aspects of food preparation clean, including washing hands before food preparation and washing fruits and vegetables thoroughly.

• Use special care in handling raw meats, fish, poultry, and eggs.

• Thoroughly clean all utensils, countertops, cutting boards, and sponges that have contact with raw meat; keep raw meats and ready-to-eat foods separate.

• Cook to proper temperatures; meats, poultry, and seafood should be thoroughly cooked and beverages (milk and juices) should be pasteurized. Use a food thermometer to check internal temperatures of meats before serving.

• Store foods promptly at low temperatures (below 40°F) to minimize bacterial growth.

• When eating in restaurants, avoid foods that may have potential bacterial contamination such as items from salad bars; sushi; or raw or undercooked meat, fish, shellfish, poultry, and eggs.

• Avoid raw honey, milk, and unpasteurized fruit juice, and choose pasteurized versions instead.

• If there is any question or concern about water purity (eg, well water), it can be checked for bacterial content by contacting your local public health department.
 

Questions and issues for your doctor or nutritionist:

bullet

How can I prepare food so that it's safe to eat when I'm immune compromised?

bullet

How can I know if I am digesting my foods properly? (bloating, diarrhea, constipation, leaky gut, etc.) 

bullet

What types of exercise can I safely do, and how often?

bullet

Is it okay to do strenuous exercise routines?

Return to top

Resources

DURING TREATMENT:
bullet
Highly recommended:

Nutrition for the Person With Cancer During Treatment Cancer.org
bullet
Getting ready for cancer treatment Cancer.org
bullet
Diet for Immune suppressed, overview Lymphomation.org
bullet
Cancer Nutrition Consortium:
Nutritional Guidance & Support http://bit.ly/18qPw28
 
PREVENTION and PROMOTING GOOD HEALTH:
bullet
AACR 2005 - Frontiers in Cancer Prevention Research  PDF 

Research articles on natural compounds that may prevent cancer
bullet
Defending Against Disease With an Anti-Inflammation Lifestyle  brighamandwomens.org Pdf 
bullet
Food Additives PAL
bullet
Food Allergies information WebMD
bullet
Food and Cancer Prevention Physicians Committee for Responsible Medicine
bullet
Food Nutrition and the Prevention of Cancer: a global perspective aicr.org 
bullet
Natural sources of fats are essential to good health as described in this excellent presentation to the FDA on food groups submitted by the Weston A. Price Foundation  FDA.gov PDF 
bullet
Dietary Fats, overview Lymphomation.org
FIGHTING CANCER AND TREATMENT EFFECTS:
bullet
"Eating Well Through Cancer" by Holly Clegg  Amazon.com

Focuses on cancer and nutrition with a mainstream approach. 
Recipes were selected to ease symptoms while undergoing treatment and to maintain a healthier lifestyle. (We have no affiliations with the authors.)
bullet
Early Nutritional Intervention Recommended for Cancer Patients  mdanderson.org 
bullet
Weight Loss & Cachexia PAL

A symptom of lymphoma progression is weight loss that cannot be explained by diet.  Cachexia, the loss of lean body mass, is most typically associated with advanced progression of the disease. 
DIET AS TREATMENT?
Presently, there is no credible published evidence that diet can influence the clinical course of lymphoma.
bullet
Complementary and alternative (CAM) dietary therapies for cancer. Pediatr Blood Cancer. 2008 Feb;50(2 Suppl):494-7; discussion 498. Review. PMID:18064662  Related articles 
bullet
Diet and Supplements to Delay Relapse?
bullet
Gerson Diet Therapy? 
 
Report by Concerted Action for Complementary and 
Alternative Medicine Assessment in the Cancer Field (CAM-Cancer)

Project funded under the European Commission 5th Framework Program “Quality of Life”.  cancer.org/gerson.pdf
 (fixed)
bullet
Macrobiotic diet? and cachexia medicine.wustl.edu  

A symptom of lymphoma progression is weight loss that cannot be explained by diet.  Cachexia, the loss of lean body mass, is most typically associated with advanced progression of the disease. 
bullet
Sugar restriction?  PAL
Research News 
Diet & Nutrition
Links to resources with answers to the questions above can be found here.

Return to top

 

 

RESEARCH NEWS

bullet
Home Diet and Exercise May Benefit Long-Term Cancer Survivors oncologystat.com 

A home-based diet and exercise program reduced the rate of functional decline in a study of more than 600 overweight and older cancer survivors, according to a report in the May 13 issue of JAMA. 
bullet
Fatigue: Physical Exercise May Help Reduce Fatigue During and After Cancer Treatment Medscape

"Exercise appears to have some benefit in the management of fatigue both during and after cancer treatment," the reviewers conclude. "Therefore it should be considered as one component of the management strategy for fatigue that may include a range of other interventions and education. . . . Further work is necessary to determine the most effective parameters of exercise for fatigue management including the types of exercise (aerobic and resistance), mode of exercise, frequency and length of sessions, and intensity of exercise carried out."
bullet
Performance Status Is the Single Most Important Prognostic Factor in Elderly Patients With Lymphoma: Presented at ESMO  docguide.com

Dr. Lim said, "Perhaps it is also important what treatment you administer or what they have, but if they are of good health they will do well, and if they are of poor health no matter what you do, it seems that they will not do well."
bullet
Exercise May Reduce Fatigue, Nausea Associated With Adjuvant Breast Cancer Therapy  Medscape (free login req.)

Although this is about exercise during breast cancer treatment,
thought it interesting -have known several breast cancer pts who were treated with Cytoxan and adriamycin-( 79% of pts in this study)-- so, some overlap with some of the chemos used for NHL
bullet
AACR 2005 - Frontiers in Cancer Prevention Research  PDF 

Many abstracts on cancer prevention
bullet
“Fish Oil Probably Doesn’t Fight Cancer”  http://thecheerfuloncologist.blogsome.com 

Now, there’s a misleading headline if ever I saw one - do they mean that fish oil is too chicken to put up its dukes against a cowardly band of sneering, narcissistic cancer cells? Is fish oil destined to join its comrade laetrile on the ash heap of ineffective cancer treatments?
bullet
An apple a day keeps Cancer away  cbsnews.com
Source: www.aacr Prevention_Abstracts.pdf 
bullet
Agricultural Experiment Station has led to a patent for a new use for derivatives of DIM, or diindolylmethane, a natural compound derived from certain vegetables, to treat cancer - the mechanism seems to be inhibition of  PPAR-gamma  agnews.tamu.edu
bullet
Related item: Human B lymphocytes and B lymphomas express PPAR-gamma and are killed by PPAR-gamma agonists. Clin Immunol. 2002 Apr;103(1):22-33. PMID: 11987982 | Related articles
bullet
Does Catsup Have A Link To Cancer? From our Nutrition Specialist:   umich.edu
Interesting with good general guidance. -KS
bullet
Diet Linked to Non-Hodgkin's Lymphoma Lots of Meat, Saturated Fat, Dairy May Raise Risk  webmd.com 
bullet
Impact of weight on mortality of patients with lymphoma undergoing autologous hematopoietic cell transplantation (AHCT)  Abstract No: 3342 
bullet
Research Beginning to Reveal Clues About Impact of Diet on Cancer Survivors, Scientists Say  - Survivors, Researchers Share Knowledge, Concerns at AICR Conference for Nutrition After Cancer aicr.org

Do exercise! to improve your fitness and quality of life

"Depression has a lot of trouble finding a moving target, 
it's outstanding at hitting a stationary one."
 ~ Dr. Himle

TOPIC SEARCH: PubMed

Resources & Research News
Be sure to consult a qualified profession when creating an exercise plan.

Return to top

There is mounting evidence that exercise should become a routine part of cancer care.   An appropriate exercise program can help to improve our general health, fitness and, quality of life - helping to combat fatigue and depression. 

 

Taking part in regular exercise can also alert us to changes in our performance level that can help to guide our care.    Improved fitness and general health that comes with adopting a healthful diet and exercise program is also associated with improved outcomes among cancer survivors.

What's New:

bullet
Exercise as part of care -
Medscape: Treatment for Cancer Patients

Resources:

bullet
Exercise should be 'standard part of cancer care
bullet
Physical activity for patients undergoing an allogeneic stem cell
transplantation: benefits of a moderate exercise intervention.
bullet
A Healthful Diet Promotes Fitness and Better Health (above) 
bullet
Exercise should be 'standard part of cancer care' http://bbc.in/nNIgTL
bullet
Regular Exercise! Mayo Clinic 

"Regular exercise increases your sense of well-being after cancer treatment and can speed your recovery." 
bullet
Guidelines Call for Cancer Patients to Get Moving http://bit.ly/bSoetK

"The primary objective of prescribing exercise to cancer patients and survivors is to help them regain and improve physical function, said Dr. Schmitz of the center for clinical epidemiology and biostatistics at the University of Pennsylvania in Philadelphia. Exercise can also help improve body image and quality of life for these patients."
bullet
Lymphoma Patients Benefit From Exercise!  http://bit.ly/4A5sXL 
bullet
Randomized Controlled Trial of the Effects of Aerobic Exercise on Physical Functioning and Quality of Life in Lymphoma Patients http://bit.ly/3q2BEf 
bullet
AACR 2009: Oncologists Should Recommend Exercise, But Not Supplements medscape.com
there is accumulating evidence to show that it can improve both prognosis and quality of life

Can exercise improve survival?

Moderate exercise and remaining active will improve your general performance, and your quality of life. There is evidence that having good general performance is a prognostic factor for improved survival, therefore, indirectly, it's highly plausible that exercise and keeping fit can improve your survival.

What about exercise during or after chemotherapy? 

Seems to be a very good idea ... in moderation and within your limits: 
bullet
Can Exercise Reduce Fatigue During Chemotherapy?
Source: www.aafp.org 

"During chemotherapy, patients in the exercise group did not have any change in fatigue level, while the non-exercise group showed a significant increase in fatigue. The non-exercise group also had less vigor and higher somatization scores." 
bullet
The Effects of Exercise on Fatigue during Chemotherapy
www.noblemed.com

"These studies suggest that fatigue levels correlate with sleep difficulties and that walking as little as 12 minutes per day can significantly improve sleep and decrease fatigue and anxiety. I have attached several abstracts that summarize some of the recent research on the value of exercise during chemotherapy. Many therapists recommend a moderate exercise program along with good skin care and compression as part of the comprehensive management of lymphedema."

Related Resources and Articles

bullet
Regular Exercise! Mayo Clinic 

"Regular exercise increases your sense of well-being after cancer treatment and can speed your recovery." 
bullet
Performance Status Is the Single Most Important Prognostic Factor in Elderly Patients With Lymphoma: Presented at ESMO  docguide.com

Dr. Lim said, "Perhaps it is also important what treatment you administer or what they have, but if they are of good health they will do well, and if they are of poor health no matter what you do, it seems that they will not do well."
bullet
Exercise to Stay Active  cancer.org/docroot 

Find out how much activity is healthy during treatment and create an exercise program that's right for you.
bullet
Exercise and lymphocyte activation following chemotherapy for breast cancer. Med Sci Sports Exerc. 2005 Nov;37(11):1827-35. PMID: 16286849 

Exercise may improve immune function by increasing lymphocyte activation in patients with breast cancer following treatment.
bullet
Individualized exercise program for the treatment of severe fatigue in patients after allogeneic hematopoietic stem-cell transplant: a pilot study. Bone Marrow Transplant. 2006 May;37(10):945-54. PMID: 16565742   | Related articles
bullet
Immunity and intense exercise  Related PubMed Abstracts
bullet
Regular exercise could both help people avoid developing cancer, or help them make a more successful recovery, say scientists  BBC News  
bullet
Children: "It has been shown that exercise such as riding a bike or walking can maintain a patient's strength and endurance while undergoing therapy."  rch.unimelb.edu.
bullet
General Exercise Tips and Suggestions for Energy Conservation  cancerlynx.com
bullet
Exercise and cellular innate immune function. Med Sci Sports Exerc. 1999 Jan;31(1):57-66. Review. PMID: 9927011  PubMed
bullet
Nutritional strategies to minimize exercise-induced immunosuppression in athletes. Can J Appl Physiol. 2001;26 Suppl:S23-35. Review. PMID: 11897880  PubMed
bullet
Effect of dietary intake on immune function in athletes. Sports Med. 2002;32(5):323-37. Review. PubMed abstract
 
Disclaimer:  The information on Lymphomation.org is not intended to be a substitute for 
professional medical advice or to replace your relationship with a physician.
For all medical concerns,  you should always consult your doctor. 
Patients Against Lymphoma, Copyright © 2004,  All Rights Reserved.