Markus Vinzent's Blog

Tuesday, 22 September 2015

What should cancer patients eat during Taxol (paclitaxel) chemotherapy?

Nothing spectacular for those who have experience with eating diets for cancer patients, but I think the following information summarises well the latest information on what to prefer and what to leave during Taxol (paclitaxel) chemotherapy in ovarian cancer:

Taxol (paclitaxel) is effective in improving breast cancer prognosis: numerous studies have found that it protects against breast cancer recurrence and death. Taxol and other taxanes can result in side effects such as hair loss, mouth sores, nausea, fatigue, low white blood cell count, neuropathy, muscle and joint pain, cognitive impairment (chemo brain) and serious infections. While obtaining relief from these side effects obviously is desirable, it is very important for breast cancer patients to avoid consuming foods or taking supplements that will lessen the cytotoxic impact of chemotherapy on cancer cells.
While various micronutrients found in fruits, vegetables and other foods have been shown to help protect against breast cancer development and metastasis, some of the same micronutrients might enable breast cancer cells to survive chemotherapy. Therefore, the strategy we recommend during chemotherapy and for the following month is to consume the foods recommended below, as well as those listed on the bland chemotherapy diet (also below), while limiting or avoiding the foods listed below that should not be consumed while on Taxol (as well as those on our avoid list). Please see also our web page on factors influencing Taxol's effectiveness.

Foods that enhance the effectiveness of Taxol

The following foods are very good sources of compounds that have been shown to increase the anti-cancer effects of Taxol:

Bell peppers
Black pepper
Bok choy, or Chinese cabbage
Brazil nuts
Brussels sprouts
Collard greens
Grape juice, purple
Grapes, red
Hot peppers
Olives and olive oil
Onions, yellow
Rice, brown
Salmon, wild
Turnips and turnip greens
Many women undergoing chemotherapy develop abnormally low iron levels, which must be treated. However, excess iron is also to be avoided during chemotherapy. Curcumin (found in turmeric) has been shown to be an iron chelator, a compound that removes iron from the body. Turmeric might also protect the brain from chemotherapy, thereby possibly reducing chemo brain.

Sour cherries, olive oil and vitamin D might relieve joint and muscle pain, although their effectiveness has not specifically been studied in the context of taxane chemotherapy. Brazil nut consumption should be limited to no more than one nut per day, on average, to avoid consuming excess selenium.

Please note that while salmon and the closely-related Arctic char are recommended for consumption during Taxol chemotherapy, recent research suggests that herring, sardines, anchovies, mackerel, lake trout and similar fish should not be consumed the day before through the day after a chemotherapy treatment. In addition, these fish should be consumed only in moderation during the remaining days of each cycle. Fish oil supplements should not be consumed by those undergoing chemotherapy.

Foods and other products that should not be used during Taxol chemotherapy:
The following foods and supplements have been found either to interfere with the effectiveness of Taxol or, in the case of raw shellfish, should not be consumed by those with impaired immunity:

Açaí berries
Caffeine, any source
Coffee, regular or decaf
Fish oil
Hormone replacement therapy, including bioidentical or natural hormones
Iron supplements (unless medically necessary)
Mint tea
Multivitamins & antioxidant supplements
Shellfish, raw
Acetyl-l-carnitine, which is sometimes used for the prevention of taxane-induced neuropathy, has been found actually to increase neuropathy.
Citrus flavonoid hesperidin could reduce effectiveness of cyclophosphamide

Hesperidin, a flavonoid found in oranges, tangerines, kumquats, lemons, limes and grapefruit, has the potential to interfere with chemotherapy regimens containing cyclophosphamide, such as TAC (taxotere, adriamycin and cyclophosphamide). Cyclophosphamide is an alkylating agent frequently used in combination with taxanes (Taxol, Taxotere) and/or anthracyclines (Adriamycin, epirubicin) to treat breast cancer. Hesperidin is found most abundantly in the peel, pith and membranous parts of oranges and other citrus fruits. Prepared food sources include orange tea, unfiltered orange juice, orange marmalade, and dishes that incorporate citrus peel such as Szechuan Orange Chicken.

Bland diet for use during Taxol chemotherapy

The list below features bland, as well as somewhat bitter-tasting foods, that do not promote cancer (when consumed in moderation). It is important not to drive up blood sugar and insulin levels with high carbohydrate/low fiber meals. Select as wide a variety of these foods as possible and consume any one of them in moderation in addition to the foods recommended above.

Almonds, skinless
Beans, white
Bread, whole grain
Chicken, organic
Coconut, raw
Green beans
Honey, minimally processed
Lettuce, iceberg
Melons, pale winter
Onions, Vidalia
Peaches, white
Turkey, organic
Vinegar, white
Yogurt, low-fat

Weight loss and weight gain during chemotherapy

Recent studies suggest that fasting around chemotherapy treatments could protect normal cells from the toxic effects of chemotherapy while sensitizing cancer cells to the treatment. However, more studies and human trials are required before it can be determined whether fasting during chemotherapy is safe and effective.

On the other hand, weight gain, which is common during chemotherapy, is known to be associated with less favourable prognosis and should be avoided.
Unfortunately no specific webpage exists so far for food and diet in ovarian cancer cases, so the occasional posts here may make a start of what has already been well developed in the field of breast cancer research:

On side-effects of chemotherapy, see the informative diagram and commentary of Healthline.