Patients need to beware of cancer diet myths

MDs and dietitians help those bombarded with advice

Back in the 1870s there was very little to be seen in Grantham Township between Carlton Street and Lake Ontario other than acres and acres of fruit farms and scattered farm houses. But times were changing.

The northeastern quarter of that township was divided into School Sections, each of which had its own schoolhouse for the local farm children. In 1874, a small two room school was built out on the southwestern corner of Niagara Street and Linwell Road.

The school became known as “S.S. No.2” since it served School Section No. 2, a well-defined school attendance area extending (roughly) from Geneva Street on the west to Bunting on the east, and north-south from Lake Ontario all the way down to Carlton Street.

For decades this new school and the Grantham Methodist Church, built across Linwell Road from the school in 1878, were among the few substantial buildings other than farm properties in that part of the township.

Slowly the population of that area

TORONTO — When Miguel Roger began chemotherapy for chronic lymphocytic leukemia last summer, he didn’t realize the challenges he’d face with food.

“I noticed a change in my appetite and a lack of energy,” said the 65-year-old retired engineer.

His wife Jenny, 61, became his primary caregiver and found it challenging navigating all the nutrition advice from books, their doctor and the hospital nutrition centre.

“I once cooked him calf liver to help with his anemia,” she said, “I read it in a book, but when I spoke to Miguel’s doctor, we were told it wouldn’t help since the anemia was not related to nutrition, but to the cancer itself and the chemotherapy.”

Nutrition is an under-recognized challenge for cancer patients. Fad diets can cause unnecessary weight loss, disrupt treatment and sometimes make outcomes worse.

Many patients struggle with navigating the “cancer-specific” dietary increased as the decades passed, no doubt encouraged by construction of the Third Welland Canal across Grantham Township in the 1870s. By the time this week’s old photo, showing students posing in front of S. S. No. 2, was taken in August 1896, the area’s population had already significantly increased. That was further encouraged by construction of the Fourth Canal (the Welland Ship Canal), which began just to the east in 1913.

By the 1920s the little 1874 red brick school house at Niagara and Linwell was seriously overcrowded. It was replaced by a new building, containing four classrooms and an information found in popular books, blogs, and websites.

A British study found caregivers and patients were concerned about the lack of accurate and clear information — something Canadian health providers are keen to provide.

“In clinic, I once overheard a woman saying how she was getting mega-doses of vitamin C, rose hip tea, bee pollen and antioxidants,” said Jenny Roger.

“But I heard the dietitian advise that those things may not be regulated and could be contraindicated during chemotherapy.”

This is a familiar story to many cancer specialists and dietitians, including Thomas Jagoe, director of the McGill Cancer Nutrition-Rehabilitation Program in Montreal.

One of his challenges is dealing with diet trends that conflict with what an oncologist advises. One trend is “short-term fasting” before chemotherapy.

“This is a hot topic of research but at this time the evidence doesn’t support that a patient who is already losing weight starve themselves for a few days,” Jagoe said.

An open line of communication helped Stacey Sheppard, a dietitian with the Nova Scotia Health Authority, identify the real reason behind a patient’s issue. auditorium, which opened on the same site in November 1922.

In the late 1940s, with the return of servicemen from the war and the return to a peacetime economy, the area boomed and the farmland of Grantham Township began to be steadily replaced by tract housing and the children of the Baby Boom.

Soon S.S. No. 2 — by then re-named Maplewood School — was becoming overcrowded again. In the 1940s an eight-room extension was added south of the 1922 building, and further expansion was avoided only by construction of other schools in the area.

By the beginning of the 21 century

“One patient with nasal cancer got advice from a holistic nutritionist to omit gluten. When we got to the bottom of it, we realized they actually had issues with swallowing crackers — it was a swallowing issue, not a gluten issue,” she said.

It’s all about control, says Jonathan di Tomasso, a nutritionist at the McGill University Health Centre Cancer Rehabilitation Program.

“People often lose control over many aspects of their life when they are diagnosed with cancer. Food is something they can control, but the roar of misinformation out there is deafening,” he said.

Toronto-based naturopath Daniel Lander, who has an undergraduate degree in nutritional science, works closely with physicians to offer evidence-based nutrition advice.

“Patients are generally relieved when I tell them they don’t have to follow those strict diets, and I focus on making sure they are getting enough calories and important macronutrients,” Lander said.

He advises a Mediterranean-style plant-based approach with leanprotein sources and whole grains.

“It’s nothing too exciting or flashy but from the science, that’s the best we can tell people to do,” he said.

For good online sources of information, Daniela Fierini, a registered dietitian at Princess Margaret the school authorities decided that Maplewood School had outlived its useful life. In 2002 the school was closed.

Two years later the Greek Orthodox Church bought the property, which now is occupied by the St. Katherine Greek Orthodox Church (opened in 2005) and the Greek Community Centre, notable for the colourful depiction of Christ which now occupies a niche above the former entrance to Maplewood School. Dennis Gannon is a member of the St. Catharines Heritage Advisory Committee. He may be reached at gannond2002@yahoo.com Hospital in Toronto, recommends the American Institute for Cancer Research, B.C. Cancer Agency and Nourish Online, but still cautions against the “one size fits all” model.

Due to a good response to chemotherapy and radiation, Roger’s cancer has been in remission for the last month.

“Now my appetite’s normal. I lost around 10 pounds, but I think I have gained it all back ... my energy level is fine and I’m no longer swollen,” he said.

The Rogers were cautious about following popular cancer diet trends and maintained open communication with their doctor.

“You can get caught up with reading things on the Internet and I think everyone should be working with their doctor,” said Jenny Roger.

“People need to have a bond of trust with their doctor. Some people don’t and so they look elsewhere, which can sometimes be overwhelming and can cause more harm than it helps.” Amitha Kalaichandran is a pediatrics resident and Shuang Esther Shan is a culture and food writer. Both are fellows in global journalism with the Munk School of Global Affairs at the University of Toronto.

My mother and I have had a tumultuous and toxic relationship ever since I was a child. It was a mess of bitter resentment, jealousy, explosive fights, abuse and disappointment on both sides.

It has taken some time, space and, of course, some therapy (I participated, she did not), but we have gone a year without an incident.

Now that I am a mother myself, I have found some understanding, healing and forgiveness.

Our relationship is the best that it has ever been, but she has always been disappointing when I needed her.

Now I have a huge opportunity for us to bond and for her to be there for me like the mother I have always wanted and needed.

My second child is due in a month. I always said she would be the last person I’d want with me in the delivery room, but I now think I want her there.

Should I give her the chance? She missed helping me with prom, my wedding, the birth of my first son. If it goes well it will strengthen our relationship; if it doesn’t — more therapy, I guess? — MOMMY DEAREST

Given the toxic history, I think giving your mother a “huge” opportunity is also offering her a huge way to fail you. This is an extremely stressful and “loaded” situation; while giving birth you might not react to her in the way she would like, and the stress and anxiety might plunge both of you right back into your old dynamic.

And yet — I understand the symbolism for you, as well as why you want this so badly.

Proceed with caution. Ask her if she wants this (she might not). Give her plenty of outs, and make sure you have reliable and companionable backup.

Keep your therapist’s number on speed-dial.

I’ve been with my boyfriend for six months. He was living out of state and returned shortly before we started dating. He had dropped out of grad school and moved back in with his mother. He doesn’t have a car, and has significant student loan debt that he claims is preventing him from getting his own apartment or vehicle.

He has a job where he makes about the same as me, but I’m able to afford an apartment and car. I look down on him for this. I worked my way through college. If I could do it, he should be able to. He’s almost 30.

His monthly student loan payment is about equal my rent, but I’m becoming concerned that there’s more than debt holding him back. He gets offended and says he feels judged or stressed out when I try to push him toward making positive changes.

I’m beginning to doubt that I can ever rely on him as a life partner, and sometimes I feel that he is just so incompetent. I also wonder if I’m being too harsh, but it’s embarrassing for me to have to tell my family and friends that he still lives with his mom and doesn’t have a car.

I haven’t expressed these feelings to him because he always reacts so sensitively, but I’m thinking about an ultimatum. I don’t want to waste time with someone who can’t get his life together. What do you think?

— FED UP

You say you haven’t expressed your feelings to your boyfriend, but of course you have. He reacts defensively and feels judged, because you are judging him.

An ultimatum would definitely force this issue, but don’t expect him to capitulate or cooperate.