Healthy Food: A Game-changer Before, During, and After Cancer

At 57, Arletha Patterson says she feels renewed and restored “like a butterfly leaving the cocoon.”

Patterson is a cancer survivor. She was so focused on getting through surgery, chemotherapy, and radiation after being diagnosed with cancer of the small intestine in 2009 that she didn’t think much about her food choices. 

And she didn’t realize nutrition therapy could help:

• prepare her for cancer treatment
• ease her symptoms during treatment
• minimize her risk of new cancers and symptoms from developing years after treatment

Now, the Miami resident says, she is ready to “take care of Arletha” with personalized nutrition counseling with Federika Garcia, M.S., RDN, LDN, CNSC, a clinical nutrition manager (oncology nutrition), at Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine.

Patterson’s experience is common among people first diagnosed with cancer, Garcia says. Patients have too much going on or don’t realize there is a specialized area of oncology nutrition that can help them through every phase of cancer. 

Nutrition is power.

According to studies, nutritional interventions can significantly contribute to patient preparation, improving surgical outcomes and tolerance of treatments.

Particularly for individuals undergoing cancer treatment, tailored nutrition plans may improve treatment-related toxicity, reduce hospitalization durations, lower readmission rates, and help the successful completion of prescribed treatment regimens.

“With cancer patients, nutrition therapy depends on not only the cancer diagnosis but also the stage, symptoms, past medical history, and future health risks,” Garcia says. 

In Patterson’s case, she is cancer-free but hasn’t felt good for a long time. She is using nutrition therapy to address long-term complications from treatment in survivorship. 

“Arletha is experiencing late effects from undergoing chemoradiation and the surgery that impacted her ability to digest and absorb nutrients, resulting in significant weight loss,” Garcia says.

“We’ve been working on nutrition education and interventions to improve her gastrointestinal symptoms, recommendations for adequate nutrient absorption, healthy weight gain, and ultimately focusing on health promotion, recovering her strength and energy after cancer treatment.”

Survivors are educated on how they should eat, which includes a well-balanced diet, says Garcia.

What constitutes a well-balanced diet?

That often means encouraging a variety of colorful fruits and vegetables high in antioxidants to help with inflammation, such as oranges, berries and leafy greens. 

Fiber-rich foods are important for helping to maintain good gut bacteria. Garcia also emphasizes the importance of adding protein to all meals to maintain lean muscle mass, with protein sources such as salmon, chicken, and plant-based options such as beans and lentils.

Some foods are better left on store shelves. 

Among those are highly processed foods, like deli meats, as well as sugary foods and drinks. 

Still, Garcia says she does not suggest patients make unnecessary food restrictions or avoid entire food groups, particularly during treatment. 

“For some patients, especially those facing challenges with oral intake, eating familiar comfort foods can be beneficial. These foods can help them maintain adequate nutrition, prevent rapid weight loss, and preserve muscle mass,” she says. 

Medical nutrition therapy for cancer patients can take many forms. 

This includes personalized outpatient plans and intravenous nutrition therapy, called total parenteral nutrition (TPN).

“We want to optimize patients’ nutritional intake by mouth as much as we can. If that’s not possible with foods alone, we introduce nutritional supplements, including shakes and powders. If that is limited, the third line would be tube feeds or TPN,” Garcia says. 

How can nutrition impact my recovery from cancer treatment?

The CRANE Lab, led by Tracy E. Crane, Ph.D., RDN, co-lead of the cancer control research program and director of lifestyle medicine, prevention and digital health at Sylvester is leading important studies in many cancer types, looking at nutrition’s role in cancer outcomes and survival. 

“We are bridging the gap between the research setting to care in the clinic by having Sylvester’s dietitians and our patients involved in the research,” Garcia said.  

Utilizing a novel model, Sylvester researchers are partnering directly with support services to design, test, and deliver interventions that will ultimately inform nutrition in oncology clinical practice. 

Among them, the Trial of Exercise and Lifestyle (for women newly diagnosed with ovarian cancers), evaluates whether a medical nutrition therapy and exercise intervention during chemotherapy improves chemotherapy completion and reduces cancer-related symptoms. 

The Precision Oncology Interventions in Nutrition and Training study is working with survivors of breast, prostate, and colorectal cancer to explore whether a tailored diet and physical activity intervention can improve adherence to the lifestyle recommendations for survivors and improve quality of life, physical function, nutrition and body composition.

Yet another study, the Lifestyle Intervention of Food and Exercise for Lymphoma Survivors, is working with newly diagnosed lymphoma cancer patients to explore whether a Mediterranean diet and increased aerobic and strength training exercise can improve outcomes from treatment, including reducing side effects from chemotherapy and enhancing well-being and quality of life. At Sylvester, patients are offered the latest drug trials and access to a wide assortment of lifestyle medicine trials, providing them with cutting-edge, comprehensive care.

“When we focus on nutrition in a way that empowers them to take charge of how to improve their symptoms as much as possible while helping them have the best quality of life that they can (and not just by doing it with a very restrictive diet but rather something that fits into their lives), that means the world to them,” she says. “Patients are so happy when they discover there is help for their constipation, diarrhea, overwhelming fatigue, or their inability to gain or lose weight.” 

In the meantime, Patterson is happy to be rebounding from her rapid weight loss in the last year, which resulted in pain, heartburn, and diarrhea and even made it hard for her to walk.

“I want to share my story,” Patterson says. “God gave me a purpose to help other people get back to their lives.”

Sylvester’s dietitians and pharmacists presented a poster at the American Society of Parenteral and Enteral Nutrition and will be presenting at the European Society of Parenteral and Enteral Nutrition conference on survival and outcomes in patients who need TPN, with some successful cases being able to wean off the therapy.  

Lisette Hilton is a longtime health reporter and regular contributor to Sylvester Comprehensive Cancer Center and University of Miami Miller School of Medicine news.

Go-to recipes used for cancer patients.

A nutritious sandwich option (instead of a deli meat sandwich)

• Pick your protein: tuna, hard-boiled eggs, rotisserie chicken or shredded chicken breast, mashed chickpeas, or hummus for a vegetarian option
• Instead of mayo, use plain Greek yogurt for some extra protein, avocado for some healthy fats and smooth flavor, and a drizzle of extra virgin olive oil
• Add a variety of vegetables and herbs for additional vitamins, minerals, and antioxidants (cilantro, celery, carrots, cucumbers, peppers, etc.)
• Add a pinch of salt and pepper for some additional flavor 
• Choose a whole-wheat sandwich, tortilla, arepas, crackers, or make it into a bowl and enjoy for any meal of the day

Easy pancake recipe, high in fiber and protein

• 2 bananas
• 1.5 cups of uncooked rolled oats
• 2 eggs
• Add one scoop of protein powder (unflavored or flavored as per your preference) (optional)
• Add cinnamon to taste
• ¼ tsp salt
• 2 tsp baking powder 
• ½ cup of milk 

Add all ingredients to a blender, mix well, cook in a pan

High-calorie and high-protein smoothie

• 1 cup of milk of your choice (or ½ a cup of Greek yogurt and ½ cup of milk)
• 1 scoop of protein powder (flavored or unflavored as per your preference) 
• Add 1-2 fresh or frozen fruits for flavor and natural sweetness (banana, mix of berries, peaches) 
• Add extra protein or calories 1-2 tbsp of peanut or other nut butter, hemp seeds, ground flaxseeds, choose coconut milk or avocado if extra calories are needed
• Add veggies for additional nutrients (leafy greens such as spinach and frozen cauliflower)

Tags: cancer nutrition, Federika Garcia, nutrition for cancer survivors