Cancer not only wages war on our bodies, but also our relationships with food. Are cancer-fighting diets really the answer?
Jen Sotham is a freelance journalist and screenwriter/director. She was working as a university professor in Busan, South Korea, where she lived for almost a decade, when she was diagnosed with metastatic melanoma in 2014. Still doing battle with the beast, Jen has since returned to New York, where she has been using her voice to share her story through film, essays and her blog, jenvscancer.wordpress.com
I've come to think of the word “foodie” as a ridiculous word, or at least a word that has lost its exclusivity. We live in an era where anyone can become a gourmand, either voyeuristically or tangibly. I mean, I've watched on TV as an 8-year-old kid from rural Missouri whipped up a flawless Beef Wellington. And today, dietary restrictions don't really suck that much... I made a batch of Betty Crocker gluten-free brownies last month that were the real deal. The thing with cancer is that there aren't any foods that I can't eat. Instead, it's a matter of what I should or shouldn't eat, and, sometimes, what I do and don't want to eat.
Call me ridiculous, but I am, in fact, a foodie. As much as I despise the word, it's one that I think most people who know me would use to describe me. I was lucky to grow up in a family that dined out at fine restaurants on a regular basis, and my family boasts generations of badass cooks. I can bang out a few choice dishes, myself. I wouldn't call myself an excellent cook - but I am an excellent eater. By that, I don't mean that I can eat a larger quantity of food than someone else - I've always been pretty mindful of portion control. I just have a profound understanding of what foods complement each other, of exactly what and how much to order in a group dining situation, of how long to pause between courses to get the most out of a meal, in terms of both consumption and socialization.
The immunotherapy combo (Yervoy + Opdivo) that was my first course of treatment when I was diagnosed with metastatic melanoma demolished my thyroid. With thyroid issues come appetite issues. There was a brief period of time when I struggled with eating, but as soon as my body adjusted to the hormone replacement drugs, my appetite went back to normal. The immunotherapy also demolished my cancer, and I spent an entire year NED. In the month leading up to my one-year scans, my love for food did a runner on me. I remember being at a fine restaurant with guy I was dating, barely getting through half of a phenomenal short rib risotto before welling up in tears and throwing in the towel. I thought it was my thyroid again – it had flip-flopped a few times and my meds had to be adjusted – until I went in for my one-year scan results to learn that my melanoma was back, worse than before, and all in my GI system.
Since that recurrence 14 months ago, I have lost 30 pounds and required quite a few blood transfusions. Treatment after treatment works for a short time to slightly shrink my tumors or keep my disease stable before my cancer becomes resistant and my oncology team has to try something new. How fortunate we are to live in a time with endless treatment options and clinical trials coming down the pipeline.
Fortunately, I have mostly been “on-again” in my love affair with food. Many people have recommended special diets, especially ones that call for zero sugar intake. I have been encouraged by both my doctors and my loved ones to do what makes me happy... if eating delicious food improves my quality of life, then eat delicious food. My oncologist always tells me to pay attention to my body, to eat what I want in moderation. I am lucky that, for me, good eating mostly equates with healthy eating. I eat three meals a day, I never binge, I don't drink alcohol save for the occasional glass of wine when a meal calls for it. When I buy a pint of ice cream, it lasts me two weeks.
When I stopped responding to my most recent treatment, and was told that the clinical trial that seemed my best option wouldn't start for a month, I panicked. I hadn't been treated for three weeks before the negative scans, which meant that it would be a total of almost two months without any form of treatment. In melanomaland, two months without treatment can mean rapid progression... distant metastasis... it's kind of like dog years.
I decided to finally read through the literature a friend has been sending me about the ketogenic diet. Basically, it's a high-fat, high-protein diet where you cut all carbohydrates and sugar out of your regimen. The theory is that, since cancer feeds on glucose, if you deprive your body of foods that turn into glucose, your body goes into a state of ketosis, meaning your cells feed on fat. Apparently, healthy cells are able to thrive on only fat, where your abnormal cells - or cancer cells - starve. The thing is that even a tiny 'cheat' brings your body out of ketosis and it can take two or three days to get back into it. The science behind it seemed legit, so I decided to give it a try. At least I'd be doing something while waiting for the clinical trial to start.
After consulting a few online meal plans, I did a big food shopping trip and became confident in my ability to stick to this. Eggs, cheese and bacon; tuna salad with extra mayo; steak and creamed spinach, fatty salmon with cauliflower in butter sauce; as many avocados as you desire - totally doable. The only thing that seemed daunting was the 'no fruit' thing. To address this, I bought sugar-free Jello. The first two days were easy... with the exception of missing bread and fruit, my meals weren't that much different than normal. By day three, I began to feel weak and food, once again, started to lose its appeal. I wasn't sure if it was the diet or the cancer.
My fourth day on the diet, I had to have baseline scans for the upcoming clinical trial. I ate a keto-friendly breakfast of muffins I baked with almond flour and stevia. They were friggin' disgusting. Then, as required for the CT scan, I fasted for three hours. Then I realized that the dye they injected me with is made of glucose (another reason people theorize about the correlation between cancer and sugar... the glucose in the contrast fluid is what causes the cancer to light up). By the time the scans were done and I met my sister for dinner, I was feeling a bit weak and light-headed. Now, I'm no scientist, but I figured that the glucose I was injected with probably already took me out of ketosis (if I was even in it in the first place), so I might as well eat normally for dinner. A couple of corn tortillas at my favorite place for enchiladas weren't going to kill me.
Despite the fact that I was starving, I barely got through half the plate. It was delicious, but at the same time terribly unappetizing. I returned to keto-friendly foods for the next 24 hours, and at dinner the next night, I found myself picking at a gorgeous piece of salmon with distaste. The next morning, I headed straight to the bagel store and procured a mini everything bagel with veggie cream cheese. I devoured it. It was delicious. I washed the bagel down with some dark chocolate almond milk and suddenly I felt like myself again. I was back in action.
As much as the science behind all of these cancer-fighting food trends individually make sense to me, many of them contradict each other. One says fruit juices are the enemy, another says juices are the answer. One says red meat is the devil, another says bacon is my savior. The fact of the matter is that having late-stage cancer is exhausting - mentally, emotionally, and physically. So, if I can find a little reprieve in a piece of toast with my morning coffee, I'll take it.
In just over two weeks, I'll begin a promising new treatment and until then (and continuously), yes, I'm going to lay off sugar and limit my carbs, but I'm done trying to starve my cancer out. When I explained this to my ever-supportive sister, she said, "Jen, if there really was a definitive food fix... a diet that flat out killed cancer, don't you think every oncologist would be putting their patients on it?" Keep in mind that she was the first person to suggest cutting out sugar. I honestly don't know the answer. What I do know is how to listen to my own body, and right now it's telling me to go eat a nice, juicy peach.