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The Role of Nutrition |
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I have been looking forward to writing this article for some time now. I think our profession does an excellent job of diagnosing and treating cancer but has done poorly in the past in terms of dealing with nutritional management. Cancer is growing as our pets live longer; almost a full 10 percent of a veterinarian's case load may now deal with cancer. I won't keep those of you whose dogs have cancer in suspense any longer; you may be surprised to learn that an Atkins-type diet may be best for your pet. Many dogs with cancer end up looking like they have been starved. This condition, known as cancer cachexia, is very important because it is often associated with a poor quality of life and a lower response to treatment. Therefore, nutritional therapy becomes important when we treat cancer. We'll go through a few of the things you need to know. Let's start with some basic nutrition. The macronutrients are carbohydrates, protein and fats. Carbs are probably the most important in regards to cancer. Many tumors/cancers love carbohydrates, and they use them in a way that robs the host (your pet) of energy. It can get complicated, but put simply, cancer uses carbs anaerobically (without oxygen) and the by-product is lactic acid. Your pet must spend energy to get rid of this poison. It's a double whammy really; your pet is robbed of energy-providing carbs and then must spend its own energy to get rid of the lactic acid. Ouch. One study showed that dogs fed a high fat diet were more likely to go into remission following chemotherapy than those fed a high carb diet. Protein is the next macronutrient under the microscope. Cancer can cause decreased muscle mass and can lower the amount of protein produced in the skeleton. It can also use protein for energy, which can, in turn, lower immune and gastrointestinal system functions. Some amino acids (the building blocks for protein), however, may be useful in treating cancer. The amino acids arginine, cystine, glutamine, and glycine have been shown to help prevent toxicity for chemotherapy, enhance the natural immune system, and lower anemias. So, certain proteins and amino acids are good for some cancer patients. Fat chance you will be able to guess the next nutrient! Lipids and fats are very exciting frontiers in cancer. The lipid profile of cancer patients in phases of cancer cachexia is very off, but no one really knows what this means at the cellular level. Most of the weight loss is fat loss, but this is not good. The exciting news is that these abnormalities can be lessened by feeding a higher fat diet. It seems some tumor cells have a tough time using fat as a fuel source as compared to protein and carbs. The type is important, too. The n-3 series of fatty acids (EPA and DHA) may actually prevent the growth of some tumors as well as slow the onset of cachexia and metastasis, or the spread of cancer, while n-6 fatty acids are just the opposite. N-3s are a hot topic of research, and scientists are trying to decide how much n-3 is best. Some foods high in n-3 are cold-water fishes, flax oil and primrose oil; steak is high in n-6 fatty acids. So, the guidelines for macronutrients are high fat, low amounts of high-quality protein, low-to-no carbs and certain amino acids. Then supplement with n-3s. You can construct a diet like this yourself or can buy one from HillsTM Nutrition called N/D. Dogs love N/D, but we call it the diarrhea diet for unfortunately all-too-obvious reasons. You'll want to change your dog's diet slowly. Next, we move on to everyone's biggest concerns, the micronutrients. These are things like vitamins, minerals, garlic, tea, and shark cartilage. This is a poorly understood area, but it is growing in research due to the fact that much of the world claims success using such remedies. Studies using dogs are very hard to find; most of the useful data has been derived from rats or humans. If you are an American, please heed the following advice: more is not necessarily better (you do not need to overdo your vitamins). Retinoids, beta carotene, and vitamins C, D, and E have all been popular at one time or another. Melanomas and squamous cell carcinomas in humans have responded to retinoids. Dogs with lymphoma of the skin and other benign skin tumors have been treated successfully with retinoids as well. Vitamin C has been shown to mute the carcinogenic effects of nitrate-rich food and has also been shown to lower cancer resistance to some chemotherapy drugs. Vitamin E also helps with nitrate-rich foods and may protect against some malignancies. Studies at Harvard University show that vitamin E may help some oral tumors if injected directly into the tumor. Minerals thought to have anti-cancer or cancer-fighting properties are selenium, zinc, copper, magnesium, calcium, potassium, iodine, lead, and germanium. Selenium and zinc are probably the two most popular, and they show promise for prostate and GI cancer. One study in rats held promise for mammary gland, colon, and stomach cancers. Garlic is also a good thing, and not just for breads, sauces, and pizzas. Garlic appears to protect our DNA from oxidant damage. In a test tube garlic can slow the growth of cancer cells while leaving normal cells alone. Soy can keep cancer cachexia away by preserving fat stores and enhancing the effects of chemotherapy. Tea extracts, both green and black, are thought to have anti-cancer properties also; these extracts inhibit cancer-promoting agents, protect against oxidative damage and can make the antioxidants work better. One disappointment out there is shark cartilage. There have not been any real studies, despite all the media hype, that shows this stuff works. I've been a victim myself and still have patients on the stuff because I don't see any harm, but the studies were stopped because of poor results. So let's stop the slaughter of innocent sharks, because it isn't doing us any good. As you can see, nutrition is important. I try to stress this to all my cancer patients. Feed N/D or an Atkins-type, high fat, low carb, good protein diet. Supplement with a high quality antioxidant vitamin (I use Cell Advance, which is made for dogs, from VetriScience. It's a little pricey but an excellent product and cheaper than individual vitamins), and add in n-3 fatty acids. A holistic veterinarian-friend of mine has me use shiitake mushroom extracts as well. Try some green tea extracts, too; they probably won't hurt anything. Last, follow the advice of your veterinarian and remember that nutrition is just one key to the puzzle; it does not replace the basic principles of cancer therapies but rather enhances them. It would be upsetting to know someone passed on a proven cure for lymphoma (for example) and opted instead to give a multivitamin! -Dr. Stephen M. Sheldon, D.V.M. practices at and owns Hammocks Veterinary Hospital in Miami, Florida. A University of Florida graduate, he is President of the South Florida Veterinary Medical Association, and a member of the Veterinary Cancer Society. He can be reached at (305) 388-0880. Visit his website at http://www.hammocksvet.com/. |
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