With the exception of
canine lymphoma which responds well to a high fat low carbohydrate diet
(Hill's N/D), there is no accepted dietary recommendation for cancer
patients. Veterinarians and pet owners interested in alternatives or
complements to conventional practice often shun commercial diets, and
some cancer patients refuse them, as well. Below are some recipes and
suggestions for nutritional support of cancer patients.
Are there any good
home-made diets for cancer patients?
Based on Ogilvie's work
using low carbohydrate, moderate fat and moderate protein diets
for lymphoma patients, we have used homemade diets that reduce
carbohydrates while providing quality protein, presumably appropriate
fat and fatty acid profiles, and high levels of nutrient rich
vegetables.1
Rule number one is to
KEEP THEM EATING, so we don't stand on principle if our patients
dislike our cooking. On the other hand, the majority of canine and
feline patients appear to improve in general condition after becoming
acclimated to the diet below, and we assume that their general
improvement bodes well for the course of their disease, at least to
optimize survival times.
Guidelines for cooking for
canine cancer patients:
-
50%
fish or poultry (organic preferred but not necessary)
-
50%
mixed frozen or fresh vegetables
-
Flax
or olive oil as a source of fat calories - about 1 teaspoon per 20
pounds of body weight
-
A
HUMAN daily vitamin-mineral supplement (one dose for animals over 20
pounds, ½ dose for animals under 20 lbs)
-
A
calcium carbonate source - (tums work well) about 250 mg per
15 pounds of body weight
(This recipe can be
used for cats with the meat at 80% and vegetables 20%, and added taurine,
250-400mg daily)
Many people use a crock-pot
to stew all ingredients together. Some prefer to steam the vegetables,
add the cooked meat, and throw everything into a food mill so that it
looks like commercial canned food. Raw meat is never recommended for
animals undergoing chemotherapy or who are immune suppressed in any way.
This recipe is NOT balanced - the patient and the recipe should
be re-evaluated frequently in order to adjust the recipe according to
the animal's weight, disease progression, and other changes in
condition.
Can I use spices to
improve palatability?
There are a number of
spices shown to have anti-neoplastic activity that will also improve the
flavor of this recipe. Try:
-
FRESH minced garlic -
about 1 clove per 40 pounds of body weight.
Garlic may oxidize red blood cells and at high doses can lead to
clinically significant anemia, but the benefits, and the fact that
the taste can sometimes stimulate appetite, make use of the herb
worthwhile. The CBC can be monitored regularly to curtail potential
problems before they become serious.
-
Turmeric, about 1
teaspoon per 50 pounds of body weight.
Turmeric, the yellow (and rather mild) spice that gives curry its
yellow color, is a strong antioxidant. Curcumin itself is not
well absorbed systemically, but is currently in favor for treatment
of GI cancers.4-7 Turmeric is rather milder tasting than
one would expect. Most dogs, and even some cats, accept it readily.
The dose of turmeric is high, up to one tablespoon daily for large
dogs.
Are there nutritional
supplements that have antineoplastic or immunomodulatory properties?
Nutritional supplements
are supportive and mild, but many do have anti-cancer effects in
in-vitro and even in vivo studies. Because of their mechanisms of
action, it has been suggested that they are best used in combinations of
at least 10 to 15 elements.
Antioxidants are
often recommended for cancer patients; they may slow proliferation of
neoplastic cells and reduce adverse effects of chemotherapy. While many
believe that antioxidants interfere with chemotherapy, others suggest
that they actually enhance the effects of chemotherapy. Some
trials suggest that antioxidants are effective in mitigating the side
effects of chemotherapy and radiation, and improve quality of life.
Human clinical trials addressing this subject have been published, but
the evidence is still conflicting. A critical review of 50
randomized controlled trials or observational studies reporting
concomitant use of nutritional supplement and chemotherapy and/or
radiation therapy was recently published. In 15 of those studies, 3738
patients took antioxidants and other nutrients, and were reported to
have increased survival.
We use antioxidants in
cancer patients who are old (where there is clear benefit for joint
pain, mobility and cognitive dysfunction in these patients) and where
patients are experiencing side effects from conventional treatment.
Antioxidants such as Vitamin C, E, selenium and the antioxidant enzymes
are mutually dependant on each other for their generation and activity.
For this reason, antioxidants should be provided as a broad spectrum,
rather than singly. The beneficial effects of fish oil may also be
suppressed by high levels of added antioxidants, so I usually recommend
low to moderate doses of a combination product.
Fish oil
appears to have antiproliferative activity in some tumor cell lines,
antimetastatic activity in laboratory animals, and anti-cachectic
activity in human patients. The benefits for patients with
cancer are linked with the ability to attenuate systemic inflammation.
It is frequently recommended for canine and feline cancer patients
at a rate of 1 extra strength capsule (500-600 mg of DHA and EPA) per
10-20 lbs of body weight.
Plant-derived flavonoids
have been studied in the prevention of cancer. These include
resveratrol from red grapes (and wine), green tea polyphenols,
and phytoestrogens from soy and other plants. Other less well
known flavonoids commonly found in medicinal herbs include curcumin
(from turmeric), apigenin, anthocyanidins (from berries),
quercetin, and many others (approximately 4000 flavonoids have
been described). In addition to well-recognized antioxidant effects that
may help in prevention of cancer, certain flavonoids have been found to
have activity in reducing cancer cell invasion mechanisms and
metastasis mechanisms, as well as enhancing immune function.
The green tea polyphenol,
epigallocatechin gallate (EGCG), has been shown to have anti-angiogenic
and antiproliferative properties in addition to preventing cancers. In
human clinical trials, 200mg daily of EGCG led to benefits, while up to
800mg daily was tolerated. I would suggest scaling the dose down by
weight, and using the extract instead of dried green tea leaves, as the
dose of the dried herb may affect patient appetite if provided in food.
What else can I do to
support my patient?
Cancer patients are most
often older, with the age-related diseases that accompany that process.
Practitioners and caregivers must consider pain from arthritis,
rheumatism (muscle spasms, trigger points) and the tumor itself. In
addition, geriatric patients may experience cognitive decline or the
cumulative effects of chronic disease and chronic medication
administration (in some cases leading to bowel hyperpermeability). For
these patients, various supportive measures, such as massage and
acupuncture may literally be helpful. For those who have chronic
allergies, or have been administered NSAIDs, steroids, antibiotics and
other drugs that affect bowel bacterial balance or mucosal integrity,
prebiotics and probiotics may be appropriate.
Do we know if they work?
None of the nutritional
therapies discussed have proven effects, used alone, in specific cancers
of canine or feline patients. However, they caused no harm and appeared
to benefit the patient. If cancer patients feel good enough to tolerate
the diet change and supplements, this regimen of low carbohydrate
homemade diet with therapeutic spices, antioxidants and fish oil can
improve and maintain good physical condition in a number of patients.
