Dietary Recommendations During Watch and Wait

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Topics include: Living With Chronic Lymphocytic Leukemia

Are there any dietary suggestions or restrictions for patients in watch and wait?  Patient Power founder, Andrew Schorr, asks CLL expert, Dr. Nicole Lamanna of Columbia University Medical Center to explain diet recommendations during this phase of CLL.  Dr. Lamanna is quick to point out that the Internet can be both helpful and harmful. However, she explains, the most important factor is keeping your doctor informed about all supplements that you are taking.

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Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

Andrew Schorr:

So when people are in the watch and wait stage or, you know, we patients often call it watch and worry, any dietary suggestions or restrictions? 

Dr. Lamanna:

Yeah.  Fair enough.  I think the issue around diet is a very common one, not just for CLL but for cancer patients in general.  If you get—the Internet can be great, but it could also be very dangerous.  You get online, and there [are] all those cancer diets, right, so sugar is bad, this is bad, this is bad, this is bad.  We have very limited data about particular things with either CLL specifically or even other cancers. 

The closest thing we have obviously from a real clinical trial in CLL was a study done by my colleagues at the Mayo regarding green tea.  There was a study that looked at very high doses of green tea extract.  You guys cannot get that in your little stores locally, but there showed some softening of people's lymph nodes, a slight reduction in lymphocyte counts, so I tell people if they feel they want to do something and they want to take some green tea, I think that's fine. 

Nothing—I think the problem is nothing excessive.  We don't know, I think we flip from one side of the spectrum to the other.  You know, we'll read something, take some herb that we hear might be good for cancer, and then remember everything you process, whether it's over the counter or a prescription has to go through your organs, so your kidney and your liver.  So if you take high doses of something, you might have adverse consequences on those organs, and we need them to function. 

So I always tell people moderation in anything you do.  I don't mind people—I actually have no problem with people doing supplements, particularly when they're not on chemotherapy.  Chemotherapy is a different issue. But if they're in this watch and worry stage or watch and wait stage and they want to do something, I always encourage them, just tell me what you're on so we can just know.  I don't want you to do anything in extreme.  And I'm always checking when they come in.  I actually do send their kidney and liver function anyway in addition to their blood counts, so I'm kind of keeping an eye on if there's something going up. 

But it's important to share with your physician what other supplements you may be doing and to get a feel if your doctor is okay with that, because you just—you know, it's not something you have to hide anymore.  We realize that there are alternative medicines.  There are medicines that, you know, cancer therapies come from plants and we're all trying to learn this together, so it's not that doctors—you know, they used to have this perception that most Western doctors don't want to hear about alternative therapies.  I think that's changing, and so you really should be discussing what you might be taking, what you might be buying with your physician, because it may have interactions with other medications you're on. 

So from that perspective, as I said, green tea is probably the only thing we know something about with regards to CLL.  If you want to do other things, talk to your doctor about that.  There's things about turmeric and a whole bunch of other stuff.  So just talk to your physician about that.  I say moderation in diet and exercise combined.  If you're taking care of the rest of your body, that will probably help your CLL.  

So when people are in the watch and wait stage or, you know, we patients often call it watch and worry, any dietary suggestions or restrictions? 

Dr. Lamanna:

Yeah.  Fair enough.  I think the issue around diet is a very common one, not just for CLL but for cancer patients in general.  If you get—the Internet can be great, but it could also be very dangerous.  You get online, and there [are] all those cancer diets, right, so sugar is bad, this is bad, this is bad, this is bad.  We have very limited data about particular things with either CLL specifically or even other cancers. 

The closest thing we have obviously from a real clinical trial in CLL was a study done by my colleagues at the Mayo regarding green tea.  There was a study that looked at very high doses of green tea extract.  You guys cannot get that in your little stores locally, but there showed some softening of people's lymph nodes, a slight reduction in lymphocyte counts, so I tell people if they feel they want to do something and they want to take some green tea, I think that's fine. 

Nothing—I think the problem is nothing excessive.  We don't know, I think we flip from one side of the spectrum to the other.  You know, we'll read something, take some herb that we hear might be good for cancer, and then remember everything you process, whether it's over the counter or a prescription has to go through your organs, so your kidney and your liver.  So if you take high doses of something, you might have adverse consequences on those organs, and we need them to function.  

So I always tell people moderation in anything you do.  I don't mind people—I actually have no problem with people doing supplements, particularly when they're not on chemotherapy.  Chemotherapy is a different issue. But if they're in this watch and worry stage or watch and wait stage and they want to do something, I always encourage them, just tell me what you're on so we can just know.  I don't want you to do anything in extreme.  And I'm always checking when they come in.  I actually do send their kidney and liver function anyway in addition to their blood counts, so I'm kind of keeping an eye on if there's something going up. 

But it's important to share with your physician what other supplements you may be doing and to get a feel if your doctor is okay with that, because you just—you know, it's not something you have to hide anymore.  We realize that there are alternative medicines.  There are medicines that, you know, cancer therapies come from plants and we're all trying to learn this together, so it's not that doctors—you know, they used to have this perception that most Western doctors don't want to hear about alternative therapies.  I think that's changing, and so you really should be discussing what you might be taking, what you might be buying with your physician, because it may have interactions with other medications you're on. 

So from that perspective, as I said, green tea is probably the only thing we know something about with regards to CLL.  If you want to do other things, talk to your doctor about that.  There's things about turmeric and a whole bunch of other stuff.  So just talk to your physician about that.  I say moderation in diet and exercise combined.  If you're taking care of the rest of your body, that will probably help your CLL.  

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

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Page last updated on June 28, 2019