After a cancer diagnosis, the focus is understandably

on monitoring the spread and resurgence of the cancer,

but patients often also want to know what additional steps

they themselves can take to support their body's fight.

Previously, I addressed what to eat after a cancer diagnosis.

What about eating nothing at all?

Fasting is purported to “ameliorate” cancers,

but to support such claims, they cite studies like this

on castrated mice.

That's because there are no human studies of efficacy,

though there are a few case reports.

For example: “Water-only fasting and an exclusively plant foods diet

in the management of... follicular lymphoma.”

Traditional chemotherapy has been

the mainstay of treatment for follicular lymphoma.

But in the majority of patients, the cancer surges back

within a few years, and the chemo is associated with immediate

and enduring toxicities, including secondary malignancies,

meaning new cancers caused by the chemo drugs themselves,

raising the question of whether chemotherapy

should be abandoned for the disease.  

So anyway, a 42-year-old woman presented

to her primary care provider with a palpable mass

in her groin and was immediately sent for a CT scan.

Surgical biopsy confirmed the diagnosis

of a low-grade follicular lymphoma.

They then found involvement in the lymph nodes in her armpit,

which would make it stage 3, meaning spread throughout the body.

Because it didn't appear to be aggressive,

she was just advised to follow-up

every three months to monitor its spread.

But she didn't want to just sit around.

So, she contacted the TrueNorth Health Center in California

to explore medically supervised, water-only fasting.

She had never smoked tobacco, but she had consumed

the Standard American Diet; so they started her

on a whole food plant foods diet free

of added salt, oil, and sugar.

Then, she did 21 days on water only, before transitioning back to a diet

of minimally processed plant foods, including fresh, raw fruits

and vegetables, steamed and baked vegetables,

whole grains and legumes, and about an ounce a day

of nuts and seeds.

Okay, so what happened?

On physical exam, her cancerous lymph nodes seemed to be shrinking,

and indeed, on CT scan, her enlarged nodes shrunk

up to 90 percent and no longer seemed to be active.

Before and after.

What could it have been?

She did lose weight, about 20 pounds, but follicular lymphoma does not appear

to be associated with obesity,

nor does BMI appear to affect clinical outcomes.

It's possible the plant-based diet alone helped.

Follicular lymphoma is the second most common type

of non-Hodgkin lymphoma, which itself

is the most common type of blood cancer in adults.

Higher intakes of dietary fiber, whole grains, and several fruits

and vegetables are reported to reduce

the risk of non-Hodgkin lymphoma, whereas animal-derived proteins

and fat in meat and dairy may increase it.

A dietary pattern high in meats, fats, and sweets

was associated with three times the risk of follicular lymphoma,

or just the fat and meat was associated

with up to a fivefold higher risk. But why?

The thought that foods of animal origin may increase

the risk of blood cancers originated from the frequent finding

of an increased incidence among people who are occupationally exposed

to animals and meats, like livestock and poultry farmers, butchers,

and slaughterhouse workers.

It must be acknowledged that animal foods are a potential source

of infection by cancer-causing viruses.

But it may just be the animal protein.

Excessive consumption of animal protein

may encourage malignant changes through chronic persistent stimulation.

The thought is that the continuous exposure

to these foreign proteins may act like a chronic irritant.

The animal protein theory is bolstered by the fact

that straight protein— casein milk protein—

increases the number of lymphomas in rats,

but that doesn't mean the same applies to people.

Maybe it's the hormones and antibiotics contained in meat

or just the saturated fat, which may both impair

the immune system and promote chronic inflammation,

which may play a role in lymphoma?

Now, it appears to just be animal fat consumption;

so, maybe it's just something building up in the animal fat?

There may be a link between exposure to industrial pollutants

and non-Hodgkin lymphoma, and food— especially meat, milk, and fish—

is the immediate source of almost

all dioxins and PCBs in the general population.

Dioxin-like pollutants build up in animal fat,

which can then be passed along to consumers.

Vegetarians may only be exposed

to about 2 percent of the dioxin dose

compared to the general population.

The highest single levels in the U.S. have been found

in chicken, but thankfully the contamination levels

are declining in all meats across the board.

Furthermore, consumers may further reduce exposures

to dioxin-like compounds by trimming fat before and after cooking

and by thoroughly draining fat from cooked meat.

What about buying organic meat?

The title kind of gives it all away.

When it comes to carcinogenic contaminants,

the differences between organically and conventionally produced meats

were surprisingly minimal, exceeding the maximum limits

regardless of what kind of meat we buy.

Strikingly, not only does the consumption

of organically produced meat not diminish the carcinogenic risk,

but for some meat, it appeared even worse.

What can decrease your exposure to fat-soluble pesticides is fiber.

And then, our good gut flora can turn fiber into butyrate,

which is absorbed back into our body from the colon

and acts as a tumor suppressor, demonstrated in more than

one hundred published studies, including protecting against lymphoma.

It also has potent anti-inflammatory effects.

That may help explain why fruit and vegetable consumption

has not only been associated with decreased risk

of developing lymphoma, but also been linked to improved survival.

Maybe it's all the antioxidants in plant foods,

which appear protective when it comes to follicular lymphoma,

but not necessarily when in supplement form.

Vitamin C intake from foods, for example,

may be protective but not from supplements.

So, maybe the reason the risk of lymphomas and cancers

of the bone marrow tissues are significantly lower

in vegetarians and vegans is not just

because of what they're avoiding,

but all the goodies that they're getting more of.

The phytochemicals and antioxidants in fruits and vegetables

may inhibit tumor progression via a variety of mechanisms

beyond just the potential adverse effects of meat.

So, given the link between fruit and vegetable intake

and lymphoma survival, maybe a lymphoma diagnosis can be

an important 'teachable' moment to improve diet in patients.

That certainly seemed to be the case here.

At her six and nine-month follow-up, she reported strict compliance

with her whole food plant-based diet, and her lymph nodes

remained unpalpable.

Okay, but this was published in 2015.

How's she doing now? We'll find out next.