ASCO Part 2: How Diet Affects Cancer

I'm reporting again on the ASCO Conference. While the Scientific Program for the conference happened in June, the Education Program happened this past weekend. These sessions are more immediate, in a way -- the scientific stuff is fascinating, but not might not result in treatments for years (or maybe never). The Education Program has information for oncologists that can make them better doctors right away. It's all about information they can use to better understand and work with patients.

Of course, I'm not a doctor. But I can pass along some interesting information directly to you, skipping over the need to actually talk to your oncologist. (That's a joke, of course. You should always talk to your oncologist about stuff you read here. Doctors know more than I do. Seriously.)

So here's some stuff to talk to your doctor about.

The ASCO session called "Hungry for Data: The Evidence of Diet and Cancer in 2020" was supposed to feature three presentations, but one of them isn't showing up. It's the presentation on fasting and keto diets, which I'm sure many people would like to know more about. I'm hoping the presentation will be posted soon, though it's been four days now, so my hopes are diminishing. If I can access some time, I'll be sure to write about it.

Still, the other two presentations were very interesting.

The first was on diet and cancer prevention. My first reaction to this was, "I'm not going to bother with this one. It's a little late for cancer prevention at this point." But, really, the advice is very good for overall health, not just cancer prevention, and we could all use reminders about staying healthy. The presentation was given by Dr. Cynthia Thomson, and she focused on the the American Cancer Society's updated Guidance on Diet, Physical Activity, and Cancer Prevention.  The ACS last issued guidelines in 2012, and new research has changed them slightly. Here they are -- things you can do to help lower your cancer risk by about 18%:

• Keep your body weight at a healthy level
• Engage in physical activity (150-300 minutes of moderate activity each week, or 75-150 minutes of vigorous activity)
• Establish healthy eating patterns -- lots of fruit and vegetables and whole grains, with limited sugar and refined grains
• Do not drink alcohol
  

That "no alcohol" guideline is new -- it used to be no more than 1 drink per day for women and 2 for men. But new evidence suggests No Alcohol will better prevent cancer. I have to admit that I'm going to violate this one. I don't drink a lot, maybe one or two a week, but I enjoy Scotch too much to give it up completely. (Back me up on this, PopplePot.)

And I'm good about exercise. I've always gone to the gym at least a couple of times a week, though I've given that up for Covid reasons. But my wife and I have been walking 2 miles every morning since we've been stuck at home (thanks to William for the inspiration). 

Diet? I could do better. The only reason I don't drink more Scotch is that I like ice cream so much, and I at least have enough self control to chose one or the other every night.

But, really, even adding one more serving of fruit a day seems like a reasonable goal, doesn't it?

We may not have been able to prevent our Follicular Lymphoma, but we can do things to keep ourselves healthy while we have it, and we can encourage our loved ones to be healthy, too.

The second presentation was by Dr. Jennifer Wargon, and focused on the ways diet could affect the microbiome, especially during treatment. 

There has been a lot of research in the last few years on microbiomes, especially gut microbiomes. If you're not familiar with it, we have billions of bacteria living in our bodies. Some can hurt us, but lots can help us. When the good ones are killed off, our bodies get thrown out of balance (which is why some antibiotics can cause digestive problems -- good bacteria are killed off with the bad ones). We can do things that can keep our microbiome healthy (which is why some doctors tell you to take a probiotic when they prescribe you an antibiotic). One of those things can be to change your diet.

Now, I am deliberately not going to get into much detail about this presentation, because while I found it fascinating, the research is also in its early stages, and I don't want to give the impression that if you eat XXX, all of your problems will be solved. So here is the general outline of what the presentation said.

• There is some evidence that bacteria can play a role in cancer treatment. Some research found that certain bacteria were present in pancreatic cancer tumors. When antibiotics were given along with chemo, some patients had better outcomes. This suggests the bacteria in the tumor were making the chemo less effective.
• Other research found that a more diverse microbiome (having lots of different types of bacteria in the body) were related to longer survival among cancer patients. There is some suggestion that the microbiome could be a biomarker (in other words, if tests show there is a variety of bacteria in the body, that could be a sign that certain treatments might be more effective than others). 
• Microbiome composition could also be important. That is, specific types of bacteria might be helpful with certain treatments. A study with mice showed that this was true. More importantly, it was possible to change the microbiome to make the treatment more effective in the mice.
• The microbiome can be changed in several ways -- through fecal transplants, through probiotics (taking pills that add good bacteria to the body), and by prebiotics (eating foods that help create an environment in the body that helps god bacteria live). 
• None of these is as easy at it seems. Fecal transplants have had great results, but have also caused some deaths. Changes to diet require the patient to actually make those changes, but even then, our individual bodies are so different, it's hard to measure how much someone's diet has actually helped them.
  

It's early research, but fascinating research. And while we're still learning how, exactly, the microbiome has an effect on us as cancer patients (before, during, and after treatment), it's clear that the microbiome has an effect on our overall health.

Again, I'm not a doctor or a nutritionist, but it seems like some sensible diet guidelines could be helpful here, especially getting more fiber into our diets. How to do that? Well, look a few paragraphs above -- more fruits, more vegetables, more whole grains. 

The presentations in this session don't address Follicular Lymphoma specifically (I have no idea how the microbiome affects blood cancers, if at all). But there's no harm -- and possibly a lot of help -- in making some changes to our diets, if we haven't already done so. 

Stay healthy, everyone.