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Is there an evidence-based booklet on cancer and diet available for patients undergoing chemotherapy? Is there any evidence that sugar causes cancer? —Karen Klarkowski, RN, OCN

Most patients going through chemotherapy experience side effects such as nausea, vomiting, and changes in smell and taste. Food choices that appeal to them are usually limited, but it is necessary that they eat the proper food to boost their immune system to help fight off their cancer. Foods that are mild tasting and easy to eat are the most favorable. Here are a few examples.

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Citrus fruits are a good source of vitamin C and antioxidants, and help to alleviate the metallic taste that can occur after chemotherapy. If the patient develops canker sores in his or her mouth due to chemotherapy treatment, a banana would be a better choice. Fresh turkey and chicken are good sources of protein, which can help to maintain a patient’s strength during chemotherapy treatments. Whole grains, such as brown rice, whole wheat bread, and buckwheat, provide the body with B vitamins, selenium, vitamin E, and healthy carbohydrates for energy. Yogurt is soft on the palate and is beneficial for those patients who developed canker sores in their mouths due to chemotherapy treatment. Yogurt is also a good source of protein, calcium, B vitamins, and potassium.

Many websites offer diet information for patients with cancer. A few Web sites with dietary information for patients with cancer are LiveStrong, The Scott Hamilton CARES Initiative, and the American Cancer Society.

The connection between cancer and insulin is growing but is not yet conclusive. As we know, there are many reasons to limit excess sugar in our diets. Here’s another reason. Recent studies have shown that excess sugar consumption increases insulin secretion, and hyperinsulinemia has been shown to have a direct tumor-promoting effect.1 Hyperinsulinemia also increases insulin-like growth factor (IGF) which is correlated with an increased risk of breast cancer.2 Moderation is key here. A balanced diet with protein, fat, and fiber is recommended so that sugar is processed more slowly without overproducing insulin.3 —Maria Deutsch, MS, PharmD


1. DeCensi A, Gennari A. Insulin breast cancer connection: confirmatory data set the stage for better care. J Clin Oncol. 2011;29(1):7-10.

2. Chowdhury TA. Diabetes and cancer. QJM. 2010;103(12):905-915.

3. Sugar and cancer: is there a connection? Caring4cancer Web site. https://www.caring4cancer.com/go/cancer/nutrition/questions/sugar-and-cancer-is-there-a-connection.htm. Accessed January 22, 2013.