1. NUTRITION &
BREAST CANCER
AOIFE GORHAM
SENIOR DIETITIAN
29th Sept 2012

2. Nutrition Is Good Medicine
 While a healthy diet can help prevent
cancer, if you are loosing weight because
of your cancer or treatment, the diet you
should be following may be very different
to usual healthy eating advice.
 Speak with your dietitian/doctor if your
loosing weight.

3. Causes of Poor Nutrition Pre &
Post Treatment.
- Sore or dry mouth
- Disturbances of taste & smell
- Changes in odour perception
- Mood

4. Sore Mouth or Throat
 Side effect of treatment.
 Usually starts to improve some time after your
treatment finishes.
 It may be difficult to eat your usual foods.
 Discuss with your doctor / nurse about mouth
care and pre-meal pain control.
 Eat little & often
 Choose soft moist foods.

5. Sore Mouth or Throat
 Chop, mince, mash or liquidise your foods
 Drink plenty of nourishing drinks.
 Take care with the following foods and drinks- as
the may worsen a sore mouth or throat.
- Very hot food and drinks, allow to cool a little
before you eat/drink them.
- Salty or spicy foods e.g. packet or tinned soup,
curry, chilli and vinegar

6. Sore Mouth or Throat
 Rough or dry foods e.g. toast, crisps, raw
vegetables or biscuits
 Acidic fruit drinks such as orange,
pineapple or tomato juice.
 Alcohol, especially spirits e.g. whiskey,
brandy, vodka.

7. Dry Mouth
 Your medication or treatment may reduce
the flow of saliva.
 Can cause taste disturbances.
 Saliva is needed to keep your mouth moist
and protect against tooth decay.
 You may be recommended an artificial
saliva spray /gel if you suffer with a dry
mouth.

8. Dry Mouth
 Helpful Hints:
1) Drink often
2) Fizzy drinks may make your mouth feel
fresher.
3) Try sucking on ice cubes or ice pops
4) Sugar free gum, boiled sweets or
pastilles may help saliva flow.

9. Dry Mouth
5) Eat soft, moist foods.
6) Avoid chocolate, pastry and freshly baked
bread .
7) Use lip balm on dry lips

10. Taste Changes
4 basic tastes: sweetness, bitterness,
saltiness, and umani (the savouriness of
protein).
 Taste changes depend on tumour site.
 Head and neck cancer patients report
more complaints of taste acuity.
 88.8% for one taste; 66.7% for more than
one taste compared with breast 21% or
lung cancer 23-25%.

11. Taste Changes
 Taste sensitivity decreases in most cases
after chemo/ RT due to destructive effects
on sensory organs & tissues associated
with taste and smell.
 Common taste changes are metallic or
bitter taste or after taste.

12. If food tastes metallic:
 Eat your food cold or at room temperature.
 Chicken and fish tend to taste less metallic than
red meat.
 Marinate (soak) meat or chicken and fish in red
wine, soya sauce, sweet fruit juices or lemon
juice to help mask the metallic taste
 Use plastic cutlery.

13. If food tastes too sweet
 Add a pinch of salt to reduce the sweet
taste.
 Add salt to custard and milk puddings.
 Eatsavoury snacks instead of sweet ones.
Try crisps, crackers, cheese or nuts.

14. If foods taste too salty
 Don’t eat salty foods.
 Add a pinch of sugar to your food to
reduce the salty taste. You can add sugar
to soups, sauces, stews or gravy.
 Snack on sweet foods instead of savoury
ones, such as cakes, chocolate, sweets or
biscuits.

15. If foods taste bland or you have no
taste
 Add flavour to your food with sauces such as
mustard, ketchup, mint, soy sauce, barbecue
sauce or curry sauce.
 Use seasonings and herbs to flavour your food,
such as salt or pepper, fresh herbs or spices,
garlic or lemon.
 Use more seasoning than you would normally.
 Try sour foods such as lemon juice, fruit or fruit
juices, sour boiled sweets, sour cream or sweet
and sour sauce, to stimulate your taste buds.

16. General tips
 Eat foods that taste good to you.
 Experiment with different flavours.
 Take good care of your mouth – brush
your teeth and tongue with a soft
toothbrush and use mouthwash.

17. General Tips
 Don’t stick to a small number of foods, try new
ones. Food you didn’t like before may taste
better now.
 Re-try foods every 2-3 weeks as the taste may
have returned to normal.
 Tea and coffee may taste very different so try
other drinks such as fruit teas, cocoa, Ovaltine,
Horlicks or Complan.
 Suck on pineapple chunks before meals.

18. Nausea & Vomiting
 Can be a side effect to treatment or due to
the cancer itself.
 Speak with your doctor about an anti-
sickness tablet.
 Eat
little and often (6-8 small meals per
day) rather than 3 main meals per day.
 Avoid
fried, spicy or very sugary foods as
may make nausea worse.

19. Nausea & Vomiting
 Choose foods that don’t have a strong
smell.
 Fresh air.
 Don’t lie down for up to an hour after
eating but if you need to rest, ensure head
is elevated about 2 x pillows high.
 Constipation can make nausea worse.

20. Nausea & Vomiting
 Avoid dehydration, aim 8-10 glasses of
fluid daily.
 Drink a glass of fluid each time you vomit.
 Rinse you mouth before eating.
 Fizzy
drink may help relieve nausea e.g.
lemonade, ginger ale or soda water
sipped slowly through a straw.

21. Diarrhoea
 Can be caused by your treatment or
medication or an infection.
 Drink plenty of fluids
 Eat little and often e.g. snack on cereal
Rice Krispies or cornflakes, toast, rice
pudding, custards, yoghurts, cheese and
crackers.
 Avoid fizzy drinks, chewing gum, beans,
peas, cabbage.

22. Diarrhoea
 Avoid
foods that contain sorbitol (artificial
sweetener
 Probitotics – eat 1-2 Bio or live yoghurts
drinks as part of your diet unless your
white blood count is low. Ask you doctor or
dietitian if you are unsure.

23. Constipation
 You illness, chemotherapy or medication can
make you constipated.
 You may need to get you doctor to prescribe you
a laxative.
 Eat regular meals
 Include a high fibre at each meal
 Drink plenty of fluids

24. Constipation
 Ifyou have been very constipated you
may get watery stools passing through the
solid stool. This is called ‘overflow’
diarrhoea. If you develop diarrhoea after
being constipated talk to your doctor or
nurse.

25. Fatigue
 Ask family or friend to help with shopping/
cooking
 Cook extra portions of food and freeze or
use ready meals for time when you are too
tired to cook .
 Have a nutritional drink when you don’t
feel like cooking
 Eat small portions but more often as you
may need to rest after a meal.

26. Fatigue
 Try exercising when you can. Research shows
exercise may actually help you feel less tired.
 Have a bed time snack e.g. hot milk
 Avoid drinks that contain caffeine and chocolate
a few hours before bed.
 Don’t drink alcohol near bed time as it tends to
cause a broken sleep pattern.

27. Nutritional Supplements
 A Nutritional supplement is a drink packed with
energy, protein, vitamins and minerals to help
and you meet your nutritional requirements with
diet.
 Specific supplements can be used as a sole
source of nutrition if you are not tolerating diet.
 Nutritional supplement are best taken as a
snack in between your meals as they are not
intended to replace your meals but to act as a

28. Nutritional Supplements
 Can be consumed warm or chilled.
 Range of flavours available
 They have to be consume within 24 hours
once opened and follow storage
instructions.
 Can be store in a cool, dry place away
from radiators and direct sunlight.

29. Nutritional Supplements
 Your dietitian/ doctor will advise you if you
need to commence them and for how
long.
 Nutritionalsupplements are available on
prescription and are dispensed by a
pharmacy.
 Cover under the medical card / Long Term
Illness / Drug Payment Scheme.

30. Nutrition is Good Medicine
 It is important for those with cancer or who have
had cancer to take care of themselves. Taking
care of yourself includes:
 Being a healthy weight
 Being Physical Activity
 Following the Healthy Eating Guidelines/ Food
Pyramid ( if weight stable)
 Being aware of complimentary/ alternative diets
and Supplements

31. Facts About being a Healthy
Weight.
 Being overweight can lead to heart
disease, type 2 diabetes and some
cancers.
 Its a good idea to weight yourself once per
month and to measure your waist every
few weeks.

32. Facts About being a Healthy
Weight.
Waist Measurement should be:
 Less than 80 cm or 32 inches in women
 Less than 94 cm or 37 inches in men.
 49% of Irish men and 70% of Irish women
exceed the above waist measurements.

33. Weight & BMI
 Body Mass Index (BMI):
Weight (kg)
Height (m2)
Normal BMI = 18.5 -25 kg/m2
Underweight = <18.5 kg/m2
Overweight = >25 kg/m2
Obese = >30 kg/m2

34. Weight & BMI

35. Old Food Pyramid

36. New Food Pyramid
Maximum 1
Choose any 2
Choose any 2
Choose any 3
Choose any 5 +
Choose any 6 +

37. Healthy Eating Guidelines
 Enjoy your food
 Eat a variety of different foods
 Eat the right amount to be a healthy weight
 Eat plenty of foods rich in starch & fibre
 Eat 5 or more portions of fruit and vegetables
per day

38. Healthy Eating Guidelines
 Reduce intake of high fat foods
 Don’t eat more than 500g (18oq) of red meat
(cooked) a week. A standard portion is 60g
(2oz) cooked meat. Choose leaner cuts of
meat.
 Reduce intake of salt and salty foods
 Reduce intake of sugar and sugary drinks
 If you drink alcohol, drink sensibly

39. Healthy Eating Guidelines
 Youdo not need a vitamin/ mineral
supplement if you have a balance diet.
Only take one if you doctor/ dietitian
advises you to.
 Be physically active.

40. Breads, Cereals & potatoes
 Choose any 6 or more servings each day if you
are active.
 Provide energy.
 Choose wholemeal / wholegrain versions
where possible.

41. WHAT IS A Serving??
Pitta Pocket/ 1x tortilla 2 Serving
wrap/ small bagel/ small
scone/ small French roll
4 dessertspoons of a 1 Serving
High fibre cereal without
sugar/ honey/chocolate
coating e.g. Bran flakes
1 x slice of Brown sliced 1 Serving
Bread or wholegrain soda
bread
3 dessertspoons of 1 Serving
Dry Porridge oats
2-3 Crackers or 1 Serving
crispbreads

42. WHAT IS A Serving??
2 x Breakfast Cereal 1 Serving
Wheat or oat Biscuits
1 x medium or 2 x small 1 Serving
potatoes
2 x Dessertspoons mash 1 Serving
potato
3 x dessertspoons or ½ 1 serving
cup boiled
pasta/rice/noodles (25g
uncooked)
3 x dessertspoons of 1 serving
Muesli without honey
coating

43. Breads, Cereals & potatoes (6)
 Evidence is mounting that eating
wholegrain regularly as part of a healthy
diet and lifestyle may help to reduce the
risk of many common diseases e.g. heart
disease, Type 2 diabetes and some forms
of cancer.
 Wholegrain may also help in maintaining a
healthy body weight over time.

44. How can I increase my intake of
wholegrain?
 When choosing foods from the starchy
group replace refined cereal foods with
wholegrain varieties. Wheat ,oats, rye,
rice and oats are the most commonly
available cereals in the wholegrain form.
 Look for the word “whole” before the name
of the cereal e.g. whole wheat pasta.
 Aim to have at least half your servings per
day as wholegrain.

45. Fruit & Vegetables (5)
 Eating more fruit and vegetables could
significantly reduce the risk of many chronic
diseases, including, high blood pressure,
cardiovascular diseases and some cancers.
 Good source of vitamins, minerals, fibre and are
low in calories.
 Including more fruit and vegetables reduces the
overall calorie density, which helps us maintain a
healthier weight.

46. Fruit & Vegetables
 Plant foods are an important of antioxidants,
nutrients vitamin A, C, E, B carotene, Trace
minerals as Selenium and zinc.
 These are proposed to have a protective against
the initiation phase of breast cancer.
 Principle source of fibre which is thought to
reduce circulating estrogen concentration in
blood.

47. Fruit & Vegetables (5)
 Fresh, frozen, canned, juiced or dried
fruits and vegetables all count in the diet.
 Potatoes are a carbohydrate and are
therefore included in the bread and
cereals food group.
 You should aim to eat a minimum of five
portions of a variety of fruit and vegetables
each day.

48. Quick guide to fruit and vegetable
portions
Fruit Portion
Medium sized fruit e.g. apple 1
,banana, pear
Small sized fruit e.g. plum, 2
Satsuma, kiwi
Large fruit e.g. grapefruit Half
Dried fruit e.g. raisins, currants, 1 tbsp.
sultanas, mixed fruit

49. Quick guide to fruit and
vegetable portions
Berries, grapes or 10-12
cherries
Cooked fresh fruit, fruit 4 x dessertspoons
tinned in own juice or
frozen fruit.
Unsweetened fruit juice 100ml ( small glass)
or a smoothie made only
from fruit or vegetables

50. Quick guide to fruit and vegetable
portions
Vegetables Portion
Broccoli spears 2
Cauliflower Florets 8
Cabbage, spinach, green beans 4 heaped
tbsp.
Cooked vegetables e.g. steamed, 4
boiled, microwave dessertspoon
s
Canned & frozen vegetables is 4
roughly the same as a fresh portion dessertspoon
s

51. Quick guide to fruit and vegetable
portions
Vegetables Portion
Bowl of salad 1
Bowl homemade vegetable 1
soup
Pulses and beans e.g. kidney, 3 heaped tbsp.
butter beans, chick peas.
Remember these only count as
one of your five a day portions!

52. Milk & Dairy Foods
 Choose any 3 servings each day.
 Importantsource of protein and calcium
which are essential for healthy bones and
teeth.

53. Milk & Dairy Foods
 One Portion is:-
Milk 200ml (1/3 Pint)
Low fat soft cheese 50g (2oz)
Yoghurt 1 pot (125ml)
Cottage cheese 75g (3 oz)
Hard Cheese (edam/ 25g (1oz)
Cheddar)

54. Milk & Dairy Foods
One Portion is:-
Yoghurt drink 200ml
Low fat soft cheese 50g
Cheese Triangles 2 portions

55. Meat, Poultry, Fish, Eggs, Beans,
Peas, Lentils
 Choose any 2 servings per day.
 These foods provide protein, which is essential
for cell growth, repair and immunity.
 They are also important sources of minerals
such as Iron.

56. Meat, Poultry, Fish, Eggs,
Beans, Peas, Lentils
 Don’t eat more than 500g (18oz) of red
meat (cooked) a week.

57. Meat, Poultry, Fish, Eggs, Beans,
Peas, Lentils
 One Portion is:-
Cooked Lean meat/ 50-75g
Poultry
Cooked oily fish or 100g
white fish.
Eggs 2
Cooked beans/peas 6 dessertspoons.
Unsalted Nuts 40g

58. Meat, Poultry, Fish, Eggs,
Beans, Peas, Lentils
One Portion is:
Soya or tofu 100g
Hummus 125g

59. Reduced Fat Spreads & Oils
Choose any 2 servings per day.
Provide essential fats but these are only
needed in small amounts.
Choose low fat and reduced fat spreads and
oils e.g. Rapeseed or olive oil
(monounsaturated) instead of hard margarine,
oil or butter.

60. Reduced Fat Spreads & Oils
 One Portion is:
Low fat 1 heaped tsp.
spread/reduced fat (should cover 2 x
spread slices of bread)
Full fat spreads Less than 1 heaped
tsp.
(should cover 3 x
slices of bread)

61. Foods & Drinks high in Fat,
Sugar & Salt.
 There are no recommendations for this
group because they are no essential.
 Limit what you eat from to no more than 1
serving per day and ideally not everyday.

62. Reduce Intake of High Fat Foods
 While all types of fats are high in calories,
some fats can also raise cholesterol
levels. The main problematic fat is
saturated fat, found in fatty meat, dairy
foods, cakes and pastries and palm oil.
 Some easy ways of reducing your intake
of this unhealthy fat include:
 Change to reduced-fat dairy products e.g.
semi-skimmed milk

63. Reduce intake of high fat foods
 Use soft spreads made from vegetable
oil, such as rapeseed or olive oil, rather
than choosing butter and use sparingly.
 Trim the visible fat from meat and the skin
from chicken
 Limit your intake of fried fast food, meat
products such as sausages, pies and
streaky bacon
 Go for snacks which are low in saturated
fat such as fruits, breads, nuts, seeds, low
fat yoghurt, vegetables and cereals.

64. Reduce intake of high fat foods
 EPIC Norfolk Cohort (13,000 Females) showed
the women who ate more than 45g saturated fat
per day were twice as likely to get breast cancer
than those who ate less than 12g saturated fat
per day.
 Monounsaturated fats and omega 3
polyunsaturated fats appear to be protective
while saturated fats, trans fats and omega 6
polyunsaturated fats seemingly increase risk.

65. Omega – 3 fatty acids
 Main source is oily fish/ seafood.
 Tuna (Fresh)
 Salmon
 Herring
 Pilchards
 Mackerel
 Trout (rainbow)
 Shrimp
 crab

66. Omega – 3 fatty acids
 Benefits of eating oily fish:
1. Lower risk of heart and blood vessel
disease.
2. Maintenance of healthy joints.
 To get the most benefit adults are advised
to eat 2 portions of fish per week ( 140g),
one of which should be oily.

67. Stanols & Sterols
 Occur naturally in foods such as
vegetables, nuts seeds, cereals, legumes,
olive & peanut oils.
 Estimated we consume 150-400mg per
day of naturally occurring stanols and
sterols, but an average dietary intake at
this level has little effect on cholesterol
levels.

68. Stanols & Sterols
 They work by reducing cholesterol
absorption from the gut.
 Both have similar effect on cholesterol
 A healthy diet, regular exercise in
combination with plant stanols and sterols
can help reduce total cholesterol and LDL
cholesterol (bad cholesterol) by 10-20%
 Recommend a intake of 2 – 3g per day for
those with raised cholesterol.

69. Stanols & sterols
Product Package size Varieties
Benecol Yoghurt 70g Plain, light, strawberry
Drink
Flora Pro-activ 100g Original, strawberry,
probiotic yoghurt orange
drink
Danone Danacol
100g (1.6g sterols per Original, strawberry
yoghurt Drink
bottle)

70. Salt
 Eating too much salt can increase your risk of
developing high blood pressure.
 The average salt intake is currently 9.5g a day,
we should be having much less than this.
 The recommended salt intake is 6g per day
about 1 tsp.
 75-80% of salt we eat is already added to the
food we buy.
 Reducing your intake of salty processed foods is
an important part of a healthy diet.

71. Salt
 Use herbs and spices in cooking instead
of salt.
 Try not to add extra salt at the table.
 Cut right down on salty processed foods
and ready meals.
 Check out food labels for salt content and
choose lower salt options.

72. Salt
 Use herbs and spices in cooking instead
of salt.
 Try not to add extra salt at the table.
 Cut right down on salty processed foods
and ready meals.
 Check out food labels for salt content and
choose lower salt options.

73. FOOD LABELS
Ingredient listing
 A lists of the product’s ingredients is
required by law.
 This listing tells you what was used to
make the product.
 The ingredients are listed in descending
order, so the ingredient that was used in
the greatest amount will appear first on
the list, all the way through to the last
ingredient which was used least in the
product.

74. Foods Labels
Nutrition labels
 Nutritional labelling is any information
appearing on food labels relating to the amount
of calories (energy) and nutrients contained in
the product.
 Nutrition labels can help you make healthy food
choices as you can compare the nutrition
information on similar products.
 Guideline Daily Amount is nutrition information
that is presented on the front of pack.

75. Some tips for reading Food Labels
 Sugar can be listed as: sucrose, maltose,
honey, palm sugar, hydrolysed starch,
syrup and invert sugar.
 Reduced fat products likely to still be high
in fat.
 Salt may be listed as sodium, to convert
sodium into salt just multiply by 2.5.

76. A Guide to Food Labels
A Lot per 100g A Little per 100g
15g of total sugars 5g or less of total sugars
20g of fat 3g of fat
5g of saturated fat 1.5g or less of saturated fat
3g of fibre 0.5 of fibre
1.5g of salt 0.3g of salt
0.6g of sodium 0.1g of sodium

77. Old Alcohol Guidelines
RECOMMENDATIONS:
 WOMEN 1 UNITS PER DAY
 MEN 2 UNITS PER DAY
 ALSO HAVE A FEW ALCOHOL FREE
DAYS IN A WEEK
 CONSULT WITH YOUR DOCTOR IF IT
IS SAFE FOR YOU TO DRINK ALSOHOL
DURING YOU TREATMENT.

78. NEW ALCOHOL GUIDELNES
For low risk drinking the weekly limits are:
 Up to 11 standard drinks per week for
women.
 Up to 17 standard drinks per week for
men.
 Do not take more than 5 standard drinks
in one sitting.
 Have 3 alcohol free days during the week.

79. Unit Guide
100ml Glass of wine 1 unit
35ml Spirit 1 ½ units
½ pint 1 unit

80. Complementary, Alternative Diets &
Supplements
 Have become very popular, with information
available on the internet, in books, through the
media.
 There is no scientific evidence to support any of
these diets cure or prevent cancer recurring.
 In some cases they are harmful.
 Always discuss with your doctor/ dietitian

81. What are Complementary &
Alternative Diets
 A complementary diet is one you follow
while you have medical treatment.
 An alternative diet is instead of the
recommended medical treatment.
 Health professional do not recommend
any of these diets.

82. Complementary & Alternative Diets May leave out
one or more of the following:-
 Dairy foods e.g. milk, yoghurts, cheese.
 Main source of calcium.
 Calcium is needed for healthy bones and to
prevent osteoporosis.
 Very important in women after menopause.
 If you diet is not rich in calcium you may need a
calcium supplement.

83. Red meat, Poultry, eggs
 Good source of protein. Protein repairs your
body, particularly after cancer treatment.
 Iron is important for healthy blood cells.
 Red meat is the best dietary source of iron.
 If your diet is not rich in iron you may need a
supplement.

84. sugar
 No evidence to support sugar “feeds a
tumour”.
 Sugar is present in many foods and gives
you energy.

85. Bristol diet
 Basically dairy free
 Also avoid red meat, salt & sugar.
 Eat lots of fruit and vegetables.

86. Gerson Diet
 Avoid nearly all animal products and all
fats and oils except flaxseed oil.
 All foods to be fresh and organic.
 No processed, preserved, canned, bottled,
boxed or frozen foods.
 No salt allowed.
 Avoid sources of toxicity e.g. tobacco.
Alcohol, fluoride, pesticides, food chemical
and all medicines.

87. Macrobiotic Diet
 Completely vegan ( no dairy products of
meat allowed)
 Promotes organic whole grains e.g. brown
rice, oats & buckwheat, organic fruit &
veg, soups made with vegetables,
seaweed, beans, chickpeas lentils and
fermented soy.
 Allowed small helpings of nuts, seeds &
pickled vegetables.

88. Macrobiotic Diet
 Only eat when hungry and chew food for a long-
time until it become liquid in your mouth.
 Drink only when thirsty & only allowed water or
non-flavoured decaffeinated tea.
 Food is prepared and cooked in a certain way.
Avoiding microwaves or cooking with electricity.
 No vitamin/mineral supplements allowed.
 No processed foods with artificial colours,
flavours, preservatives.

89. Soy
 Evidence: Research in the role of soy/soy
foods in breast cancer is inconsistent
 For breast cancer survivors, the evidence
suggests neither benefits nor harmful
effects when soy is eaten in moderate
amounts as part of a healthy diet
 Moderate amount = approx 25g/day (4g in
soy yoghurt, 7g in 200ml glass of soy milk,
10g in 200g/7oz portion tofu)

90. Soy
 Safety:
Higher doses of soy may have an
oestrogen-like effect and higher levels of
oestrogens increase the risk of
progression of post-menopausal and
oestrogen-receptor positive breast cancer
 Breastcancer survivors should avoid the
high concentrations of soy found in soy
powders/supplements - AICR

91. Soy
 Safety: Soy can interact with thyroid
hormone medications – do not take
thyroid medications within 2-3 hours of
eating soy
 No conclusive evidence to show that soy
interacts with tamoxifen
 Other Benefits: No conclusive evidence
that soy can help reduce hot flushes (NCI)

92. Vegetarian Diets
 Evidence: No evidence to show that
vegetarian diets prevent or reduce risk of
recurrence of breast cancer
 Safety: Safe to consume vegetarian diet
that provides all food groups and essential
nutrients
 Other Benefits: Elements of vegetarian
diet protective against heart disease e.g.
low in animal fat, high in fruit & vegetables

93. Dairy Foods
 Evidence: Research does NOT support a
link between consumption of dairy foods
and increased risk of breast cancer.
 Animal studies have shown that dairy
foods may have a protective effect against
breast cancer – human studies needed.

94. Dairy Foods
 Safety:Safe to consume as part of a
healthy balanced diet.
 OtherBenefits: important for maintaining
bone health / prevention of osteoporosis.

95. Green Tea
 Evidence: No evidence to show that green tea
reduces risk of recurrence of breast cancer -
results from human studies are not consistent
 Safety: Safe non – toxic drink **
3 – 10 cups per day
Contains caffeine
 Other Benefits: may offer protection against
some bacterial infections
**Very high amounts of green tea components (usually
associated with over dosage of green tea supplements)
have been shown interact with drugs that affect blood
clotting such as aspirin.

96. Antioxidants
 Vitamins A, C and E
 Sources – fruit and vegetables
 Evidence: High intakes of supplements not
advisable as research is conflicting regarding
role in cancer
 Safety: Not recommended to take > 100% of
RDA
 Anti-oxidants from fruit & vegetables not harmful
 Other Benefits: protect against heart disease

97. Echinacea
 Evidence: No evidence to show that Echinacea reduces
risk of recurrence of breast cancer
 Safety: Safe to use continuously for < 3 weeks
 Should not be taken by:
- diabetics
- individuals with impaired liver
function or autoimmune diseases e.g. TB, MS,
rheumatoid arthritis
- if taking immunosuppressant
medications
 Should not be taken by those with cancer of immune
system e.g. leukaemia, lymphoma
 Other Benefits: Stimulates immune system

98. Aloe vera
 Evidence: No evidence to show that aloe vera
reduces risk of recurrence of breast cancer
 Safety: Should not be taken orally as oral aloe
vera intake is known to slow down or reduce
absorption of nutrients and drugs
 Other Benefits: Topical application is beneficial
in treating radiation dermatitis, post-surgical
scars, cuts, burns, sunburn
 Check with your radiation therapist / breast care
nurse before using

99. Ginseng
 Evidence: no conclusive evidence at present to
show that ginseng reduces risk of recurrence of
breast cancer
 Safety: Should not be taken by individuals with
high blood pressure, anxiety disorder and in
those taking oestrogen or steroids
 Other Benefits: may boost immune function
and aid treatment of fatigue, weak evidence that
ginseng may reduce hot flushes

100. Co-enzyme Q10
 Evidence: No evidence to show that it
reduces risk of recurrence of breast
cancer
 Safety: may make some chemotherapy
drugs/ radiotherapy less effective
 Should not be taken if taking anti-
coagulants e.g. Warfarin
 Other Benefits: may be beneficial in heart
disease/ heart failure

101. Supplements and Tamoxifen
 The
following supplements interact with
Tamoxifen :
- St John’s Wort
- Black Cohosh
- Dong Quai
If considering taking the above
supplements, please consult your
doctor first

102. Diet, Supplements and Menopause
 Ensure adequate calcium intake
 Follow low-fat diet to reduce risk of heart
disease
 Physical activity may reduce hot flushes
 Evening primrose oil not recommended for hot
flushes
 Dong Quai – little evidence to support it’s safety
 Black Cohosh not recommended as may
damage liver

103. Organic Foods
 Tend to be more expensive.
 Have same nutrients as non- organic food.
There is no harm choosing organic but
has no known benefits.

104. Vitamins, Minerals & other
supplements
 If your diet is not healthy and varied you may
need a multivitamin/mineral supplement.
 Multivitamin/mineral supplement, should not
contain more than 100% RDA for vitamins &
minerals.
 Mega dosing on multivitamin/mineral
supplements can have harmful side effects.
 Always discuss with your dietitian / doctor before
taking a c0-enzyme/ herbal supplement as it can
interfere with your treatment.

105. AICR Guidelines
1. Choose a variety of fruit and vegetables
2. Limit intake of red meat to less than 3oz/day
3. Decrease the amount of fatty food in especially those
from animal and decrease total fat intake
4. Eat less salty foods and less salt in cooking, use herbs
and spices instead
5. Limit alcohol to less than 2 drinks a day for men and one
for women
6. Do not eat charred meat often, nor cured and smoked
meats
7. Avoid being overweight
8. Take 1 hour brisk walk or similar daily

106. Myth or Fact
1) Organic foods are better for you.

107. Myth or Fact
1) FALSE. Nearly all foods can be healthy
once you eat them as part of a balance
diet.
2) Processed foods are less nutritious and
not as good as fresh foods.

108. Myth or Fact
.– FALSE. As part of a balance diet
processed foods can be healthy.
Processed foods may keep most of their
goodness.
 3)
Large doses of vitamins can prevent or
cure many diseases.

109. Myth or Fact
– FALSE. There is no scientific evidence for
this and large doses may be dangerous.
4) Sugar feeds cancer and you should avoid
it .

110. Myth or Fact
 FALSE. Sugar if found in may foods and
gives the body energy as part of a balance
diet.

111. Useful Websites
 National Cancer Institute:
www.cancer.gov
 American Institute of Cancer
Research
www.aicr.org
 Macmillan Cancerline (UK)
www.macmillan.org.uk

112. Useful Websites
 Irish
Nutrition and Dietetic Institute
www.indi.ie
 Irish
Cancer Society
www.cancer.ie
 Irish
Hospice Foundation
www.hospice-foundation.ie