Asked by Mary, North Carolina
I have breast cancer and have been through surgery (lumpectomy). Most recently, I have had radiation. Now that it's over, I am wondering if I should take a vitamin, and if so, what would be a good vitamin for me?
Diet and Fitness Expert
Dr. Melina Jampolis
Physician Nutrition Specialist
Hi Mary. This is a terrific question and I think the role of diet -- which includes vitamins and supplements -- in breast cancer is important to address. In order to provide you the most up-to-date and practical information, I spoke with Dr. Donald Abrams, chief of Hematology and Oncology at San Francisco General Hospital and director of Integrative Oncology Research at the University of California San Francisco's Osher Center for Integrative Medicine. He works with people living with and beyond cancer on a regular basis. While he does not recommend treating cancer through diet and supplements, he believes in creating an environment in the body that is least conducive to cancer in the hopes of preventing cancer return, further cancer growth, or spread.
He believes, as do I, that nutrients are much better obtained from whole foods rather than vitamin and mineral supplements. He recommends following as much as possible an organic, plant-based, antioxidant rich, antiinflammatory diet with particular emphasis on cruciferous (broccoli, cabbage), orange-yellow and leafy green vegetables and heavily pigmented, deeply colored fruits. He also recommends deep cold water fish (salmon, black cod, albacore tuna, herring, mackerel and sardines) and organic poultry in place of red meat and high-fat processed meats and limiting or eliminating dairy, particularly non-organic, full fat dairy, since epidemiologic studies have found that populations consuming less animal fat including dairy have lower rates of breast cancer in most cases. Finally, he recommends limiting refined and processed foods and foods with refined sugar as much as possible as high glycemic index diets have been linked to higher levels of growth factors that may stimulate tumor growth.
In addition to a healthy diet, there are a few supplements that he does recommend, all of which are also important for optimal health. He notes a growing body of evidence linking vitamin D deficiency with breast cancer, and suggests taking 1,000-2,000 IU of vitamin D3 in gel cap form if possible or with a meal containing some fat. Bone strength is critical in women, particularly post-menopausal women or women taking anti-estrogenic cancer treatment, so he also recommends a taking a calcium and magnesium supplement (1,000-1,500mg of calcium divided into 2 doses and 500-750mg of magnesium). Omega 3 fatty acids (1,000 mg/day) play an important role in decreasing inflammation and may also help with depression, which may be associated with breast cancer diagnosis and treatment.
His final recommendation is vitamin C, a powerful antioxidant that may also help combat stress, at a dose of 250-500mg per day. If you had radiation to the left breast (near where you heart is), you may also consider taking CoEnzyme Q10 60-100mg in a soft gel capsule to protect your heart muscle after radiation. This may be particularly important if you are also taking a statin cholesterol-lowering medication. One thing Abrams does not recommend is a multivitamin, as he feels that it may lead to excess intake of some vitamins that may actually be harmful. A very large study of over 161,000 postmenopausal women participating in the Women's Health Initiative published in the Archives of Internal Medicine earlier this year echoed this sentiment, finding no decrease in cancer risk (or heart disease) in women taking multivitamins.
Finally, he stresses the importance of getting to and maintaining a healthy weight, especially in women with post-menopausal breast cancer which has been associated with obesity.
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