October 2007

With a diagnosis of Glioblastoma stage 4 brain cancer, Lydia Johnson’s recovery is dependent on a lot of things. She spent this summer completing radiation and chemotherapy. She’s incorporating exercise as much as she can. And, of course, she’s eating as healthy as possible to aid in her recovery.

"Actually, it hasn’t been that difficult," says the Oconomowoc resident. "I’ve always been a Weight Watcher’s person, and this isn’t that much different."

With the help of Dena McDowell, a clinical dietician specializing in oncology at Froedtert Hospital, Johnson has learned the importance of eating a wide variety of foods, particularly nonmeat sources of protein and fresh fruits and vegetables. "My friends have been bringing me meals twice a week, and virtually everyone is including salads and fresh fruit," she says. "I also have smoothies, too."

While no one food group is a super food, fruits and vegetables do earn a gold star from local nutritionists for both cancer patients and the general public. "A good diet is never about one particular food," says Barb Taggart, a dietician at Community Memorial Hospital in Menomonee Falls. "When you eliminate a particular food group, you also eliminate the important nutrients that food group offers."

And when you make a point to include fruit and vegetables, tables, and they don’t lend themselves so easily to isolation. "They’re still quite undefined," says Taggert. "People sometimes will ask: Can’t I just take a vitamin pill or a supplement? They don’t work that way."

A classic study involving smokers and beta-carotene supplements unfortunately bore this out. Beta-carotene was given to smokers in two clinical studies during the 1990s to reduce their risk of lung cancer. Unfortunately, ingesting the isolated substances had the opposite effect: Trial participants began to develop lung cancer at an extra high rate.

"The best way to get those phytochemicals is to eat the food the way nature intended it: Fresh out of the ground," adds Taggert.

But fresh doesn’t necessarily mean totally raw, caution the dieticians. While all of us can benefit from incorporating raw fruits and vegetables into our diet, subsisting on an all-raw food diet is not a good idea either. "The principles behind an all-raw food diet are not evidence based," cautions Taggert. "People get trapped into wanting to believe the exaggerated benefits."

While eating raw food as a primary component of a diet has been around in various forms for more than a century, raw foodism as a movement has gained momentum for about the past decade. Its acceptance has been fueled by the embrace of celebrities like Woody Harrelson and the culinary world’s experimentation with raw haute cuisine. "Essentially, this diet is raw veganism with no consumption of any animal products at all," says Margaret Allen, an oncology dietician at Columbia St. Mary’s. "The aim is to consume ‘living foods’ as quickly as possible."

While adherents claim that the diet does provide substantial improvements to their health, there are risks, and some of the claims amount to junk science, says Allen. "First of all, there’s a significant potential for B12 vitamin deficiencies because you don’t consume animal products," says Allen. "Some grains are also actually toxic when eaten raw."

Likewise, raw food adherents also do not heat their food above 118 degrees, a point that falls right in the noted danger zone for bacteria growth. "This is not the diet that anyone recovering from cancer should follow," says McDowell. "Depending on the type of cancer treatment a patient is following, he or she can be quite immune compromised, in which case it’s a good idea to avoid raw food all together to decrease the risk of food-borne illness."

Allen also notes that adherents focus on eating raw to consume plant enzymes. "Unfortunately, those enzymes are no match for your stomach acid, which literally inactivates the enzymes so you can absorb the nutrients from the food," she says. "And the claim that the enzymes become ‘reactivated’ in the small intestine don’t make any sense at all."

Likewise, research has shown that some important nutrients actually aren’t released until the fruit or vegetable has been cooked. "Lycopene is a perfect example of this," she says.

An antioxidant found in tomatoes, lycopene is thought to promote cancer reduction. "The longer you cook a tomato, the more lycopene is released," explains Allen. "It’s found in higher concentrations in tomato sauces and ketchup than in a raw tomato."

Even though her diagnosis was a surprise, Lydia Johnson says she hasn’t been tempted to try alternatives such as a raw food diet to aid in her recovery. She’s decided to take a more balanced approach, and one that includes the nutrients she needs from all the food groups.

"I have a tremendous amount of faith in the doctors at Froedtert, and my dietician, Dena," she says. "I know the importance of eating healthy right now, and I’m confident in my treatment. Perhaps if I find at some point that this isn’t working, then perhaps I’ll consider an alternative treatment. But for now, I don’t have fear and I’m just going to keep doing what I can to stay healthy and do the right thing for my body."

Clues of the heart Dr. Michael Earing, one of only two formally trained adult congenital heart disease specialists in Wisconsin, works to help patients understand their condition and encourages them to be proactive in their health care plans. Earing says that the number of people living with congenital heart defects has risen due to the increased success rates of identifying and treating those patients. Just 50 or 60 years ago, nearly 80 percent of children born with congenital heart defects would not survive. But today, thanks to advancements in medical care and surgical technologies, 90 percent of patients with the condition will live. As a result, there are more than 1 million American adults living with congenital heart disease. Earing, a Medical College of Wisconsin cardiologist who practices at Froedtert Hospital and Children’s Hospital of Wisconsin, says every adult patient with a congenital heart defect is a little different. Often adults who had procedures when they were children don’t have recollection of the surgeries or have the ability to relate their history to the doctors. Many patients also have a poor understanding of the process of their disease. "We almost have to go back in time to understand what happened to them when they were young," he says. "Often a young adult has no idea of what his defect is. We have to start at square one trying to teach him." Heart surgeries done in infancy don’t always correct the defects and adults with congenital heart defects should be evaluated continuously throughout life to avoid serious consequences that could arise later in their life, he says. The Adult Congenital Heart Disease Clinic, a collaboration of Children’s, Froedtert and the Medical College of Wisconsin, follows and monitors patients, as well as "intervening when necessary to keep them healthier in the long term. That’s an important goal," Earing says. By tracking the patient throughout his life, doctors can plan a health care strategy ahead of time. "As we follow them longer, we’re better able to identify problems," he says. "It’s important to identify those problems before they become major health issues." Problems that might arise for an adult with a congenital heart defect include rhythm problems, leaky and tight valves, high blood pressure and aneurysms. There are also noncardiac issues that can result from the defect. "It’s much easier to plan ahead than at 2 a.m. in the ER while looking at the patient’s scars and trying to figure out what has been done for him earlier in his life," Earing says. In addition to taking care of their own health, those who are continually monitored are providing protocols for patients of the future. "Because it’s such a new field (adult congenital heart disease) providing care for them allows us to develop protocols for the next generation. This generation will help those in the future." — Julie Larrivee