Clinical Nutrition Dilemma

You may probably have heard of prophylactic mastectomy and hysterectomy in women with BRCA mutations, thanks to Angelina Jolie for bringing us the awareness. This article caught my eye because of this prophylactic surgery: total gastrectomy, complete removal of the stomach of people carrying CDH1 gene mutation. The stomach is one of the main organs of the gastrointestinal tract that breaks down and digests food to extract necessary nutrients you need. The protein, carbohydrates and fat are broken down in small enough amounts to be absorbed into the bloodstream through the wall of the intestine. When gastric cancer strikes, it is difficult to treat because of the rapid growth of the tumor and malnutrition is also not uncommon among patients with gastric cancer because the stomach is a key player of the digestive system. After a gastrectomy, prophylactic or not, the person has less room to hold food in the remaining part of the stomach. Cramping, diarrhea, bloating, nausea, vo...

Many of my oncology patients ask me: Does sugar cause cancer? The fact is sugar does not directly cause cancer or promote faster growth of cancer cells. However, eating excessive amount of added sugar can lead to weight gain which eventually increases the risk of obesity. Obesity promotes inflammation which damages DNA which in turn increases the risk of cancer. The misunderstanding of sugar probably originated from the misinterpretation that cells that use more energy, including cancer cells, absorb more glucose-based radioactive tracer in positron emission tomography (PET) scans. Therefore, it was wrongly concluded that cancer cells grow faster when they were provided with sugar. For this reason, many of my cancer patients are starving themselves from sugar and many of their favorite foods. In fact, a patient with cancer going through surgery, radiation, chemotherapy or stem cell transplant often requires additional calories just to maintain their weight. In fact, all cell...