Oncology (General Cancer)/nutrition

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Question
Dr. Higby,

I have a quick question.  Why do most oncologists never seem to put much importance on nutrition?  I have been in remission for breast cancer for 4 years.  I have done a lot of research into low glycemic diets and their impact on cancer. If cancer is fed by glucose, than why have I never heard an oncologist mention this to their patients?  Thank you so much for your time?

Answer
While it's probably true that nutrition plays a role in prevention of cancer, we have much less evidence that it does much to change the outcome when a person has cancer.  A lot of studies have been done; in fact, I started out in oncology under Dr. James Holland, who had a whole experimental kitchen set up on his cancer ward.  As for the issue of cancer being fed by glucose, the fact is that if I draw a blood sample from someone who has an ultra-low glycemic diet, it will still show a "normal" glucose level, all other things being equal.  A low glycemic diet doesn't really change your glucose level much; it does however reduce the insulin surges that probably do a lot of things that aren't so good.  The other thing I would say, and I know that you probably don't agree, is that when people report things, it's important to understand the process by which those conclusions were reached.  In my own field, we had a situation many years ago when women were undergoing relatively serious procedures (autologous bone marrow transplant) in order to receive doses of chemotherapy which would otherwise have been lethal.  The procedure caught on because prominent oncologists were vigorously advocating that this be done.  Eventually a randomized clinical trial comparing the new treatment with standard treatment was carried out.  It showed no difference in outcome.  I suspect some women lost their lives because of this, and certainly a lot of women went through more toxicity than they needed to.  In oncology, we've learned to be very cautious about accepting new treatments unless they have gone through a randomized trial.
That being said, I personally counsel my patients a lot on nutrition.  However, I haven't advocated a low glycemic diet for them.  I do one myself when I need to lose weight, though.  Hope this helps.  

Oncology (General Cancer)

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Donald Higby, M.D.

Expertise

I can answer almost all questions related to the treatment and natural course of most kinds of cancer, especially cancers of prostate, colon, lung and breast.

Experience

I have been a practicing medical oncologist for 36 years, and have been chief of service at a major medical center for 25 years. I've also done research in cancer treatments.

Organizations
American Society of Clinical Oncology

Publications
New England Journal of Medicine American Journal of Medicine Journal of the American Society of Clinical Oncology Hematology Transfusion Medicine

Education/Credentials
MD, Stanford University Internal Medicine residency, St. Louis University School of Medicine, St. Louis, MO Medical Oncology Fellowship, Roswell Park Cancer Institute, Buffalo, NY

Awards and Honors
America's Best Physicians, last 14 years

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