BY DANNY PARKER

Years ago when I was making critical decisions on my chemotherapy induction for high-risk multiple myeloma and upcoming stem cell transplant, my wife Lisa and I spoke with Dr. Brian Durie at Cedars-Sinai Medical Center. It was a trying time for our family, and Lisa wanted to ask Dr. Durie about what she could do?

Were there foods that would help me through the autumn as I prepared for a stem cell harvest? I had experienced problems with indigestion from the Velcade and Dexamethasone, and Durie counseled that those were important to address as it was important for me to continue with the therapy. But Lisa had a more surprising question: was there food to eat that would help make the induction chemotherapy more effective? Durie said that dietary changes may be helpful, but the information on exactly what is best is lacking. Still, he believes that processed foods are important ones to avoid as they have risks and will make room for nutritious fresh food. “Shop at the edge of the grocery store,” he counseled, “and avoid foods that your grandmother wouldn’t know...” (He likes Michael Pollan’s book, Food Rules.)

While genetics, age and condition at diagnosis are most important, it seems nearly certain that diet can influence our body’s ability to ward off myeloma, influence its progression or affect our ability to tolerate treatment. On average each day, we ingest four pounds or more of food of complex chemistry. As it digests and is broken down to nourish us, this food interacts with the many intricate systems in our body that regulate metabolism and even cellular activity within our immune systems. How would it not be important? Moreover, we have emerging evidence that dietary changes and exercise changes can make a difference in battling cancer. Could adjusting how we eat help?

For instance, a 2008 study found that dietary and exercise changes for patients with prostate cancer can actually lead to changes in gene expression that may improve response to treatments and retard cancer progression.

Might the same things be true with myeloma?

The question is one of extent. The influence of diet may be fairly weak– particularly after the disease has established itself. If the effects were profound then individuals would be going into spontaneous remission merely from eating certain foods. So, while the influence may be subtle, my standpoint is that we can use every advantage available. And spending time to ferret them out seems worthwhile.

Perhaps we can extend the length of time where smoldering myeloma is not needing treatment, how long remissions from drug treatments may last and how successful ongoing treatments may be. And then there is the potential for a better quality of life as we live with the disease. All these outcomes would be valuable even if the beneficial impacts are likely modest.

Furthermore, while the studies aren’t as extensive as we would like, there are research data from a variety of sources suggesting that what we eat can make a difference. Next time, we get down to some specifics. Bring your appetite!