Functional Medicine:The Role of Nutrition and Diet in

Ovarian Cancer SurvivorshipOvarian Cancer Summit Sharon M. Day, RD, CSO, CNSC

Director of NutritionSeptember 16, 2012

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The objective: to improve understanding of the food choices that support the detoxification process and aide in healthy gut function.

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Known Ovarian Cancer Risk Factors

Other cancers: you or your mother, daughter, or sister had cancer of the ovary, breast, colon, rectum, or uterus

Genes: you have mutations in genes (BRCA1 and BRCA2)

Age: >55

Childbirth: never gave birth

Estrogen: you took estrogen (without progestin) for >10 years.

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Complete Support for Detoxification

Optimal Intestinal Health

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Complete Support for Detoxification

•Liver•Gastrointestinal Tract•Lymphatic System•Lungs and Respiratory System•Skin

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Textbook of Functional Medicine. Gig Harbor, Wash: The Institute for Functional Medicine, 2005, p 278. © 2005 The Institute of Functional Medicine.

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Detox continued..

Phase I – “activation” -- Fat soluble toxins are converted to unstable intermediate molecules

Phase II – “conjugation” -- intermediate molecules are converted into more stable, water soluble molecules

glucuronidation

sulfation

acetylation

glutathione conjugation

amino acid conjugation

methylation

** water soluble molecules can be excreted

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Foods & Nutrients that Up-Regulate Pathways

Fruits and Vegetables

Cruciferous Vegetables

Tumeric

Green Tea

Fibrous Foods

Probiotics

Eggs, Garlic and Onion

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Detoxification Do’s…….

Optimize calories and protein to support detoxification pathways

Eliminate toxic ingredients and harmful cooking methodsreference: www.ewg.org

Remove food allergens and interolances

Focus on Fiber and Fluids

Boost antioxidant and micronutrient defenses

Include detoxicants

Integrate complementary healing modalities

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Optimal Intestinal Health

Avoid alcohol

Avoid processed foods

Increase Plant Foods

Increase fiber from whole food sources-•Binds, aids in excretion of toxins, increases transit, helps to balance microflora

Increase Pre &Probiotics

Increase Water

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National Cancer Institute guidelines for cancer prevention can be used to decrease the chance of a recurrence.

These guidelines include:

Increase intake of fruits, vegetables and whole grains Decrease fat intake to < 30% of calories

Minimize intake of cured, pickled and smoked foods Achieve and maintain a healthy weight

Consume alcoholic beverages in moderation, if at all

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Important Plant Sources for Good Health

Grains: Wheat, rye, oats, quinoa, amaranth, spelt, bulgur, barley

Green leafy vegetables: Lettuce, spinach, swiss chard, endives, beet greens

Cruciferous vegetables: Broccoli, cabbage, turnip, brussels sprouts, cauliflower, kohlorabi, bok choy, watercress, collards, kale, mustard greens, rutabaga

Umbelliferous vegetables: Celery, parsley, fennel, carrots, parsnip

Allium vegetables: Garlic, onion, shallots, chives, leek

Legumes: Soybeans, peas, chickpeas, lima beans, peanut, carob, dried beans (kidney, mung, pinto, black-eyed), lentils

Solanaceous vegetables: Nightshade family: eggplant, tomatoes

Cucurbitaceous vegetables Gourd family: pumpkin, squash, cucumber, muskmelon, watermelon

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Potential Cancer Fighters in Foods-Phytochemicals Isothiocyanates: Cruciferous vegetables, mustard, horseradish

Phenolic compounds: Garlic, green tea, soybeans, cereal grains, cruciferous, umbelliferous, solanaceous, cucurbitaceous vegetables, licorice root, flax seed

Flavanoids: Most fruits and vegetables (cruciferous, umbelliferous, solanaceous, cucurbitaceous), citrus fruits, wine, green tea, onions, cereal grains, soybeans,

flax seed Mono-terpenes: Garlic, citrus fruits, caraway seeds, umbelliferous, solanaceous,

Cucurbitaceous vegetables, sage, camphor, dill, basil, mint

Organo-sulfides: Garlic, onion, leeks, shallots, cruciferous vegetables

Isoflavones: Soybeans, legumes, flax seed

Indoles: Cruciferous vegetables

Carotenoids: Dark yellow/orange/green vegetables and fruits

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Why Phytochemicals?SafeLow ToxicityGeneral AvailabilityMultiple Signaling Pathways

•Cell proliferation•Apoptosis•Angiogenesis•Inflammatory Signaling Pathways

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Research made by the American Cancer Society in July of 2003 explained that women with ovarian cancer who eat a vegetable-rich diet have a greater chance of survival than those who don’t.

Based on the Oregon State University, phytochemicals are associated with reduced cancer risk.

Based on accumulative studies publicized by the Ovarian Cancer National Institute (OCNI) diets rich in soy can also minimize risk of ovarian cancer

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What to do:

More Fruits/Vegetables may improve survival

Drink Tea Daily

Increase Fish – Decrease processed meat

Increase Foods rich in Flavonoids with anti-cancer properties:

Tumeric – potential mechanism: angiogenesis. Clinical trials pending

Anti-inflammatory phytochemicals: inhibit VEGF production

Kaempferol – sources; turnip greens and spinach

Genistein –tofu, soy milk, tempeh, miso

Apigenin – sources; celery, parsley, tomato sauce, red wine

Luteolin – greens, celery, herbs, artichokes

Quercetin – green vegetables, parsley, apples, cherries, onions

• Stay lean. Some studies suggest obesity may increase ovarian cancer risk. Maintain a healthy body weight.• Exercise regularly. Regular aerobic exercise, such as brisk walking, running, swimming, or exercise classes, are one more way

to limit cancer risks and decrease risk of recurrence.

Journal of the American Dietetic Association"; Prediagnosis Food Patterns Are Associated with Length of Survival from Epithelial Ovarian Cancer; T.A. Dolecek et al.; March 2010

Chen SS, Michael A, Butler-Manuel SA. Advances in the treatment of ovarian cancer: a potential role of antiinflammatory phytochemicals. Discov Med. 2012 Jan;13(68):7-17. Review. PubMed PMID: 22284780.

Zhang M, Lee AH, Binns CW, Xie X. Green tea consumption enhances survival of epithelial ovarian cancer. Int J Cancer. 2004 Nov 10;112(3):465-9. PubMed PMID: 15382073.

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Questions?