Cancer Help and Support – getting the diet right, Part One
For this entry I thought I’d talk a little about the so-called cancer diet; I say “so-called” because from where I sit, there are many variations, and what I tend to use with an individual dog draws from many sources. On the internet, when people go looking for nutritional support for their dog with cancer, they are often confronted with some ideas that are either not true for all dogs, or are not really valuable at all. Some of these are just sensationalized versions of the science we do have; others are the author’s opinion with no science behind it at all. I work with cancer cases every single week of my life and I have since 1999; the way I approach it is based on science, as well as on what I have learned about dogs and how they react, as individuals, to various nutrient manipulations I may try. In this entry I want to cover at least a bit about what I see as the truths behind the hype and claims. It’s a starting point, at least, for those facing major decisions about how to feed their dog with cancer.
To begin with: macronutrients. Before delving into supplements and iron restriction and more, the main concept I hear from folks all the time focuses on macronutrients – how much fat, carbohydrate and protein to feed. What it generally boils down to is, restriction of carbs and elevated protein is widely promoted as THE correct way to feed all dogs with cancer. In many cases, people are aiming for zero carb content – which I feel is deleterious to the wellbeing of the whole dog – and are jacking up that protein at an alarming pace. Not very often do I hear much about fats! There are many aspects to consider with designing a diet for a dog with cancer, but it makes sense to start with macronutrient content, both because it IS important and because it is the single topic I hear discussed most (aside from turmeric). The belief is that all carbs are “bad” (and ‘feed cancer’) and that protein should be as high as possible. This leads to many potential problems and imbalances that can be detrimental to your dog’s overall wellbeing, and his or her fight against cancer.
Let’s first look at where this idea came from.
“Several years ago, Dr. Greg K. Ogilvie, oncologist at Colorado State University College of Veterinary Medicine and Biomedical Sciences, and his team conducted intensive research into the dietary needs of canine cancer patients. The results of this research have served as the foundation for the current dietary recommendations for dogs with cancer, and led to the creation of the only commercial dog food clinically proven to improve outcomes for dogs with lymphoma, nasal and oral cancers – Hill’s n/d (neoplasia diet).
In short, Dr. Ogilvie’s research found that cancer cells easily metabolize simple carbohydrates (including sugar), and use them to produce energy and reproduce. However, tumor cells cannot readily use fats. So, a diet low in carbs and high in quality protein and fats will essentially help to starve the cancer cells and reduce the likelihood of cancer cachexia, or wasting as a result of depleted body fat stores. “
Let’s look a little deeper at what the science tells us.
Dr. Ogilvie’s own words:
“To test this (LOW CARB ) hypothesis in the dog, a group of dogs with lymphoma were evaluated to determine if a diet high in simple carbohydrates is detrimental compared to a diet low in simple carbohydrates. In this study, dogs were randomized and fed isocaloric amounts of either a high fat diet, or a high carbohydrate diet before and after remission was attained with up to 5 dosages of doxorubicin chemotherapy. As hypothesized, the mean lactate and insulin levels from the dogs fed the high carbohydrate diet was significantly higher than the level from the dogs fed the fat diet after the dogs were fed the diets and put into remission with chemotherapy. Interestingly, dogs fed the high fat diet were more likely to go into remission. This study showed, therefore, that diet was effective for influencing response to therapy and select aspects of carbohydrate metabolism.
The bottom line is that simple carbohydrates may not be ideal for the cancer patient. Therefore, when considering a diet for a pet with cancer, a diet that has minimal amounts of simple carbohydrates may be ideal.”
Now – there are a few things here we need to address. First – researchers compared diets HIGH IN SIMPLE CARBS – meaning things like white rice, pasta, all low fiber and nutrient depleted – with diets low in those foods, and high in total fat. The problem with extrapolating from this that ANY carb at all –poses any kind of similar risk – is a very wild and unreasonable leap to make. Nutritious, high fiber plant foods that might make up between 15 to 20% of a balanced diet are a very far cry from what this study used, and cannot be considered in any way similar.
We do certainly know that all “the whites” sugar, white bread, white rice and pasta – are likely to create inflammation and wreak havoc with the body over time, in dogs or in us! But nowhere in Ogilvie’s research do we see that all healthy carbs should be totally eliminated. I would love to interview him with regard to these findings, but for now, I use complex and healthy carbs for many purposes in the diets of both healthy dogs, and those dealing with illness, including cancer.
Moving to the anecdotal level – which I do not dismiss or undervalue – I can say this. Despite the lack of studies and the general confusion about how to formulate diets for cancer, many people do see dogs living past prognosis – in some cases well past it – and attribute some of this to the diet. On the other hand, most of these cases involved dogs who were also receiving a range of supplements and usually, some kind of veterinary intervention. So what is the bottomline here, at least as far as I understand it?
I have worked with cancer in dogs on a professional level for over fifteen years, and much of that time I have immersed myself in research. I will state with no trace of doubt that whenever any animal is facing disease –and in this case often intensive drug therapy as well – optimal nutrition is of paramount importance. For me, this means a foundation of balanced nutrition, in other words formulated to meet nutrient requirements – and a diet that uses the most wholesome foods obtainable by the owner. Additionally, specific macronutrient manipulation is worth a try. In most cases I work with, this means raising total dietary fat up to around the 50% mark, keeping protein stable and plentiful at about 35%, and lowering carbs to about 15%.
This is an ideal and a goal that may not be attainable for all dogs, I hasten to add. If a dog has had a pancreatitis attack there is no way we can elevate fats so high without endangering him. Dogs with IBD or any type of fat intolerance are included here. The high fat diet should only be utilized in cases of healthy function (ascertained by bloodwork) and then, we move incrementally toward that goal. I will state here that on many occasions, too numerous to count, I have worked with cancer cases whereby the dog indeed was fat intolerant, or in some instances, the vet wanted vegetarian diet, or else the dog was in advanced renal failure and we needed to reduce not only fat but protein…and almost to a case, we have seen extended and good quality survival time – on diets I would consider too high carb for regular use. What does this tell us, if anything? I believe it indicates that other approaches, besides the one based on Ogilvie, may have therapeutic value as well.
What we always have to bear in mind is, that dogs are individuals and there are multiple variants at work with every cancer case – the type, stage of the cancer – treatment used, whole dog history, and more. My own approach is to work with incrementally raised total fat, but also manipulate the fatty acid content to reduce inflammation and provide higher than usual levels of the Omega 3s and of GLA (gamma linolenic acid, found in borage, black currant and evening primrose oils). I keep the protein rotated, sometimes non-mammalian, always emphasize the cleanest sources available and keep an eye on contaminant potential (mercury/pcbs in fish, hormones and antibiotics in beef and poultry). Carbs are restricted, but not eliminated – the link between specific types of fiber and colon health, even cancer prevention, are well documented. Most of my “cancer diets” include quinoa, sweet potato, an array of green veggies and some legumes. But in all cases, the whole dog and her backstory are of the utmost importance. Meeting nutrient requirements is an essential foundation but it is not the whole story by any means. When high fat diets are not advisable, we can still see excellent results in terms of keeping weight up, slowing progression of associated conditions (renal failure) and protecting the heart from side effects of chemo.
It is critically important not to overemphasize the low-carb theory, especially given the myriad other aspects of cancer nutrition we need to consider!
Before we even look at herbs and supplements, in my experience a balanced, individualized diet is first – it is foundational. And that may not be the same for every dog – nor should it be.
My own – very generalized – “Cancer Diet’ would look something like, 40-45 dietary fat ( as tolerated) 40% protein and 15 – 20 complex carb, with a good presence of resistant starch, which we will talk about in more depth next entry, and rotated, appropriate veggies. If you try this yourself, please bear in mind that there is much more to diet than macronutrients – especially with cancer.
Till the next time….