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Can Diet Help Prolong the Watch-and-Wait Period?

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Published on August 22, 2018

Many patients wonder if a change to their diet will affect disease course or prolong watch and wait. How does diet impact chronic lymphocytic leukemia (CLL) progression? What should patients eat during watch and wait? CLL expert Dr. Lamanna, from Columbia University Medical Center, explains the role of diet, supplements and exercise in boosting your immune system and maintaining optimal health. Dr. Lamanna also discusses data collected on green tea, the importance of moderation and being open about what you’re taking with your healthcare team.

Provided by CLL Global Research Foundation, which received support from AbbVie Inc., Gilead Sciences, Inc., Pharmacyclics LLC and TG Therapeutics. It is produced by Patient Power in collaboration with The University of Texas MD Anderson Cancer Center.



CLL Global Research Foundation The University of Texas MD Anderson Cancer Center


The University of Texas MD Anderson Cancer Center

Transcript | Can Diet Help Prolong the Watch-and-Wait Period?

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Jeff Folloder:

Dr. Lamanna, I have a question from Facebook, of all places.

Dr. Lamanna:              

Oh. I don’t have Facebook. 

Jeff Folloder:               

Well, a member of the CLL support group wants to know if it’s possible to prolong watch and wait with diet alone?

Dr. Lamanna:              

I’m gonna say no. Do I think diet’s important, yes. But, I think there are things we just don’t know, right? So, this is one of those areas, so let’s talk about diet and supplements. That opens that up. 

Certainly, the better you are able to take care of your health—obviously, we talked about exercise, and how that could benefit, because of cytokine release, and things like that, would give your immune system a boost. Similarly, obviously, when you get online, and you google cancer, there are a plethora of diet options that come up, right? Anywhere from low sugar diets, low carb diets, this, that, the other thing. All these kind of extra supplements, beets, this. We can go on and on, and on. And, the truth is, it’s not that these things may not benefit people. The problem is, we just have such little data, and what may actually work for one cancer, may not work well for another cancer. 

And so, we just don’t have a lot of good data yet. So, I always talk to my folks that if you’re talking about—and, it’s important, right? So, when we talk about CLL, what are things you can control? We talk about diet, we talk about your lifestyle, we talk about exercise. So, these are things that are in your power. So, things that generally are gonna take care of your organs, your heart, your cardiovascular system, your kidneys, if they’re gonna benefit you, they’re gonna certainly benefit other aspects of your body.

Your immune system, and how you may need to, if you should need therapy, how you may handle therapies, because your organs are well intact, and functioning well. So, diet is important, it’s just the problem is, we just lack so much of the data about this. We looked at some of this with prostate cancer, and certain vitamins, and there were certain trials that actually wound up being detrimental to patients with prostate cancer, that enhanced their morbidity, mortality. So, we just have a lack of data in CLL. We can talk about the green tea data, by our colleagues at the Mayo.

That’s probably the one closest akin to the thing of the clinical trial we had with CLL. That definitely showed some softening of the lymph nodes, and some absolute reduction a little bit, in the lymphocyte count, but did it—was it long lasting, no, but when people say, is it okay for me to take green tea? I’m like, sure. Everything in moderation, though, right? So, anything you ingest in your body, whether it’s a supplement, a prescription, over the counter, everything’s gotta be processed by your organs, your liver, and your kidneys.

So, if you do anything on very high doses, they may impact – I bet you get online, and you can get something, some sort of a plant shipped to you, that’s the cure of all cancer, and then take high doses, and I had a patient who went into renal failure, So, you know, the problem is, it’s not that we don’t think, many of our cancer therapies do come from plants, it’s not that we don’t believe that these may have a benefit, we just have a lot of lack of data. And so, you need to be smart, so for sure, one of the things my team, and I’m sire these guys do too, is we’re always going through people’s—not just their medication list, but their supplement list, or anything they might be taking over the counter, and we talk about moderation, moderation, moderation.

Because we just don’t know. One year, one glass of wine is okay, then it’s two, depends on which clinic you’re in.

Dr. Keating:                 


Dr. Lamanna:              

I think you just need to be smart. So, we’re not poo-pooing, diet is very important. But, do I think it’s a cure of cancer? I wish. We just really don’t have that data, so just be intelligent.

But, it’s important you tell your physician what you might be doing. Because if you’re on other medications, and it could be—they may not even be CLL medication, they could be cardiac, so some of these increase bleeding time, and do other things. You need to tell your doctor, so they can run this. Either they’ll run it, or they’ll use their pharmacy to do this. So that there aren’t interactions with maybe perhaps other medicines that your taking, and that we know that they’re safe for your organ function. It’s not that we poo-poo diet and supplements, it’s just that we have to make sense of what they are for you, and to keep you safe. And, for sure, when you’re on clinical trials, there might be more and more restrictions about what you can and cannot do, depending upon the supplement. 

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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