Published on February 5, 2018
What do the experts say about a myeloma patient’s sugar intake? Should it be avoided altogether? Myeloma experts, Tiffany Richards and Dr. Robert Orlowski from The University of Texas MD Anderson Cancer Center, discuss what dietary changes are recommended to live well with a myeloma condition and how treatments interact with certain foods. Watch now to find out more.
Produced by Patient Power in partnership with The University of Texas MD Anderson Cancer Center. We thank AbbVie Inc. and Takeda Oncology for their support.
Transcript | Is Sugar Part of a Myeloma-Friendly Diet?
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What dietary changes should I make to help me deal with myeloma and such?"
I usually tell patients, "Just follow a good diet. Everything in moderation." I don’t usually tell patients to totally avoid sugar, because I think that's an impossible task. I don't know. For me, at least, I would never be able to do that. But everything is in moderation. So just like what type of diet your doctor would've been telling you to follow prior to your diagnosis, to do that. Try to minimize your weight gain as much as you can, eating fresh fruits and vegetables. And just eating a healthy, good diet is really, really important.
So kind of doing the same whether you had myeloma or not?
Yeah. That's what I say to people. Any differences? Same? There's nothing that's been said, "This diet is a benefit or not." We hear things though about green tea, grapefruit juice. Dr. Orlowski, can you say anything more about what's specifically about those that might make a difference in my treatment?
Sure. One thing on the diet front is patients sometimes come and say, "Should I avoid sugar all together?"
And as Tiffany mentioned, it's very tough to do. And there's some rationale to it, because cancer relies on sugar for energy. But even if you were able to completely eliminate sugar, your brain and kidney in particular are dependent on sugar for energy. So, you would still have your body converting things like fat and protein into sugar anyway. So low levels of sugar intake are good. But you don't have to avoid it all together. You mentioned green tea and vitamin C, for example. Those are two things that—at least in the laboratory—have been shown to interact with bortezomib (Velcade) and inhibit its activity against myeloma in the laboratory.
We don't know whether that happens in patients or not. But there's no reason to take the chance. And so, if you really love lots of vitamin C or lots of green tea, I usually recommend it's okay to do it.
But definitely probably not on the days that you're going to get your bortezomib therapy. And because carfilzomib (Kyprolis) is a proteasome inhibitor with a different chemistry, we don't have the same concerns. Because you wouldn't have that same chemical interaction.
Ninlaro or ixazomib also has a boronic acid like bortezomib. So, it theoretically would also interact with vitamin C and with EGCG as the component in green tea that maybe could inactivate it. Especially if you take them by mouth at the same time and then they're all mixing in there together. So I would definitely avoid doing green tea or vitamin C on the days that you're taking the ixazomib.