Online Health Chat with Naoki Umeda, MD
Tuesday, December 12, 2017
Integrative medicine has been widely recognized by many people, including cancer patients, but there is plenty of confusing information online. While we believe that the main course of cancer treatment should be evidence-based treatments such as surgery, drug therapy and/or radiation therapy, we also believe a holistic approach to treatment can complement your care in a profound manner. Integrative medicine providers may be able to improve cancer care by providing you with a nutritional plan, acupuncture treatments, mind-body medicine, etc.
Many patients are wondering, “What is the best diet for me?” or are having trouble eating. Diets can vary from patient to patient or even for the same patient when they are on chemotherapy or when they are not. Cleveland Clinic’s holistic or integrative approach contains traditional Oriental medicine treatments that are scientifically supported and reveal strong statistical evidence for success. Acupuncture, massage therapy, Yoga and meditation are good examples of modalities that are being used at many cancer centers in the US and all over the world. If we choose them in a proper way, it is possible to relieve your stress, chemotherapy-induced side effects or cancer-related fatigue. We also understand that many cancer patients are interested in using over-the-counter supplements including herbs. It is very critical to choose appropriately since some supplements can interfere with your current drug therapy.
Our approach can be considered as supportive treatments, and our goal is to improve your quality of life by offering evidenced-based natural methods – before, during or after your treatments.
About the Speaker
Naoki Umeda, MD is an integrative medicine specialist with an interest in cancer, nutrition/food therapy and therapeutic touch. He is originally from Japan, where the average life expectancy is the longest in the world. He has more than six years of experience providing integrative medicine for cancer patients (integrative oncology).
After receiving his medical degree from a national medical school in Tokyo, Japan, Dr. Umeda trained as an internal medicine resident and gastroenterology fellow in Tokyo. He then completed an advanced fellowship in hepatology (liver disease) and a fellowship in gastroenterology oncology at Mayo Clinic in Rochester, Minnesota. Based on his experience of treating patients in "clinically tough situations" such as liver transplant recipients and advanced-stage cancer patients, Dr. Umeda became more interested in "whole person" and "body/mind/spirit" care. He then worked as an integrative medicine staff physician and combined Western medicine with Eastern/traditional medicine such as acupuncture, Chinese herbal therapy and Ayurveda. He realized this blend would produce a beautiful "synergy effect" to relieve both physical and spiritual pain, and to improve quality of life for cancer patients.
Dr. Umeda provides one-hour integrative medicine consultations to create personalized treatment plans for patients at the Cleveland Clinic Wellness Institute.
Let’s Chat About Holistic and Nutritional Support for Cancer Care.
Side Effect Suggestions
Dr C: What suggestions would you make to heal the gut and reduce inflammation for a person with a chronic illness such as cancer? Are there strategies beyond no dairy, no sugar, no gluten and supplements beyond probiotics? What specific anti-oxidants do you use during radiation and for recovery after chemo/radiation? How can acupuncture help?
Naoki_Umeda,_MD.: For diet, I usually recommend no dairy, no sugar and no gluten. Consuming more ginger, cinnamon, turmeric, garlic and black pepper is good to reduce inflammation. During radiation, turmeric 1,000 mg per day and fish oil 2,000 mg per day is recommended, but there are no other data to support other anti-oxidants’ efficacy. Even for turmeric and fish oil, there is no definitive data for their use with radiation. Acupuncture has a great deal of data to support reduction of chemo-related side effects.
1beachlady: My son-in-law just completed his second chemo treatment and is experiencing painful mouth sores. They gave him a rinse to use. Will he have these sores throughout the course of treatment, or will they subside between treatments? Also, what foods/drinks should he avoid? I don't want to make things worse during the holidays and after that or cause him more discomfort or be detrimental to him. Thank you.
Naoki_Umeda,_MD.: I am assuming his painful mouth sores are due to the chemo. He will probably continue to have them throughout the course of treatment. He should avoid spicy food and eating too much sugar and salt.
GaryGiovin: Has there ever been a good trial of a whole-foods, plant-based (i.e., healthy vegan) diet for patients with any type of cancer?
Naoki_Umeda,_MD.: I do not think there has been a good trial of a plant-based diet for cancer patients. Just an additional comment, eating an "excessive" plant-based or vegan diet is actually bad for some cancer patients, especially those who are feeling "weak" due to chemo. Consuming more protein (such as eggs, chicken or turkey) is recommended.
GaryGiovin: Regarding your recommendation for animal protein during chemo: Is there evidence that the "weakness" is due to a lack of animal protein?
Naoki_Umeda,_MD.: There is no evidence that "feeling weak" is due to a lack of animal protein. However, physical stamina and the amount of skeletal muscle are strongly related to each other from my experience. Some people lose large amounts of muscle due to chemo side effects and become weak. Re-building muscle by eating protein is beneficial in regaining stamina.
sphoa: Will the ketogenic diet be beneficial for atypical meningioma? How does it compare with juicing? Are there any clinical trials for the ketogenic diet for meningioma?
Naoki_Umeda,_MD.: There are no data to show evidence of benefit, and there are no clinical trials for the ketogenic diet for meningioma. If a patient has been feeling weak due to having cancer, chemo or radiation, I would NOT recommend the ketogenic diet. If the patient is obese (BMI 30 or higher), a no sugar diet might be worth trying, but this is important for the patient’s general health. You cannot expect that the ketogenic diet or juicing would erase cancer, unfortunately.
17: Do you believe that dairy products are safe to consume? Also, can you suggest some meal examples to fulfill the 2/3 plant source, 1/3 or less animal source diet? I struggle to figure out this recommended balance.
Naoki_Umeda,_MD.: For the most part, I think dairy safe to consume, but if you have experienced diarrhea or abdominal pain after eating dairy, please stop consuming it. In general, a Mediterranean diet is recommended. It includes more walnuts, almonds, salmon, sardines and green leafy vegetables.
MyDay: What are your thoughts on following an anti-estrogenic diet as part of an alternative strategy for those who can't take aromatase inhibitors due to side effects (invasive ductal breast cancer, stage 2B)? Do you have any other suggestions?
Naoki_Umeda,_MD.: I assume "anti-estrogenic diet" is to avoid soy (or isoflavones), but I do not think there are any data to support its effectiveness.
GaryGiovin: What do you think of Dean Ornish's approach with prostate cancer?
Naoki_Umeda,_MD.: I do not think Dean Ornish's diet has evidence supporting its use for prostate cancer. However, there are scientific articles that have shown the effectiveness of turmeric, fish oil, omega 3 and Vitamin D. Dr. David Levy (a urologist at Cleveland Clinic) can provide very comprehensive and thorough advice. I would recommend an appointment with Dr. Levy.
earl359: I was wondering if you could please comment on the benefits, if any, that are known regarding taking Lugol's iodine for cancer, as well as the benefits of different types of mushrooms such turkey tail mushrooms. I have read that there have been some benefits from taking that. Also, are there any combinations of things put together that work with regular treatment? Thank you.
Naoki_Umeda,_MD.: I know what Lugol's iodine is, but there are no clinical data to show its effectiveness for cancer. I also know that some researchers and nutritionists are recommending certain types of mushrooms, but I do not think there are good data to support their use.
Catnap: Do you see any problems with oatstraw infusions of a few cups a day to help with insomnia? Also, would the level of phytoestrogens be a concern for breast cancer patients?
Naoki_Umeda,_MD.: I have never prescribed or recommended oatstraw (I assume this is one of Ayurvedic medicine’s traditional Indian medicinal herbs). Therefore, to be honest, I am not sure about its effectiveness. For sleep, I recommend using melatonin. I know some researchers are doing a study of the phytoestrogen-breast cancer relationship. However, I do not think there has been any definitive data released.
Avidangle: Do you believe Essaic tea is a good supplement to take even while undergoing chemo therapy?
Naoki_Umeda,_MD.: I have heard of Essaic tea, but I have never recommended it to my patients. I would advise you NOT to take it to avoid any unfavorable or unexpected interactions with the chemo.
Dodger1: Dear Dr. Umeda, thank you for taking the time to hold this chat. My 77-year-old brother was recently diagnosed with throat cancer and has just started receiving a combination of radiation and chemotherapy. Throat cancer treatment can present unique complications/challenges to the patient since it may affect vital everyday activities. He is also diabetic. Are there measures or actions you have found particularly helpful to throat cancer patients for coping with treatment effects that you might recommend? Thank you for your help.
Naoki_Umeda,_MD.: Unfortunately, I am afraid that there is no specific advice for throat cancer. However, if I speak with him in person (or via a virtual visit), I may be able to recommend something specific for him. You can find information about virtual visits here: https://my.clevelandclinic.org/departments/wellness/integrative/medical-appointments/virtual-visits.
joelhoa: We have a family member receiving care at Cleveland Clinic. She has clear cell sarcoma that has now aggressively moved to her lymph nodes. We have had several family members and friends reach out to us with various nutritional and holistic options. We have also grown to understand, although it is great to have these options, that they may not help in this specific situation. What advice do you have for us, and how can we expedite seeking more specific treatment?
Naoki_Umeda,_MD.: I think that would depend on her current condition. For example, is she struggling with chemo side effects, having cancer-related fatigue or abdominal issues, etc.? As for nutrition, the Mediterranean diet is recommended in general.
amyw: Do you have any specific dietary recommendations for thyroid cancer (papillary, s/p thyroidectomy and lymph node removal)?
Naoki_Umeda,_MD.: I do not have specific recommendations for thyroid cancer nutrition, but in general, reducing sugar and fat is recommended.
luvhorsesndog: What role do supplements have, and do they also help the cancer grow?
Naoki_Umeda,_MD.: Turmeric, fish oil and probiotics are safe to use during cancer treatment, but please first check with your oncologist or cancer-nutritionist. In general, I advise you NOT to use other supplements (including herbs) since they may trigger unfavorable interaction with chemo/radiation. I do not think supplements would trigger cancer growth, but because of their potential interaction with treatment, I do not recommend you use them.
Ginnyv: What place do herbs have in cancer treatment?
Naoki_Umeda,_MD.: If you are going through chemo or radiation, or are going to have surgery, I do NOT recommend you take herbs. As for palliative purposes, there is a study regarding "Ginseng Panax" from MD Anderson Cancer Center that suggests it can reduce cancer-related fatigue. This study was published this year, 2017. Before you start taking this, you need to ask your oncologist if it is appropriate to take with your other treatment.
sphoa: Which supplements are best and proven to boost your immune system?
Naoki_Umeda,_MD.: There are several supplements and herbs that are considered good for "boosting” the immune system, but if you are on active treatments such as chemo, radiation or surgery, I recommend you not take them. For non-cancer patients, those supplements can be used, but even for them, there is no scientific evidence since there is no definitive machine or technique to "measure your immune strength."
nsr: All this general info is good. Do you have any resources that get down to a meal-planning level that syncs up with chemo treatment schedules? An example is a pool of recipe-ingredient-specific info that can be beneficial for cancer patients currently undergoing chemo, etc.
Naoki_Umeda,_MD.: I do not think there are any resources that have what you’re looking for. During chemo, the patient's condition can change day-by-day, week-by-week and month-by-month. Therefore, an “appropriate diet" should be different. Following the guidance of a cancer-nutritionist or integrative medicine physician is the best way to go.
That is all the time we have for questions today. Thank you, Dr. Umeda, for taking time to educate us about holistic and nutritional support for cancer care.
On behalf of Cleveland Clinic, we want to thank you for attending our online health chat. We hope you found it to be helpful and informative. If you would like to learn more about the benefits of choosing Cleveland Clinic for your health concerns, please visit us online at http://my.clevelandclinic.org.
Naoki_Umeda,_MD.: Thank you very much for posting your questions. At the Taussig Cancer Institute of Cleveland Clinic, a lot of "supportive care" is being provided, such as yoga, meditation and guided imagery. At the Wellness Institute at the Lyndhurst Campus, there are acupuncturists and mind-body holistic psychotherapists. Those modalities, especially acupuncture, have some clinical evidence that they are beneficial for multiple cancer treatment-related symptoms. If you are interested, I’m very happy to see you in person at the Lyndhurst Campus, Main Campus (every Thursday) or Amherst Campus (twice a month) to discuss more about a "personalized" plan for nutrition and complementary therapies. Thank you.
To make an appointment with Naoki Umeda, MD or any of the other specialists in Cleveland Clinic’s Center for Integrative and Lifestyle Medicine, please call 216.448.4325, toll-free at 800.223.2273 or visit us at clevelandclinci.org/wellness for more information.
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