We are currently in the peak of summer, and fresh fruit and vegetables are plen­ti­­ful and in a great variety.

This made me realize how much my diet and nutrition has changed since I was diag­nosed with multiple myeloma.

The first change that indirectly impacted my eating habits was having vertebral fractures in the spring of 2009. I was immobilized for at least a month and took a lot of medication to manage the pain. My activity levels plummeted to almost nil and so did my appetite. I just couldn’t bring myself to eat much.

Then, I started induction chemotherapy with Velcade ^[1] (bortezomib) plus dexamethasone ^[2] (Decadron), which lasted for three months. During that time, other nutritional issues appeared.

I was told not to ingest ‘antioxidants’ such as vitamin C or green tea so that Velcade could work effectively. Although ‘antioxidants’ are widely regarded as cancer fighting compounds, they have been shown to di­min­ish the effectiveness of proteasome inhibitors. Thus I swore off my vitamin pills, green tea, and even any citrus fruit or juice. I desperately wanted the chemotherapy to work as quickly and effectively as possible. I reasoned that I could always catch up on my usual healthy eating with the antioxidants later, which I do now that I’m no longer on chemotherapy.

Another issue was that dexamethasone was causing food cravings and keeping me awake at night. I would be prowling around the quiet house at midnight, looking for snacks, preferably junk food, such as potato chips and granola bars. After a while I realized that this was not helping me to keep a healthy weight, so I tried to control those impulses.

At the same time, Velcade was causing nausea. I received the anti-nauseant granisetron (Kytril) intra­ve­nous­ly before my Velcade injection. Granisetron slowed my digestive system down to a crawl, which lead to my having to take a natural laxative to counteract those effects.

I still felt a bit nauseous and couldn’t handle any heavy meals. All I really wanted to eat was home-made soup, particularly the ones that a kind neighbor prepared for me. During that time, I also consumed a lot of ginger-based products, such as ginger ale and ginger candies. I even drank calorific, non-alcoholic ginger beer.

Looking back, I think that my eating habits were very disrupted during induction therapy.

Then came the stem cell transplant, which caused a period of food avoidance. I had to stay away from any foods that might carry bacteria or fungus since I basically had no immune system for awhile and my gastro­in­testinal tract was also compromised. Trips to a salad bar were not on the menu for me during this time. I could only eat mild foods and got quite nauseated by my unusually enhanced sense of smell. I had lots of stomach upsets and was just generally quite sick and exhausted.

However, 100 days after the transplant, my blood counts were climbing back to normal levels and I felt quite a bit better.

I then started a year of Revlimid ^[3] (lenalidomide) maintenance therapy, which also affected my digestive tract, sometimes causing stomach flu-like symptoms.

Having weathered that storm of 20 months of treatments, I have the greatest of admiration for myeloma patients who deal with these treatments year in and year out because I found those 20 months to be quite stressful.

Once I was finished with treatments, I could better focus on eating a good diet again.

Of course, I am highly motivated to try to stay as healthy as possible, and I am interested in eating a diet that is ‘anti-cancer’ in nature.

As a myeloma patient, I am also interested in bone health because of the weak condition of my bones. My age and gender, of course, also play a role.

For my bones, I am taking calcium supplements with added vitamin D. I am also trying to get plenty of cal­ci­um in my diet from milk, yogurt, cheese, leafy green vegetables such as spinach, as well as canned fish with bones, such as salmon. I realize that taking calcium supplements is a topic that needs to be discussed with one’s doctor because some myeloma patients have too much calcium in their blood and probably wouldn’t want to take supplements.

To help prevent a recurrence of any sort of cancer, I am now eating lots of cancer-fighting foods, which are high in antioxidants. These foods are quite similar to those generally thought to be healthy. They include berries, such as acai, blueberries, and blackberries; other fruits and vegetables with vibrant colors such as tomatoes, broccoli, carrots, and red grapes; garlic; green tea; and whole grains. My husband is a wonderful cook of south Indian food, and we eat quite a lot of dishes using lentils and whole grains.

I am also striving to use organically grown foods when available. I started to browse the ‘organic’ section of my supermarket and was surprised to find a large variety of vegetables, meat, eggs, fruit, and dairy products there.

For protein, I drink milk and eat yogurt, fish, chicken, eggs, in no particular order or amounts. I still eat red meat, but rather infrequently now.

Foods high in omega-3 fats, such as fatty fish, walnuts, omega-3 enriched eggs, and flaxseed, canola and soybean oils, have been shown to be heart-healthy and to play a role in decreasing cancers. I regularly eat salmon, nuts, and eggs that are enriched with omega-3. In addition, we use canola oil in cooking.

Although I haven’t tried taking any kinds of supplements (except for calcium/vitamin D and a multivitamin), we use fresh-frozen turmeric, which contains the active compound curcumin, in Indian cooking at home.

I try not to eat too many desserts any more, since they really are just ‘empty calories.’ I also don’t bake much anymore. I like baking but with all of the other healthy foods we are trying to consume now, there just isn’t much room for desserts in my diet anymore.

My beverage of choice is water. I try to drink lots of it and not so much juice as I did previously.  As a choir singer and exerciser, I often have a water bottle with me.  In winter, I add hot tea, coffee, and  hot chocolate to keep me warm and hydrated.

I hope that my column helps other myeloma patients to think about how they could be eating for best health too, at whatever stage of myeloma they are in.

Would anyone else like to share their diet or nutrition tips? I am quite sure that other patients and caregivers have given nutrition a great deal of thought.

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The quotation for this month is from William Shakespeare (1564 – 1616), English poet and playwright, who wrote "Our bodies are our gardens – our wills are our gardeners." (Othello, act 1, scene 3)