Carbs 101

Guangzhou Fuda Cancer Hospital

Carbohydrates have a bad reputation. But they’re actually an important part of a healthy diet and can help lower your cancer risk.

If you're watching your weight, or just trying to eat healthy, you may think carbohydrates are off-limits. It’s true that too many calories from carbohydrates (carbs, for short) can lead to weight gain, obesity and increased risk for diseases, including certain types of cancer like breast and colon cancer. And carbohydrates with a high glycemic index have been linked to increased lung cancer risk.

But carbohydrates are an essential part of a healthy diet. Getting the right amount of the right kind of carbs can help you maintain a healthy weight – an important part of lowering your cancer risk. 

We talked with Lindsey Wohlford, a wellness dietitian, to learn more about carbohydrates. Here’s what she had to say.

Three types of carbs

There are three types of carbohydrates. All three are very different and some are better for your health than others.

Sugar:Sugars are carbs in their simplest forms. They can be naturally occurring in fruits, vegetables and dairy products. Or they can be added to processed foods. Too much added sugar can lead to weight gain, obesity and an increased cancer risk.   

Starches:Starches are considered complex carbs. This means they are formed by multiple sugar units bonded together. Starches occur naturally in vegetables, grains and beans, like potatoes, quinoa and lentils. They also include grain-based products, such as pasta, crackers and bread. Naturally occurring starches can help stabilize blood sugar and provide feelings of fullness.

Fiber:Fiber is found in the skeleton of plants.  Fiber aids in digestion, either by helping food pass through the small intestine or by slowing down the digestion process, keeping you feeling full longer. 

Complex carbohydrates, the healthy kind, should make up 45 to 65 percent of your total daily calories.

Why do we need carbs?

Carbs are the main energy source for our body. Complex carbohydrates, the healthy kind, should make up 45 to 65 percent of your total daily calories. If we eat the right amount and the right kind of carbs then it can help with weight management. They keep you feeling full and give you the energy your body needs to function at its best.

What about no-carb diets?

By sticking to a no-carb diet you deprive yourself of the nutrients and an efficient fuel source. Plus, diets that require you to eliminate a certain type of food can be difficult to sustain in the long run.

Often when you cut carbs from your diet, you end up eating more protein. Protein is necessary to build healthy muscles but the best way to fuel our body is with a balance diet.  One that includes plant based foods and lean proteins.

Get the most out of your carbohydrates

Follow these tips to make sure you’re getting the most out of your carbohydrates:

Limit added sugars and processed foods
 

Incorporate a variety of whole plant based foods This includes, beans, peas and lentils, raw or steamed fruits and vegetables and whole grains.
 

Choose low-fat dairy products.

 

Building A Healthy Plate

The New American Plate is a simple way to help you achieve a healthy diet and lower your cancer risk.

Many diets come with a long list of nutritional dos and don’ts. To help keep things simple, start by looking at what foods you eat every day and then focus on how you plan on filling your plate.

 The American Institute for Cancer Research’s New American Plate provides a model meal, with mostly vegetables, fruits, whole grains, and less meat or animal protein.

“Watching how you set up your plate is easier to continue over time than a diet,” says Sarah Rafat, a clinical dietitian. “It’s best to think of your diet and your health as a long term goal.”

How it works

“It’s all about maintaining a well-balanced diet,” Rafat says.

 Aim for meals made up of 2/3 or more vegetables, fruits, whole grains or beans. In other words, most of your plate should be filled with plant-based foods.

The remaining 1/3 or less of your meal can be made up of animal protein. But choose those wisely. Limit your consumption of red meat and processed meat.

“Studies show that a diet high in red or processed meat and lower in vegetables may cause certain types of cancer,” Rafat says.

Choosing healthy beverages are also important. If you enjoy a glass of milk with your meals, chose a lower fat milk option. This counts toward your 1/3 portion of animal protein. Soy milk will count as a plant-based option.   

Follow these tips to help build a healthy plate. 

Watch your portions.

Whether you’re out to dinner or at home, make sure your portions don't contain more than one serving.

Use a salad plate instead of a dinner plate when eating. It takes about 20 minutes for your brain to signal that you are full, so try putting your fork down and take a break between bites. Eating slowly will help you digest your food better and be more aware of when you are full. Reducing your portions makes a big difference in controlling your weight so that you can reduce your cancer risk.

Plan ahead.
We all can easily make unhealthy food choices or overeat when we’re on the run. Having a plan will help you prepare for difficult situations and handle them more easily. So, plan ahead by carrying snack foods with you like carrots and hummus or an apple.

Visualize your plate.
Get to know the New American Plate to make sure you’re including vegetables, grains, fruits, protein and dairy into your diet in the right proportions.

Reduce empty calories.
Many foods and drinks are high in fat or sugar, and full of empty calories. It’s OK to treat yourself once in a while, but try not to make every meal a treat. Moderation and balance are best.

Get moving.
Eating healthy and being physically active helps lower your cancer risk. So, get moving for your health. Whether you take the stairs, park farther away, or go for a long walk, you’ll feel better and your body will thank you. 

                                 Guangzhou Fuda Cancer Hospital

Try these foods to help lower your cancer risk

Fuda Cancer Hospital

Getting the right vitamins and nutrients can help you stay healthy and reduce your risk for cancer.

No one food can prevent cancer. However, eating a balanced diet that includes foods rich in vitamins, minerals and antioxidants is important.  Making these healthy lifestyle choices, staying active and maintaining a healthy weight can go a long way in reducing your risk for cancer.

 

Many foods are beneficial to your overall health and reduce your risk of cancer and other chronic diseases. Here are five we recommend adding to your diet.

Berries

“Berries are a wonderful source of vitamin C,” says Lindsey Wohlford, a wellness dietitian.

 

Most berries also contain antioxidants. Studies show these antioxidants protect the body from cell damage that could lead to skin cancer, as well as cancers of the bladder, lung, breast and esophagus.

 

Eat berries that are fresh, frozen or dried.

 

Serving Size: ½ cup

 

Toss some raspberries in with your morning yogurt or cereal.
 

Make a low-fat strawberry smoothie for a quick, healthy snack.
 

Bake some delicious oatmeal blueberry muffins for a meal-on-the-go.

The grape's skin has the most antioxidants, so be sure to leave the grape intact.

 

Grapes 

Grapes are a rich source of the antioxidant resveratrol. Studies show that resveratrol has the potential to possibly stop cancer from starting in the breast, liver, stomach and lymphatic system.

 

“The grape’s skin has the most resveratrol, so leave the skin intact,” Wohlford says. Red and purple grapes have significantly more resveratrol than green grapes.

 

Serving Size: About 15 grapes

 

Grab a handful as a snack or add to a salad.
 

Mix them in with your favorite, low-fat chicken salad recipe.
 

Freeze as a cool treat for a hot day.
 

Grapes are great in hot dishes too.

Broccoli 

These mighty greens are in the cruciferous vegetable family, along with cauliflower, cabbage, Brussels sprouts, bok choy and kale. Studies show that broccoli and its family members have special plant compounds that may protect the body from stomach cancer, as well as cancers of the mouth, pharynx, larynx and esophagus.

 

Broccoli’s “trees” (otherwise known as florets) take on the flavor of whatever spice or sauce you prepare them with.

 

 Serving Size: ½ cup

 

Puree steamed broccoli, avocado, garlic, non-fat milk and low-fat sour cream for a refreshing cold soup.
 

Add your favorite spices to steamed broccoli for a great side dish.
 

Cure the afternoon munchies with raw broccoli and fat-free ranch dressing
 

Tomatoes 

The tomato gets its classic red hue from an antioxidant called lycopene. Studies show that lycopene has the potential to fight prostate cancer. The evidence is even stronger for processed tomato products like tomato sauce and even ketchup.  

 

“Processing the tomato ups its health-boosting power because it releases the lycopene so it can be more easily absorbed by the body,” Wohlford says

 

Freeze tomato dishes for healthy leftovers.
 

Make savory sauce  to serve on whole-wheat pasta.
 

Whole grains

 

Grocery store shelves are filled with grains and grain products. But not all grains are great for your health. Whole grains are loaded with fiber, vitamins, minerals and plant compounds and may curb your cancer risk.

 

The fiber found in whole grains helps you stay full longer, maintain a healthy weight, and keep your cholesterol and blood sugar stable.

 

Include brown rice, wild rice and whole wheat bread and pasta in your diet.
 

Try quinoa.  Of all the grains, quinoa packs the most protein.
 

Add oatmeal to your morning smoothie. It’s an easy way to sneak in extra grains.

5 Little-Known Breast Cancer Facts

Breast cancer is one of the most common cancers in women. But there are still some things you may not know about it.

Breast cancer is one of the most common cancers in women. But there are still some things you may not know about it. We spoke with Therese Bevers, M.D. about some little known breast cancer facts. Here are five things you may not know.

1. Breast cancer doesn’t always come in the form of a lump.

Breast cancer in its earliest stages usually doesn’t have any symptoms. When symptoms do appear, it’s not always in the form of a lump. Be on the lookout for any of the signs below and report them to your doctor right away.

Lump in your breast

 Swelling in or around your breast, collarbone or armpit

 Skin thickening or redness in or around your breast

 Breast warmth and itching

 Nipple changes or discharge

 Breast pain lasting for more than three to four weeks

2.Having a male relative who’s had breast cancer increases your chances.

You may be more likely to get breast cancer if you have a male relative who’s had the disease. This is especially true if it’s a close family member like a father, brother or son. If you fall in this group, talk to your doctor about genetic testing to find out if cancer runs in your family.

3. Maintaining a healthy weight can reduce your breast cancer risk.

Being overweight or obese — especially after menopause — may raise your cancer risks. To keep your cancer risk low, avoid weight gain by eating healthy foods and staying active. Stick with a plant-based diet rich in fruits, vegetables, whole grains and beans. And, try to fit in at least 30 minutes of physical activity in your day.

4. You don’t need to learn how to do a self-exam

Studies show that doing monthly breast self-exams isn’t necessary.

 

Instead, it’s more important to stay aware of how your breasts look and feel. If you notice changes, report them to your doctor without delay. This works just as well as doing a formal breast self-exam.

5. Drinking several glasses of alcohol a day can up your breast cancer risk.

Having a glass of wine now and again is not bad for your health. But, drinking several glasses a day can increase your breast cancer risk.

 

Play it safe by sticking to the recommended serving size. The American Institute for Cancer Research recommends that women have no more than one drink per day and men have no more than two drinks per day.

                                                  Edited by Fuda Cancer Hospital

Cancer Pain Management & Education

It is not uncommon for patients to feel pain. The tumor itself can cause pain. Sometimes treatments result in pain. However pain can be managed to provide a level of comfort that allows daily activities. We want you to understand about pain and how to control it. 

                                             -----Guangzhou Fuda Cancer Hospital

Why Pain Should Be Treated 

Pain can affect you in many ways. It can keep you from being active, from sleeping well, from enjoying family and friends, and from eating. Pain can make you feel afraid or depressed. Pain may also prevent your full participation in your care and may slow your recovery. 

Most cancer pain is manageable. When there is less pain, you may be more active and interested in doing things you enjoy. Tell your doctor or nurse right away if you are feeling pain. Getting help for your pain early makes pain treatment more effective. 

Causes of Cancer Pain

There are many causes of cancer pain. Most cancer pain occurs when a tumor presses on bone, nerves, or body organs. Cancer treatment can also cause pain. 

You may also have pain that has nothing to do with cancer. Like everyone else, you can get headaches, muscle strains, and other aches and pains. Other conditions, such as arthritis, can also cause pain. Pain from these other conditions can be treated along with cancer pain. Ask your doctor or nurse what you can take for these everyday aches and pains. 

Treating Cancer Pain 

Cancer pain is usually treated with medicine. Radiation treatment, surgery, and other treatments can be used with medicine to give even more pain relief. Ask your doctor or nurse how other treatments can help you. 

There are many ways to decrease pain without medicine too. First we will discuss the use of medicines, and then non-drug choices. 

Choosing the Right Medicine 

Pain medicine works differently for different people. In the beginning, you need to adjust the amount and type of medicine. Work with your doctor to find an effective combination and amount. Tell your doctors and nurses how well the medicine is working. Your feedback helps. 

Talk with them about:

· Pain medicines you have taken in the past and how well they have worked for you.

· Medicines and other treatments (including health foods, vitamins, and other "nonmedical" treatments) you are taking now. This is important because some treatments and medicines do not work well together. Your doctors and nurses can find medicines that may be taken together. 

· Allergies that you have, including allergies to medicines.

· Fears and concerns that you have about the medicine or the treatment. They can answer your questions and ease concerns. 

Types of Pain Medicine 

Many medicines are used to treat cancer pain. Your doctor may give you one or more of them to take. The following list describes the different types of medicines. Ask your doctor or nurse to tell you more about the medicine they prescribe for you. Do not take a new medicine without first checking with your doctor or nurse. Even aspirin can be a problem for some people who are taking other medicines or having cancer treatment. 

For Mild to Moderate Pain 

Nonopioids: Examples are acetaminophen, and nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen. You may buy many of these over-the-counter (without a prescription). Others need a prescription. 

For Moderate to Severe Pain 

Opioids: Examples are morphine, hydromorphone, oxycodone, and codeine. You need a prescription for these. Nonopioids may be used with opioids for moderate to severe pain. 

For Tingling and Burning Pain 

· Antidepressants: Examples are amitriptyline, imipramine, doxepin, and trazodone. Taking an antidepressant does not mean that you are depressed or have a mental illness. You need a prescription for  these. 

· Antiepileptics: Examples are gabapentin and other medications. Taking an antiepileptic does not mean that you are going to have seizures. You need a prescription for these. 

For Pain Caused by Swelling 

Steroids: Examples are prednisone and dexamethasone. You need a prescription for these. 

About Side Effects 

All medicines can have side effects, but not all people get them. Some people have different side effects than others. Most side effects happen in the first few hours of treatment and gradually go away. Some of the most common side effects of pain medicines are: 

Constipation (not being able to have a bowel movement): The best ways to prevent constipation are: drink lots of water, juice, and other liquid and eat more fruits and vegetables. Exercise also helps to prevent constipation. Your doctor or nurse may give you a stool softener or a laxative.

· Nausea and vomiting: When this happens, it usually only lasts for the first day or two after starting a medicine. If it continues, tell your doctor or nurse. They can give you medicine to stop these side    effects. 

· Sleepiness: When first taking opioids, some patients feel drowsy or sleepy. For most patients, this side effect usually disappears within one to three days. Talk to your doctor or nurse if this is a  problem for you. 

· Slowed breathing: This sometimes happens when the amount of medicine you are taking is increased. Your doctor or nurse can tell you what to watch for and when to report slowed breathing. 

More serious side effects of pain medicines are rare. As with the more common side effects, they usually happen in the first few hours of treatment. More serious side effects include trouble breathing, dizziness, and rashes. If you have any of these side effects, you should call your doctor or nurse right away. 

How to Take Pain Medicine

Most pain medicine is taken by mouth (orally). Oral medicines are easy to take and usually cost less. Most oral medicines are in tablet form. Sometimes they are liquids that you drink. If it is difficult for you to swallow or you cannot take medicine orally, there are other options. These include: 

· Rectal suppositories: Medicine that dissolves in the rectum and is absorbed by the body.

· Transdermal patches: Patches that contain medicine and adhere to the skin.

· Injections: Most injections use a tube or needle to place medicine directly into the body.

Types of injections include: 

1. Subcutaneous - medicine is injected just under the skin.

2. Intravenous (IV) - medicine is injected directly into the vein through a needle that stays in the vein.

3. Epidural or intrathecal - medicine is injected directly into the back around the spine. Most of these injections give pain relief that lasts for many hours.

4. Subdermal and intramuscular - Commonly known as "shots." A needle is used to inject medicine more deeply into the skin or muscle. This is not recommended for long-term cancer pain treatment. 

When to Take Pain Medicine 

Take your medicine on a regular schedule (by the clock). Taking it regularly helps to keep pain under control. Do not skip a dose or wait for the pain to get worse. Your doctor will usually give you additional medicine for "breakthrough pain" (brief and often severe pain that occurs even though the patient is taking pain medicine regularly).

Ask your doctor or nurse how and when to take extra medicine. If some activities increase your pain, such as riding in a car, you may need to take extra doses of pain medicine before these activities. The goal is to prevent the pain. Once you feel the pain, it is more difficult to control. 

Treating pain is important. There are many medicines and treatments to provide relief. If one does not work, other options are available. Your doctor can adjust your dose schedule or the way you take the medicine. Talk to your doctor and nurse. They can work with you to find the plan that helps you the most. It is helpful for you to keep a record of how the medicine is working. Keeping a record and sharing it with your doctor or nurse helps them make your treatment more effective. 

Non-drug Treatments for Pain 

Your doctor or nurse may recommend that you try non-drug treatments for pain. These techniques, along with your medicine, may give you more relief. Use these methods with your medicine, not instead of your medicine. 

You may use the following non-drug treatments along with your regular medicine: Ask your doctor or nurse how and when to take extra medicine. If some activities increase your pain, such as riding in a car, you may need to take extra doses of pain medicine before these activities. The goal is to prevent the pain. Once you feel the pain, it is more difficult to control. 

Treating pain is important. There are many medicines and treatments to provide relief. If one does not work, other options are available. Your doctor can adjust your dose schedule or the way you take the medicine. Talk to your doctor and nurse. They can work with you to find the plan that helps you the most. It is helpful for you to keep a record of how the medicine is working. Keeping a record and sharing it with your doctor or nurse helps them make your treatment more effective. 

Non-drug Treatments for Pain 

Your doctor or nurse may recommend that you try non-drug treatments for pain. These techniques, along with your medicine, may give you more relief. Use these methods with your medicine, not instead of your medicine. 

You may use the following non-drug treatments along with your regular medicine:

· Biofeedback 

· Breathing and relaxation exercises 

· Prayer or meditation 

· Imagery 

· Massage, pressure, and vibration 

· Transcutaneous electrical nerve stimulation (TENS) 

· Distraction 

· Heating pads and hot or cold packs 

· Rest 

Talk to your doctors and nurses about these treatments. 

When Medicine and Non-Drug Treatment Is Not Enough 

Sometimes people need more help to relieve pain. If so, your doctor may suggest:

· Radiation therapy: This reduces pain by shrinking a tumor. A single dose of radiation may be effective for some people. 

·  Nerve blocks/Implanted Pump: Certain nerve blocks, temporary or permanent, may help relieve pain. Implanted pain pumps can be of great benefit in some instances.

· Neurosurgery: In this treatment, pain nerves (usually in the spinal cord) are cut to relieve the pain.

· Surgery: When a tumor is pressing on nerves or other body parts, operations to remove all or  part of the tumor can relieve pain. 

Talk to your doctor about other pain treatments that may work for you. 

Biofeedback 

· Breathing and relaxation exercises 

· Prayer or meditation 

· Imagery 

· Massage, pressure, and vibration 

· Transcutaneous electrical nerve stimulation (TENS) 

· Distraction 

· Heating pads and hot or cold packs 

· Rest 

Talk to your doctors and nurses about these treatments. 

When Medicine and Non-Drug Treatment Is Not Enough 

Sometimes people need more help to relieve pain. If so, your doctor may suggest:

· Radiation therapy: This reduces pain by shrinking a tumor. A single dose of radiation may be effective for some people.

· Nerve blocks/Implanted Pump: Certain nerve blocks, temporary or permanent, may help relieve pain. Implanted pain pumps can be of great benefit in some instances.

· Neurosurgery: In this treatment, pain nerves (usually in the spinal cord) are cut to relieve the pain.

· Surgery: When a tumor is pressing on nerves or other body parts, operations to remove all or part of the tumor can relieve pain. 

Talk to your doctor about other pain treatments that may work for you. 

The First Step 
 

The key to getting the best pain relief is talking with your doctor and nurse about your pain. They will want to know how much pain you feel, where it is, and what it feels like. Answering the questions below may help you describe your pain. You may wish to write your answers in the space after each question. 

Where is the pain? You may have pain in more than one place. Be sure to list all of the painful areas. 

What does the pain feel like? Does it ache, throb, burn, or tingle? You may wish to use other words to describe your pain. 

How bad is the pain? You can also use a number scale and rate your pain from 0 to 10: 0 means no pain and 10 means the worst pain you can imagine. You can also describe your pain with words such as "none", "mild", "moderate", "severe", or "worst possible pain". 

What makes the pain better or worse? You may have found ways to relieve your pain (for example, using heat or cold, or taking certain medicines). You may have also found that sitting or lying in certain positions or doing certain activities affects the pain. 

If you are being treated for pain now, how well is the treatment working? You may want to describe how well the treatment is working by saying how much of the pain is relieved, such as all, almost all, none, etc. 

Has the pain changed? You may notice that your pain changes over time. It may get better or worse. Or it can feel different. For example, the pain may have been a dull ache at first and has changed to a tingle. Report changes in your pain. Changes in pain do not always mean that the cancer has come back or grown. Describe how the pain was before and how it is now. 

After talking with you about your pain, your doctor or nurse may want to examine you or order x-rays or other tests. These tests will help the doctor or nurse find the cause of your pain. 

Have a Plan 

You can work with your doctor or nurse to write a pain control plan to meet your needs. In a pain control plan, you and your doctor or nurse plan your pain control activities. This plan includes when to take your medicine, how and when to take extra medicine, and other things you can do to ease and prevent your pain. 

Benefits and Risks of Treatment 

The information below describes the benefits and risks of the different types of medicines used to relieve cancer pain. 

Nonopioids 

Benefits: Controls mild to moderate pain. Some can be bought without a prescription.

Risks: Some of these medicines can cause stomach upset. They can also cause bleeding in the stomach, slow blood clotting, and kidney problems. Acetaminophen does not cause these side effects, but high doses can hurt the liver. 

· Opioids

Benefits: These medicines control moderate to severe pain and do not cause bleeding.

Risks: May cause constipation, sleepiness, nausea and vomiting. Opioids sometime cause problems with urination or itching. They may also slow breathing, especially when they are first given, but this is unusual in people who take opioids on a regular basis for pain. 

·  Antidepressants 

Benefits: Antidepressants help to control tingling or burning pain from damaged nerves. They also may improve sleep.

Risks: These medicines may cause dry mouth, sleepiness, and constipation. Some cause dizziness and lightheadedness when a person stands up suddenly.

·  Antiepilectics 

Benefits: Help to control tingling or burning from nerve injury.

Risks: May hurt the liver and lower the number of red and white cells in the blood. It is important to have regular blood tests to check for these effects.

·  Steroids 

Benefits: Help relieve bone pain, pain caused by spinal cord and brain tumors, and pain caused by inflammation. Steroids also increase appetite.

Risks: May cause fluid to build up in the body. May also cause bleeding and irritation to the stomach. Confusion is a problem for some patients when they take steroids. 

Call your doctor or nurse immediately if your pain increases or if you have new pain. Also call your doctor early to receive a refill of pain medicines. Always have a three or four days’ supply of your medicine. 

Common Concerns 

If you are being treated for cancer pain, you may have concerns about your medicine or other treatments. Listed below are common patient concerns and the facts about them. 

Concern: I can only take medicine or other treatments when I actually have pain. 

Fact: You should not wait until the pain becomes severe to take your medicine. Pain is easier to control when it is mild. Take your pain medicine regularly as you have been instructed. This usually means taking it on a regular schedule around-the-clock. Take it even when you are not feeling the pain. You can also use other treatments, such as relaxation and breathing exercises, and hot and cold packs, as often as you want to. 

Concern: I will become "hooked on" or "addicted to" pain medicine.

Fact: Studies show that getting "hooked on" or "addicted to" pain medicine for cancer pain is very rare. Remember, it is important to take pain medicine regularly to keep the pain under control. 

Concern: If I take too much medicine, it will stop working. 

Fact: The medicine will not stop working. Sometimes, however, your body gets used to the medicine. This is called tolerance. Tolerance is not usually a problem with cancer pain treatment because the amount of medicine can be adjusted or other medicines can be added. Cancer pain can be managed; so don't deny yourself pain relief. 

Concern: If I complain too much, I am not being a good patient. 

Fact: Controlling your pain is an important part of your care. Tell your doctors and nurses if you have pain, if your pain is getting worse, or if the pain medicine you are taking is not working. They can help you manage your pain.