Nutrition Strategies for Carcinoid Tumor Survivors

Nutrition strategies for a carcinoid tumor can be very different from suggestions for other cancerous tumors. Why? Isn’t a tumor just a tumor? No, carcinoid tumors grow slowly, compared to other cancerous tumors. These tumors are often located in the digestive tract but can grow in other parts of the body like the lungs, liver, and pancreas. Carcinoid tumors can release unique substances which are excessive hormone-like agents, such as histamine, serotonin, and prostaglandins.

The release of these hormones from carcinoid tumors can cause uncomfortable side effects that can result in what is known as carcinoid syndrome. The side effects of carcinoid syndrome are facial flushing, diarrhea, abdominal pain, gas/bloating, weight loss, skin rash, fatigue and nausea. These side effects can decrease your food intake, hamper nutrient absorption, and trigger poor nutritional health. There is not a “carcinoid diet”‘ but there are strategies that may help alleviate the side effects.

Food choices that may trigger carcinoid symptoms include: large meals, alcohol, high-amine foods, dietary fat, and some spices. Everyone is unique so a food that triggers side effects in one person may not trigger them in another person. Let’s look at the nutrition related strategies to help manage carcinoid syndrome.

Limit amine intake.

Amines are substances that stimulate carcinoid tumors which can cause capillaries to dilate and possibly a spike in high blood pressure. Other symptoms of carcinoid syndrome can also present. Keep a food diary to track what foods may trigger symptoms. Foods high in amines are:

• Aged cheeses
• Alcohol
• Smoked fish & meats
• Yeast extracts-in many processed foods, Brewer’s yeast
• Fermented foods fish sauce, miso, sauerkraut, tofu

Foods moderate in amines are:

• Caffeine found in drinks like sodas or coffee
• Dark chocolate, milk chocolate, cocoa power
• Peanuts, brazil nuts, and coconut
• Avocado, banana, raspberries
• Most soybean products: soy sauce, tempeh
• Fava beans
• Certain vegetarian meat substitutes read labels

Eat more fresh meat and protein, like eggs, poultry, meats, low-fat dairy, and yogurt.

Increased protein in your meals help replace the amino acid tryptophan that is often depleted during carcinoid syndrome. The loss tryptophan can lead to a deficiency in niacin. You may need 20% to 50% more dietary protein if you experience carcinoid syndrome. Ask for a referral to a registered dietitian nutritionist for an individual meal plan that works for you and your lifestyle.

Shrink meal size and dietary fat intake.

Have 5-6 small mini-meals instead of 2-3 big meals daily.

Give your digestive system a break.

Cook vegetables well. Use raw vegetables only if well-tolerated. If diarrhea occurs, go slow on wheat bran, and foods made with wheat bran, prunes, dried fruits, and popcorn.

Choose foods low in amines.

Low amine foods often have a lower risk to trigger symptoms. These foods include:

• Fresh lean meats, fish, poultry
• Fresh lunch meats, like roasted at a deli or made at home fresh roasted turkey
• Most vegetables cook well
• Fruits (except no avocado, bananas, raspberries)
• Grains, starchy foods low fiber may be better digested
• Unaged cheese and dairy, especially low-fat (cottage cheese ricotta cheese, mozzarella cheese, yogurt and cream cheese)
• Fresh boiled soybeans(edamame), soymilk

Remember, not all tumors are alike, and nutritional strategies differ depending on the type of tumor. Only avoid foods that bother you or cause symptoms. Talk with your healthcare team or a registered dietitian nutritionist that specializes in oncology to learn more about recommended nutrition strategies for you based on your diagnosis.

References:

www.carcinoid.org

www.caringforcarcinoid.org

www.oncologynutrition.org

Lecture: “Nutrition: What to Eat and Why.” Greta Macaire, RD,MS, CSO. Helen Diller Family Comprehensive Cancer Center. http://cancer.ucsf.edu/support/crc/. 18 Nov. 2013.