Adriamycin chemotherapy is effective in improving breast cancer survivorship: numerous studies have found that it protects against breast cancer recurrence and metastases. Adriamycin can result in side effects such as hair loss, bone marrow suppression, nausea, fatigue, hand-foot syndrome, cognitive impairment ("chemo brain") and serious infections. The most serious potential side effect is heart damage (cardiomyopathy), which can lead to heart failure. Patients with BRCA mutations appear to be particularly susceptible to Adriamycin-induced cardiomyopathy.
It is important for breast cancer patients to avoid consuming foods or taking supplements that will lessen the cytotoxic impact of Adriamycin on cancer cells. Compounds that provide relief from chemotherapy side effects may also provide some protection to breast cancer cells. In fact, while various micronutrients found in fruits, vegetables and other foods have been shown to help protect against breast cancer development and metastasis, some micronutrients might enable breast cancer cells to survive chemotherapy.
Therefore, chemotherapy is not a time to adopt a diet full of antioxidant-rich fruits and vegetables or to take supplements. The goal should be to eat a healthy diet that meets nutritional needs while avoiding harmful foods that can promote breast cancer. Weight gain, which is common among breast cancer patients undergoing chemotherapy, should be avoided, since it is associated with unfavorable prognosis. It is more important to avoid unhealthy foods (fast food, junk food, meals consisting mostly of highly refined carbohydrates, unhealthy fats (including most vegetable oils), red meat, fried food) than to consume cancer-fighting foods. The purpose of food during chemotherapy is to enable patients to feel well enough to continue treatment, not to eliminate side effects that may in fact be associated with successful treatment.
On the other hand, there are a few foods that have been shown to act synergistically with Adriamycin to enhance its effectiveness against breast cancer or to protect against heart damage without interfering with the treatment. The strategy we recommend during chemotherapy and for the following month is to consume the foods recommended below, as well as those listed on the bland chemotherapy diet (also below), while limiting or avoiding the foods that should not be consumed while on Adriamycin (as well as those on our foods to avoid list). Please see our web page on factors influencing Adriamycin effectiveness for non-food influences on Adriamycin treatment.
Foods that enhance the effectiveness of Adriamycin or safely reduce side effects
The following foods are very good sources of compounds that have been shown to increase the anti-cancer effects of Adriamycin or reduce its side effects without interfering with treatment:
Turmeric might protect the brain from chemotherapy, thereby possibly reducing chemo brain. However, note that curcumin (found in turmeric) has been shown to be an iron chelator, which could negatively impact some women undergoing chemotherapy by reducing their iron stores. Brazil nut consumption should be limited to no more than one nut per day, on average, to avoid consuming excess selenium. While fatty fish such as salmon are recommended, recent research suggests that fish oil supplements should not be used by those undergoing chemotherapy.
Foods and other products that should not be used while on Adriamycin
The following foods and supplements have been found either to interfere with the effectiveness of Adriamycin or, in the case of raw shellfish, should not be consumed by those with impaired immunity:
- Açaí berries
- Black tea
- Caffeine
- Coffee
- Fish oil
- Green tea
- Grapefruit
- Hormone replacement therapy, including bioidentical or natural hormones
- Mint tea
- Multivitamins & antioxidant supplements
- Palm oil
- Sage
- Shellfish, raw
- Yerba maté
Bland diet for use during Adriamycin chemotherapy
The foods listed below have been selected based on our research concerning their antimutagenic, antioxidant, and cancer-protective properties. The list de-emphasizes antimutagenic and high-antioxidant foods such as brightly colored fruits and vegetables, while featuring bland, as well as somewhat bitter-tasting foods that have little or no known carcinogenic effects. It is important not to drive up blood sugar and insulin levels with high carbohydrate/low fiber meals. Select as wide a variety of the foods below as possible and consume any one of them in moderation in addition to the foods recommended above.
BPA can interfere with effectiveness of Adriamycin chemotherapy
Bisphenol A (BPA), an endocrine disruptor, is suspected of increasing the risk of breast cancer. BPA at low concentrations has been shown to reduce the efficacy of Adriamycin in both estrogen receptor positive (ER+) and triple negative (ER-/PR-/HER2-) breast cancer cells. BPA exposure can be limited by avoiding canned foods, canned sodas, and polycarbonate plastic bottles and food containers, which may be marked with a 7 or 3 recycling number in a triangle-shaped icon (normally found on the base).
Weight loss and weight gain during chemotherapy
Recent studies suggest that fasting around chemotherapy treatments could protect normal cells from the toxic effects of chemotherapy while sensitizing cancer cells to the treatment. However, a study in which rats were deprived of protein during anthracycline chemotherapy found that protein malnutrition reduced the elimination of both Adriamycin and epirubicin, prolonging the exposure of the heart to the drugs and increasing the anthracycline-associated heart damage. More studies and human trials are required before it can be determined whether fasting during chemotherapy is safe and effective.
On the other hand, weight gain, which is common during chemotherapy, is known to be associated with less favorable prognosis and should be avoided.