What should breast cancer patients eat during Taxol (paclitaxel) chemotherapy?
Taxol (paclitaxel) is effective in improving breast cancer prognosis: numerous studies have found that it protects against breast cancer recurrence and death. Taxol and other taxanes can result in side effects such as hair loss, mouth sores, nausea, fatigue, low white blood cell count, neuropathy, muscle and joint pain, cognitive impairment (chemo brain) and serious infections. While obtaining relief from these side effects obviously is desirable, it is very important for breast cancer patients to avoid consuming foods or taking supplements that will lessen the cytotoxic impact of chemotherapy on breast cancer cells.
While various micronutrients found in fruits, vegetables and other foods have been shown to help protect against breast cancer development and metastasis, some of the same micronutrients might enable breast cancer cells to survive chemotherapy. Therefore, 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 listed below that should not be consumed while on Taxol (as well as those on our avoid list). Please see also our web page on factors influencing Taxol's effectiveness.
Foods that enhance the effectiveness of Taxol
The following foods are very good sources of compounds that have been shown to increase the anti-cancer effects of Taxol:
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. Sour cherries, olive oil and vitamin D might relieve joint and muscle pain, although their effectiveness has not specifically been studied in the context of taxane chemotherapy. Brazil nut consumption should be limited to no more than one nut per day, on average, to avoid consuming excess selenium. Please note that while high omega-3 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 during Taxol chemotherapy
The following foods and supplements have been found either to interfere with the effectiveness of Taxol or, in the case of raw shellfish, should not be consumed by those with impaired immunity:
- Açaí berries
- Caffeine, any source
- Coffee, regular or decaf
- Fish oil
- Hormone replacement therapy, including bioidentical or natural hormones
- Mint tea
- Multivitamins & antioxidant supplements
- Shellfish, raw
Orange flavonoid hesperidin could reduce effectiveness of cyclophosphamide
Hesperidin, a flavonoid found in oranges, tangerines, kumquats, lemons, limes and grapefruit, has the potential to interfere with chemotherapy regimens containing cyclophosphamide, such as TAC (taxotere, adriamycin and cyclophosphamide). Cyclophosphamide is an alkylating agent frequently used in combination with taxanes (Taxol, Taxotere) and/or anthracyclines (Adriamycin, epirubicin) to treat breast cancer. Hesperidin is found most abundantly in the peel, pith and membranous parts of oranges and other citrus fruits. Prepared food sources include orange tea, unfiltered orange juice, orange marmalade, and dishes that incorporate citrus peel such as Szechuan Orange Chicken.
Bland diet for use during Taxol chemotherapy
The list below de-emphasizes high-antioxidant and antimutagenic foods such as brightly colored fruits and vegetables, while featuring bland, as well as somewhat bitter-tasting foods, that do not promote cancer (when consumed in moderation). It is important not to drive up blood sugar and insulin levels with high carbohydrate/low fiber meals. Select as wide a variety of these foods as possible and consume any one of them in moderation in addition to the foods recommended above.
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, 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.
We caution against taking curcumin, EGCG, gamma-linolenic acid (GLA), I3C, DIM, luteolin, quercetin, apigenin, or resveratrol in supplement form because of the possibility of unintended consequences. Safe and effective dosages for these supplements during chemotherapy have not been established. Note that curcumin has been shown to be an iron chelator, which could negatively impact some women undergoing chemotherapy by reducing their iron stores.
Below are links to recent studies on this topic. For a more complete list of studies, please click on Taxol.