Ask the Expert

When it comes to health, sometimes it can be difficult to separate myths from reality. Leap writer Debbie Olsen tracks down top doctors and researchers to get the facts


Q: My friend suggested a macrobiotic diet is a good way to prevent, and even treat, cancer. She says I should eat light meals with lots of grains, vegetables, beans, miso soup and very little meat. Does this actually work?

According to Catherine Field, professor of nutrition in the University of Alberta department of agriculture, food and nutritional science, a macrobiotic diet is a dietary regime where people eat whole grains, beans and fruit. It is very similar to a vegan diet, except for the fact that it includes fish.

“Although there have been anecdotal reports that this pattern of eating is beneficial, there is no real scientific evidence to prove that it will prevent cancer, or improve the outcome of treatment,” says Field. “A whole grain diet has been shown to reduce the risk of cancer and that is one component of a macrobiotic diet, but there are other well-researched nutrition guidelines to consider as well. Whatever your dietary regime, it`s important to make sure your body gets the nutrients it needs to be healthy. If you are on a vegan or a macrobiotic diet, you should consider taking supplements for calcium, vitamin B12, iron and zinc, because you typically won`t get enough of these vitamins and minerals in the foods you eat.”

There are a lot of conflicting reports when it comes to cancer prevention and treatment and the foods we eat. In some cases, dietary recommendations do not have much scientific evidence to support their claims. “There is no doubt that what we eat plays a role in cancer prevention, but diet is just one part of a healthy lifestyle,” explains Field. “There is nothing wrong with a macrobiotic diet for those wishing to prevent cancer, or for those undergoing cancer treatment, as long as they are careful to get all the nutrients recommended in Canada’s Food Guide to Healthy Eating, so they stay healthy and strong. Reducing alcohol consumption, maintaining a healthy body weight, and being physically active are also important when it comes to a healthy lifestyle and cancer prevention.”

If you are looking for trustworthy information on a balanced diet, the best resource is still Canada’s Food Guide, available as an interactive tool along with frequently asked questions, at www.hc-sc.gc.ca.

Q: I’m a 50-year-old woman about to go for my first mammogram. What can I expect? Will it hurt?
A mammogram is a special X-ray of the breast that can find an abnormality or lump that is too small to be felt,” says Dr. Laura McDougall, medical lead of Alberta breast and cervical screening programs for Alberta Health Services. “The mammogram procedure requires the breast to be compressed between two plastic plates and two X-rays are taken of each breast. The entire procedure takes about 10 minutes.”

Some women find mammograms uncomfortable and a few find the procedure painful, but tolerable. Pre-menopausal women who normally have tender breasts should consider scheduling the procedure between day seven and 14 of their menstrual cycle to decrease the amount of discomfort they experience.

Screening mammograms are the best way to find breast cancer early, when treatment may work better. “Some women don`t bother to get a regular mammogram, because they have no family history of cancer and they assume it isn`t necessary for them,” says McDougall. “They don’t realize that 80 per cent of the women who are diagnosed with breast cancer have no family history of the disease.”

Current statistics show that about one in eight Alberta women will be diagnosed with cancer during their lifetime, with the risk of cancer increasing as women get older. It is recommended that every woman aged 50 to 69 have a screening mammogram at least every two years. Women aged 40 to 49 and those over 70 should talk to their health care provider about whether screening mammograms should be a part of their breast health routine. Regular screening with appropriate follow-up can decrease breast cancer mortality in a population by up to 30 per cent.

You can find more information on mammogram screening at www.screening forlife.ca.

Q: Why does chemotherapy make your hair fall out?

“Alopecia, or hair loss, is considered by patients receiving chemotherapy to be one of the most distressing and worrisome side effects of treatment,” says Dr. Quincy Chu, medical oncologist with Alberta Health Services. “Hair loss affects self image and is a visible sign that a person has cancer, but it is typically a temporary side effect that doesn’t affect all patients that receive chemotherapy treatment.”

The degree of alopecia a patient experiences is related to the type of chemotherapy they are receiving. Some chemotherapy drugs lead to significant or total temporary hair loss, while others may cause only minimal hair loss. Chemotherapy drugs, whether they cause alopecia or not, are prescribed by medical oncologists based on their effectiveness against a particular cancer. Typically, alopecia starts two to four weeks after the first chemotherapy treatment and hair will re-grow a couple months after chemotherapy ends.

“The exact mechanism of alopecia due to chemotherapy is not clear, but it is related to either death of dividing hair cells, increased shedding of normal hair, or both,” Chu explains. “Although a number of experimental approaches have been developed for prevention of significant alopecia from chemotherapy, none have proven useful in humans. But avoidance of these chemotherapy drugs just because of alopecia would be detrimental to cancer treatment.”

It is important to remember that, under most circumstances, alopecia due to chemotherapy is reversible. Patients with alopecia due to cancer treatment can ask their doctor to provide access to wig services at the cancer centre or get a prescription for a wig, if it is covered by their private insurance plan.


Ask the Expert is an opportunity to have your questions regarding cancer prevention and treatment answered by an expert at Alberta Health Services. We’ll answer different reader-submitted questions in each issue of Leap; please submit them via email to letters@myleapmagazine.ca. Remember, this advice is never a substitute for talking directly to your family doctor.

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