"When I talk to my patients about treatment, one of the most frequently asked questions is: 'What should I eat?'" Miletello says.
Last spring, Miletello collaborated with cookbook author Holly Berkowitz Clegg to create Eating Well Through Cancer, a collection of 200 recipes to help cancer patients better tolerate treatment.
Despite improvements in long-term survival and treatment advances, cancer remains a diagnosis that devastates both the patient and their family. The disease is defined as an unbridled growth of cells that destroys the function of healthy cells; therefore, the goal of treatment is to halt the growth of cancerous cells. New methods continually are added to the arsenal of cancer therapies, but the mainstay of treatment relies on a combination of surgery to remove tumors and chemotherapy and radiation to remove microscopic traces of the disease.
Chemotherapy and radiation eliminate cancer cells. Unfortunately, they also affect healthy tissue and can produce side effects such as a metallic taste that destroys the appeal of even favorite foods, gastrointestinal discomfort, a weakened immune system, and elevated blood sugar. Ironically, at a time when nutrition is crucial for maintaining a patient's stamina to fight the disease, they commonly experience a loss of appetite resulting from the cancer itself, side effects of treatment, depression, stress or anxiety.
"Before we began to work on the cookbook, we did an Internet search to find cookbooks for cancer patients," says Clegg. "The few books on the subject were very technical or required a complete change of lifestyle." She also conducted an informal survey of Dr. Miletello's patients to discover what types of foods they would like to see included in a cookbook. "I had expected to receive results that indicated bland foods," Clegg says. "Instead, I was surprised and pleased that patients wanted recipes for everything from Mexican to Cajun dishes."
In addition to the information gathered in patient surveys and online, Clegg's understanding of the challenges faced by patients and their families was further deepened when her father was diagnosed with and successfully treated for cancer of the larynx. "My father now considers this his book," she says.
Based on the most common side effects suffered during treatment, requests from patients and family members, and lists of ingredients known to be well tolerated by patients experiencing each symptom, Clegg and Miletello evaluated more than 400 recipes. They focused on each recipe's nutritional value, taste, simplicity, preparation time and whether the ingredients required are readily available.
"During the course of their treatment, cancer patients don't have the energy to spend a lot of time shopping for and preparing food," Miletello says. "Because the healthy dishes in this book are palatable for everyone, there's no need to make one meal for the patient and another for the rest of the family."
In Eating Well Through Cancer, the personal experiences and medical and culinary expertise of its authors combine to produce a cookbook that serves as a guide for nutrition before, during and after cancer treatment. Besides the recipes themselves, the book features diabetic exchanges, menu planning, high-calorie variations, doctor's notes and a section that cross-references recipes and side effects.
Chapters are organized according to the phase of treatment and possible side effects; additional sections are devoted to long-term, post-treatment healthy eating as well as snacks and suggestions of foods for friends to bring those undergoing treatment.
Some chapter titles are more characteristic of a medical encyclopedia than a culinary tome, but the recipes resemble anything but hospital cafeteria fare. Although there are a few medicinal recipes for a natural laxative or basic weight-gain shake, Eating Well Through Cancer excels in presenting gourmet dishes with a healthy twist, including chicken scampi, egg souffle, cous cous salad, loaded enchiladas, herbed shrimp, pina colada bundt cake and vichyssoise.
"You don't have to have cancer to benefit from these low-fat, healthy recipes," Miletello says. "The book also has application for anyone experiencing the symptoms, including patients being treated for AIDS, ulcerative colitis or chronic constipation as well as those receiving high-dose immunotherapy or bone marrow transplant. Just as important, this is a good, healthy cookbook that can be used by anyone to prepare everyday meals." Eating Well Through Cancer should be available in bookstores early next month. For information, contact Holly Clegg at 800-88-Holly or www.hollyclegg.com.