Nichole Giller, RD, LD, CSO is the outpatient oncology dietitian at the GW Hospital. She works with patients at the Survivorship Clinic (Thriving After Cancer) in partnership with the GW Cancer Institute, Breast Cancer Clinic, Radiation Oncology Center, and at the Amyotrophic Lateral Sclerosis (ALS) clinic at the Neurology Center.
- Explain the work you do with the GW Cancer Institute
I see patients in the outpatient setting and create meal plans to improve some of the side effects that my patients experience from their treatments, talk to them about common cancer nutrition myths and the types of complimentary medicines that may or may not be safe during or after their treatment.
- What are the most common health problems you treat?
I counsel patients on nutrition throughout the oncology spectrum, which can improve their quality of life. My patients include those who are at risk for certain cancers, who have had surgery, radiation, chemotherapy, or all of the above. I also work with patients who have completed their therapy to reduce the chances of cancer recurrence.
- What are the most frequently asked questions by your patients and what do you tell them?
I most often get asked what my patients can do to prevent cancer. I tell them that while there is no way any dietitian can guarantee that you will never get cancer, we can take advantage of the existing information and research that have been shown to reduce our risk and we can follow those guidelines. The top two of those recommendations are eating more fruits and vegetables and exercising more, which helps to maintain a healthy body weight.
- What does eating healthy mean?
Eating healthy means enjoying every meal you eat mentally and physically. It is important to find a balance of all types of foods—we want to limit foods that are high in fat, salt, and sugar, while not compromising your health.
- Why does maintaining a healthy body weight help to prevent cancer?
According to the American Institute for Cancer Research, maintaining a healthy body weight (Body Mass Index (BMI) of 18.5-24.9) throughout life may be the most important lifestyle factor to reduce cancer risk. This is because the fat we store in our bodies is not an inert mass. Fat cells produce estrogen, which promotes cell growth, and a variety of proteins that cause inflammation and insulin resistance, which in turn promote cell growth and cell reproduction. Fat at the waist is even more active in producing these growth stimulants and those with fat at the waist have higher levels of substances circulating in their blood that stimulate cell division—and the more often cells divide, the higher the chances of cancer developing.
- What are some “super foods” known to lower our risks of cancer and how do they prevent certain cancers?
ALL fruits, vegetables, and whole grains are “super foods”! These colorful tasty foods are full of phytochemicals (compounds naturally occurring in plants). There is evidence that phytochemicals prevent the formation of potential carcinogens (substance that can cause cancer). Think of them as a cleanup crew from just simply eating fruits and veggies!
- Do organic foods really help prevent cancer?
The term “organic” is defined as plant foods grown without pesticides or weed killers. There are many reasons you may wish to choose organic, but it is not known whether organic foods help reduce cancer risk more than their non-organic counterparts. If you do opt for organic, remember that organic cookies, chips and other snacks can contain exactly the same amount of calories, fat and sugar as conventional brands.
- Where can I start to lower my risk of cancer?
Taking one meal and trading out a high sugar/fat/salty food item for a fruit/vegetable/whole grain per day will begin a new routine. Furthermore, start with one day per week of activity that you enjoy, such as walking, gardening, biking, swimming, yoga, etc. Think about what interests you. As you conquer that one-day per week physical activity goal, you can increase the number of days that you are active.
- What is the biggest misconception patients have about nutrition and cancer prevention?
Patients find or hear about some special diet, drink, supplement regimen, or food group restriction that are advertised as beneficial to their health when, in fact, there is no scientific evidence to support this and they do not work in the way they claim. If you come across a cancer prevention claim that seems too good to be true, it is. While it is great for patients to have a desire to live more healthfully, it is just as important to make sure to obtain nutrition advice and information from professionals and resources that have an oncology nutrition background.
For cancer prevention, research shows that the best way to reduce risk for cancer is to eat right and be more physically active! The patients I have had that lose weight, kept it off, and continue on to have a satisfying relationship with food and exercise are those who monitored how much they were eating, balanced their foods choices, and made physical activity a continuous part of their life.
- Please give us a quick and delicious recipe with cancer-fighting ingredients
This recipe is great for your health and the use of ingredients such as sun-dried tomatoes, garlic, whole grain pita, and leafy greens contain phytochemicals that can prevent the formation of carcinogens. The recipe also uses chicken breast, a lean protein, to keep fat content at a minimum.
Little Italy Chicken Stuffed Pitas:
2 tablespoons balsamic vinegar
1 tablespoon chopped oil-packed sun-dried tomatoes
1/4 teaspoon freshly ground black pepper
1 garlic clove, minced
4 cups shredded cooked chicken breast (about 3/4 pound)
1 cup chopped tomato (about 1 medium)
1/2 cup (2 ounces) low-fat grated Asiago, feta, or parmesan cheese
1/4 cup thinly sliced fresh basil
6 (6-inch) whole grain pitas, cut in half
3 cups mixed baby greens
Combine first 5 ingredients in a large bowl. Stir in chicken, tomato, cheese, and basil. Line each pita half with 1/4 cup greens. Divide chicken mixture evenly among pita halves.
Becky Mercuri, Cooking Light
- What midday healthy snacks would you recommend?
I would recommend whole grains, legumes (such as beans), fruits, vegetables, and lean proteins for great snack options. These types of foods are good cancer fighting foods since they contain phytochemicals, fiber, vitamins and minerals. In addition, fiber and healthy fats such as ground flax seeds, avocado, walnuts, and peanut butter are going to keep you full longer. Here are some suggestions:
Whole wheat crackers and peanut butter (1-2 tablespoons)
- Nuts (keep to a 2 tablespoon portion)
- Mini pitas and Hummus
- Vegetables and Hummus
- Hardboiled egg
- Ground Flaxseed in Yogurt
- Vegetables and Light Ranch dressing
- Unsalted pretzels
Elizabeth Hatcher, RN, is a Project Manager for the Division of Cancer Survivorship at the GW Cancer Institute. She works on the GW Cancer Institute’s Citywide Survivorship Initiative (CSI), which is funded by Susan G. Komen. The goal of the CSI is to improve access to follow-up care for breast cancer survivors in the DC area who have completed active cancer treatment. She also coordinates the GW Cancer Institute’s Thriving After Cancer (TAC) Adult Survivorship Clinic, facilitates supportive and educational programs for survivors, and educates health care providers about the issues facing post-treatment cancer survivors.
- What or whom inspired you to become a registered nurse?
My mother is a registered nurse so growing up I was always inspired by her work. I majored in psychology in college and did not come around to nursing until later in life as a “second career.” I was motivated to go back to school and pursue nursing because I wanted to have more of an impact on people’s lives in a real, tangible way.
- Describe your work with Nichole.
I work with Nichole in our TAC Adult Survivorship Clinic. She provides individualized dietary assessments and recommendations to the cancer survivors in the clinic. Many survivors have questions regarding what they should be eating or not eating in order to achieve a healthy weight and possibly reduce their risk of cancer recurrence. Nichole provides balanced, evidence-based information to cancer survivors and helps them set realistic nutrition-related goals. Nichole has also generously offered her time and expertise to educate DC-area patient navigators on nutrition. She has also been the featured speaker at a nutrition and wellness program I helped organize for cancer survivors.
- What would you recommend that readers do in order to reduce their risk of cancer?
Although not one thing can guarantee that someone will not get cancer, studies have shown that there are ways to reduce the risk of getting cancer. First of all, if you smoke, you should get help so that you can quit. The DC Quitline has helpful resources for individuals in the DC-area. Cigarette smoking is known to cause many different types of cancer such as cancer of the lung, mouth, throat, kidney, bladder, or pancreas. Smoking is a leading cause of cancer.
According to the American Institute for Cancer Research, we can reduce our risk of getting cancer by eating more vegetables and fruits, maintaining a healthy weight, and increasing physical activity. These strategies seem simple, but they may take planning and effort to incorporate into our busy lives. Even small steps toward better health can make a difference.
The HPV vaccine can also reduce the risk for some cancers; the HPV virus is associated with cervical, anal, penile, and oropharyngeal cancers. Getting a colonoscopy, as recommended for individuals 50 and over, can reduce the risk for colon cancer by removing polyps before they become cancerous.