By Jane Ehrhardt

About eight years ago, Luis F. Pineda, MD, published a book of recipes. “Cooking with Cancer was born with the idea of trying to improve the quality of life of cancer patients by providing food they would have some enjoyment in,” says the oncologist, who in addition to board certifications and training in hematology/oncology, internal medicine, psychiatry, neurology, and pain management, is also a chef.

“The book was about creating recipes that specifically addressed the nature of their suffering,” Pineda says about the over 50 recipes that are freely available for download on the nonprofit Cooking With Cancer website (cookingwithcancer.org). The recipes reflect the findings in studies on the damage caused by chemotherapy to aspects such as taste, flavor, absorption processes, and bowel function.

Olive Chowder, for instance, has an enticing sour and bitter pungency to incite the subdued tasting abilities along with a significant cathartic effect on the gastrointestinal tract. Chayote and Mozzarella Cake uses a green vegetable from Latin America called guisquil that holds a high content of water to aid with rehydration.

Most dishes are gelatinous, liquid or smooth to ease swallowing. Among the seven completely unique ice-cream dishes is Feta Cheese Ice Cream with Roasted Pepper. The fat and proteins in the cheese offer calories to those fighting weight loss and also serve as building blocks for the intestinal flora destroyed during chemotherapy.

One recipe even supplants the need for expensive treatment for nausea and vomiting, symptoms that are controlled in the brain by the neurotransmitter substance P. A common pre-chemo injection given to block that neurotransmitter costs around $400. “Capsaicin, which is the active component of jalapeno peppers, does basically the same thing,” Pineda says. “So I created Jalapeno Pepper Soup, and prior to chemo, patients eat a bowl. Basically we are pre-medicating with something you cook at home and costs pennies, rather than with an expensive injectable compound. So you see how we use scientific knowledge of taste and flavor together with the chemical compounds in the food, like capsaicin, to control common symptoms of cancer patients.”

Colon cancer is often treated with 5-flourouracil, a chemotherapy drug that dampens the receptors of smell and taste, mostly on the tongue and front part of the mouth. The receptors in the back of the mouth are less affected. “We made a recipe using a special pepper, called a Cobanero or Mayan Lover, that has the capacity to enhance the electrical activity of those receptors,” Pineda says.

For a mild option, the Anaheim Pepper Jell-O with Tamarind Granita has a sweet and bitter taste that excites the overall mouth, preferentially the middle and the back. It bypasses the front of the mouth and the lips, where patients may suffer from painful and sometimes disabling sores from a Herpes Simplex infection.

Monosodium glutamate (MSG) is also included in some recipes to intensify taste. “MSG has a bad reputation,” Pineda says. “But it’s coming back, because they have realized that headaches and migraines are not related to the MSG.”

As new discoveries have unfolded over the past decade since the book came out, new recipes continuously appear on the website to reflect that progress. Carbohydrates used to be sought after to help cancer patients regain weight. Studies now show consumption of carbohydrates relates to inflammation, the chronic nature of obesity, and insulin metabolism that now is believed to cause cancer. Basically, Pineda says, cancer loves glucose, as any PET scan using a glucose tracer proves.

Even nutritionists would offer milkshakes to chemo patients in hopes of getting them to eat and regain weight. “By comparison, an article published today shows that people who lose weight during cancer treatment basically live longer and have a better response to the treatments,” Pineda says. “Other studies mirror the benefits of low carb diets, including the popular keto diet. We have studies ongoing at UAB of glioblastoma, prostate and pancreatic cancers showing patients doing better when they eat less.”

Another new approach to aiding treatment and even prevention of cancer lies with using bacteria and prebiotics to bolster the body’s systems. “Bacteria programs your immune system,” Pineda says. Fiber from vegetables, for instance, feeds the bacteria in the intestine that activate the immune system.

The new recipes incorporate these discoveries by integrating prebiotics, postbiotics, probiotics. “The Creme Brulee With Ginger and Basil puts probiotics into it, kind of like Activia yogurt has probiotics inside it,” Pineda says. The asparagus recipe acts as a prebiotic. Prepared in a way to destroy the cellulose but still remain crunchy, the fiber in the asparagus is very rich, which fortifies the bacteria flora of the intestine. Look for the new edition of Cooking with Cancer to arrive on the site in the next six months.