Aromatase inhibitors and oranges

Jewelweed

This is quite an interesting read and it has gotten me wondering about the effects of citrus when you are using AI:

https://foodforbreastcancer.com/foods/oranges

In particular, after describing all the positive effects, the article says this:

"On the other hand, some of the chemopreventive compounds found in oranges or their components can interfere with the treatment effects of tamoxifen and some other systemic therapies. Were it not for this fact, oranges would be on our Recommended food list."

Obviously I will talk to my oncologist about this, but has anyone else out here run into this?

Has your MO recommended that you avoid all citrus while taking AI?

This would be a terrible shame given all of the many positive things associated with citrus. I eat oranges my the crate, especially in winter, so this is a tough one.

ThreeTree

I read the same article a year or so ago, and have also wondered now about eating oranges. A year or two ago I was eating tons of them, but backed off in part because of a stomach acid problem. The stomach problem resolved, but that was about the same time I read the article too, so I've been reluctant to go full hog with oranges again. I don't know that I wouldn't eat them at all these days, though. In my case I don't think my oncologist would have anything to say about it, but that she would refer me to their nutritionist. I don't know that I want to take the time to do that, but it would be interesting to know just how good or bad they might be for AI's. I take Letrozole, not Tamoxifen.

Jewelweed

I won't be taking tamoxofen, but some kind of AI. I'll know more on Thursday.

I've read elsewhere that only certain kinds of oranges are an issue. I hope that's the case. Meanwhile I'll start cultivating a pineapple addiction.

exbrnxgrl

I have been on AI's for 10 years and have never heard of this. I live in CA so many of us not only eat the states great citrus but we often grow our own. I live in a townhouse with a small patio but still grow a Meyer lemon tree in a large tub!

Since I am stage IV and have been NEAD on AI's alone for 10 years and have never changed my citrus consumption level, I think I won't worry about it. I should add that I don't now nor have I ever worried about every minute detail of what I eat, do, practice, etc. I eat a mostly plant based diet but allow myself indulgences when I want to.It's certainly not the approach everyone would choose but as a laid back person, it has worked for me. I also would drive myself crazy if I had to worry about every component of every morsel that passed through my lips. I would not find it comforting just compulsive. Having said that, I know that many people find that level of food control comforting. It makes them feel like they have control over their bc and are actively “fighting". In the end you do what's right for you!

LillyIsHere

exbrnxgrl, wow! I would love to grow citrus fruit. I have pots with lemons, oranges, and limes but they only flower and that's it! Of course, New England's climate can only grow corn and apples.

I have asked pharmacists, doctors, and nurses for interactions of AI and food and supplements and I am told there is no research done. Basically, we are on our own. I have only stopped the alcoholic drinks, everything else is the same. I love fruit and veggies and I eat tons of them!

Spookiesmom

We had the best pink grapefruit tree in our yard. I had to stop eating them, too much acid. Have heard not to eat with AI. Hurricane took the tree down, no more temptation. I think everything in moderation is the way to go

exbrnxgrl

lilyishere,
As you can tell by my user name, I grew up in the Bronx. No one grew their own food for the most part. When I moved to CA , over 30 years ago, I was delighted by the prospect of growing food. When I lived in a larger home I had raised beds with automatic drip irrigation and grew all manner of edible things. I have grown peppers, tomatoes, and eggplant on my little patio but converted those beds to flowers a few years ago however my Meyer lemon is my great joy! My older dd recently moved to Napa and bought a property with fig, apple, and cherry trees on it. She moved from a home with grape vines, pomegranates, avocados, and apricots. Yes, our climate is great for growing so many things. Now, if we could only get more rain!

I think it would be an arduous and lengthy research project to test the effects of every food compound against every medication for every ailment. In lieu of that, we just have to go with what is known and weigh the risks. I can’t go much further than that because my personal goals and concern about QOL and overall happiness preclude restrictive food habits and worrying about every morsel I consume.

Again, I am not suggesting that what I have chosen is for everyone nor I am suggesting in the least that my laid back approach has contributed to my unusual longevity because no one knows why I’ve done well. It has worked for me and allowed me to go about my normal life for the most part and I am very comfortable with that. I am about to juice the rest of the pomegranates from my dd’s former home and will make pomegranate molasses with the juice. My kitchen will resemble a crime scene* afterwards but it will be wort it.

*Pomegranate juice gets everywhere!

Anonymous

I don't recall that any foods should be avoided for Tamoxifen or Exemestane.

Check with your pharmacist. They are the ones who told me to avoid grapefruit, Seville oranges, limes, and pomegranate before I started on Ibrance. I really only miss limes.

gb2115

I think everything in moderation applies here. The whole "dose is the poison" thing. I doubt an orange here or there is going to make or break treatment outcomes. Eating a variety of foods prevents problems from excessive consumption of any one thing.

exbrnxgrl

gb2115,

I completely agree! As I mentioned earlier, it seems very impractical for every drug that be take be tested for any component that may interact(negatively) with every disease out there. It would be super interesting if we could but I’m not seeing it right now.

Jewelweed

I don't think I'm "obsessing" over every morsel that goes into my mouth. If it turns out though that a certain food will likely render my AI less effective... well good heavens, of course I'm going to rethink that food. What is the whole point of taking AI? If I'm going to take this, I want the full effect.

And if a certain food turns out to be really really good for my bones (prunes! yay!), why wouldn't I add that to my diet? This is just common sense. Besides, Agen prunes are amazingly sweet and wonderful. they are permanently on the menu.

It sounds like the common experience is that oranges are not a problem, and for this I am relieved. Oranges are one of my happy foods. Thanks everyone!

Seriously though: if they came out with a scientific study that showed that eating hairy spiders would mean I'd never have cancer again, I'd be hatching tarantulas in my kitchen by tomorrow. Sigh. I mean that.

Anonymous

Jewelweed - You asked a valid question. There are some meds with real food contraindications. It's not being obsessed if you don't eat them. I'm following the guidelines on my med. Simple as that. I eat prunes almost everyday, but I'd need more studies to consider spiders. 😁

exbrnxgrl

If we put the tarantulas in capsules they would definitely be easier to swallow 😂

I think we all have our own comfort/risk level with eating or not eating certain things. I was essentially stage IV de novo so my horse was already out of the barn. I can’t say for certain but after 10 years on AI’s (yup, I’ve tried them all) I eat whatever I want and have remained NEAD since initial tx, so for me my diet appears not to have diminished the AI’s effectiveness. I realize that at stage IV it’s a bit different. I often think about a member, no longer active, who was incredibly upset because she ate 10 potato chips and was convinced that this would fuel a recurrence. That is an extreme example, of course, but you get my point.

Jewelweed

Oh man, I do get your point! And congrats btw on being cancer free!! That's awesome!

I'll find a way to get my magic spiders in capsules. I'll shoo them in there.....

Jewelweed

I'm hoping they don't take away my precious oranges though. Without them, I think I would have to crawl off to Gollum's cave....

Anonymous

I have heard that grapefruit increases absorption of some drugs - not cancer drugs - and that's the reason to abstain from them. But apparently, it can also decrease the availability of the drug in your body.

here’s something from the Mayo Clinic . Note, I see it only mentions grapefruit and Seville oranges - not all oranges I guess

https://www.mayoclinic.org/healthy-lifestyle/consumer-health/expert-answers/food-and-nutrition/faq-20057918

Sign me up for the tarantulas when we know whether or not they banish cancer fromthe body. I am extremely grossed out by insects but I could overcome i my fear in that case. 😉.

Anonymous

Grapefruit can affect cancer drugs. Says on my box of Ibrance to avoid grapefruit. I don't plan to eat any in moderation. Not worth it.

If taking any new medication, just ask the pharmacist if there are any food contraindications.

Anonymous

Serenity, I was not saying grapefruit can't or doesn't effect cancer drugs. Sorry if I was unclear - what I meant by my comment was that I had heard about grapefruit interacting with certain medications before I ever knew anything about cancer drugs.

And although Tamoxifen and other breast cancer drugs aren't mentioned in the Mayo Clinic article, I have seen grapefruit mentioned as having interactions with AIs and Tamoxifen.

Anonymous

Olma - Sorry, I misunderstood. Grapefruit does affect many meds. Bitter citrus fruits seem to have a similar effect.

I have asked my pharmacist when getting a new drug about any foods to avoid. They just looked it up for me.

Jewelweed

Luckily, I already gave up grapefruit when I went on Atorvastatin. That made a little sad, but I made up for it with a bonafide orange addiction. All oranges all the time! And kumquats! And yuzu!! Omg, yuzu.... Mmmmm mmmmm!

Jewelweed

I promise to be the one-stop for freeze-dried encapsuled tarantulas once they establish it as the miracle cure. :-)

exbrnxgrl

I’d like to pre-order some of those capsules please 😅!

Not to be a bummer, but stage IV is never really cancer free. Some go through periods of NEAD, no evidence of active disease, but that is often short lived. I am simply extremely lucky and considered an outlier.

Jewelweed

I wish I had a miracle. I would wrestle those spiders with my bare hands for you. Big hugs. I hope your luck is endless.