For any cancer patient, a healthy and balanced diet makes particularly good sense, but for a neuroendocrine cancer patient, maintaining a healthy diet can be difficult especially if symptoms affect the digestive system. Depending on the type of neuroendocrine cancer, some patients will experience carcinoid syndrome, which is a group of symptoms (such as diarrhea, facial flushing, abdominal pain, gas/bloating, weight loss, skin rash, fatigue and nausea) that occurs when a functional neuroendocrine tumor overproduces hormone-like agents (such as histamine, serotonin, and prostaglandins).  Not all neuroendocrine cancer patients will experience carcinoid symptoms, but dietary modification may be helpful if symptoms are present. The most reliable way to identify triggers for symptoms is by keeping a food/drink and symptom diary for two weeks. 

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Many patients report a decrease in carcinoid syndrome symptoms by:

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A.  Reducing portion sizes

B.  Eating four-six smaller meals ("grazing") instead of three large meals.

C.  Reducing fat intake.  

D. Selecting foods low in amines including:

 

• Fresh lean meats, fresh poultry, fresh fish

• Most vegetables – cooked may be better tolerated than raw

• Fruits in moderate amounts – except bananas, avocados, and raspberries

• Grain foods, starchy foods – lower fiber or soft cooked grains may be tolerated the best

• Fresh cheeses and dairy – low-fat cottage cheese, ricotta cheese, mozzarella cheese, low-fat yogurt or kefir, low-fat cream cheese, low-fat milk or low-fat lactose-free milk

• Fresh soy foods – soy milk, edamame

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E. Eliminating or limiting the following foods:

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• Foods and substances with high levels of amines, nitrogen-containing organic compounds, or adrenaline-like substances including:

  • Fatty meats

  • Smoked, salted or pickled fish or meat (herring, salami, sausage, corned beef, bologna, pepperoni)

  • Pate

  • Aged cheeses (cheddar, Camembert, Stilton)

  • Red wine

  • Alcoholic beverages

  • Yeast extracts and Brewer’s yeast, hydrolyzed proteins

  • Broad beans

  • Sauerkraut

  • Shrimp paste

  • Some soybean products, miso soup, soy sauce, tofu

  • Limit: 

    • Chocolate 

    • Caffeine containing drinks, coffee (in large amounts), soda

    • Some nuts (peanuts, coconuts, brazil nuts)

    • Some pizzas

    • Raspberries

    • Bananas

    • Avocados

• Foods with high serotonin levels 

  • Eggs

  • Cheese

  • Pineapple

  • Nuts such as walnuts and pecans

  • Bananas and plantains

  • Tomatoes

  • Kiwi 

  • Plums

  • Limit: 

    • Avocados  

    • Dates                           

    • Grapefruit               

    • Cantaloupes             

    • Honeydew Melons             

    • Olives                         

    • Eggplant                  

    • Certain nuts (Brazil nuts, filberts, almonds, cashews, macadamia nuts)

    • Coconut

• Spicy foods

• Fructose

 

Everyone is unique and some patients may be able to tolerate nearly all or very few of the trigger foods. 

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