Diet and Tetrathiomolybdate

If you are undergoing treatment for cancer, your health care team will advise you about general dietary recommendations that are helpful. This may include instructions such as avoiding citrus food;spicy, acidic, or very hot food; salty items; alcohol;and tobacco.In addition to this, you may need totake some additional dietary precautions if you are taking Tetrathiomolybdate(TM) as part of y our cancer treatment.

Food and Tetrathiomolybdate (TM)

If you are taking a drug called Tetrathiomolybdate, which also is referred to as TM, your doctor may ask you to follow a low copper diet. Copper is a mineral that occurs naturally in many of the foods we eat. Copper can affect how TM, a cancer treatment medication, works in your body. If you have been told to follow a lowcopper diet, please keep the following in mind.

Following A Low Copper Diet

Some cancer treatments require that you avoid food that contains a lot of copper. The most common cancer medication that requires a lowcopper diet is called Tetrathiomolybdate or TM. If you are taking TM, you will need to follow a lowcopper diet to help your medication work properly.Your doctor can give you more information on howTM works and why you will be taking it.

Food to Avoid

Below is a list of food that contains large amounts of copper.Avoid these food items if you are taking TM.

HIGHCOPPER FOODS

• Organ meat, especially liver
• Sausage, hotdogs, bratwurst, and other smoked, processed, and mixedmeats
  Shellfish (oysters, shrimp, clams, scallops, crab, lobster, crawfish, prawns)
  Starchy beans (legumes)such as black-eyed peas, kidney beans, navy beans, lentils, chickpeas, great northern beans, white beans, soybeans and soybean products such as tofu, tempeh, andsoy milk
• Nuts & seeds
• Mushrooms
• Cocoa powder (a small amount of chocolate in candyand chocolate milk are ok)
  The "germ" of grain products, such aswheat germ
  The "bran" of grain products, such as what is found in high fiber, bran cereals

Dietary Supplements, Vitamins, Minerals, and Herbs

• Do notuse supplements, such as multivitamins, that contain copper. Most multivitaminand mineral supplements contain some copper. Even if the label does notsay so, these products can contain copper.
• Dotake any herbs or other "natural products". Even if the label does not say so, these products can contain copper.

Liquid Nutritional Supplements

• Nutritional supplements such as Ensure and Boost do contain copper. If you need to use these products, please discuss it with your doctor,nurse,or dietitian first.
• It is ok to adda can of Ensure or Boost to your diet. If you want or need to use more of these products, please talk to your doctor, nurse,or dietitian.
• If you aregetting your nutrition through a tube (tube feedingor enteral nutrition)your doctor canwork with you to adjust your medication to account for the copper contained in your tube feeding formula.