Voices: ‘Is my chemotherapy vegan?’

‘Is my chemotherapy vegan?’ | B.J. Rimel, MD

BJ Rimel_headshot 2“Is my chemotherapy vegan?”

Despite my 12 years of post-graduate training, I was completely floored by this question.  To be honest, my initial response was not what it could have been.

“I have no earthly idea,” I said, in my best doctor voice.  I left the clinic feeling completely incredulous that anyone with a life-threatening cancer would care if their chemo was in any way associated with animal products.  As a new attending, I initially felt righteous that I had not given in to a long discussion about non-evidence based treatments, and instead steered our conversation back to symptom management, dosing schedule and a review of the side effects she was likely to experience.

My patient left the clinic and decided not to return to me for care.  When I heard she had transferred her care to another physician I felt that there was probably something important I could learn from this experience. So, I did a bit of reading.  As it turns out, there are lots of reasons to ask about vegan products and not all of them are grounded in nuts and berries.

The term vegan was first coined in 1944 by Donald Watson.  The main tenant of the diet is the complete avoidance of animal products.  Followers of the vegan diet eat no meat, no fish, no dairy, no eggs, no honey and no products that are processed with the use of an animal product.  However, for some veganism is also a lifestyle choice, and the avoidance of eating, wearing or using animal products is a manifestation of the goal of non-violence.  This principle is called ahimsa in Sanskrit and the word literally means “to do no harm.”

“Do no harm” sounded eerily familiar to me.  I clearly remember sitting in Duke Chapel listening to the dean recite the Hippocratic Oath on a very humid day in 2003.  Reflecting on that experience, I would change how I responded to this patient.  I should have asked why it was important to her.  Maybe it would not have made any difference.  Perhaps she was only asking because she thought that a vegan diet would cure her cancer, but perhaps we would have found some common ground in our lifestyle choices to “do no harm.”