The Women's Healthy Eating and Living (WHEL) trial, was based on the premise that plant-derived foods contain anti-cancer chemicals.

The programme consists of telephone counseling, cooking classes and newsletters that promote the daily intake of 5 vegetable servings plus 16 ounces of vegetable juice; 3 fruit servings; 30 grams of fiber; and 15 to 20 percent off calories from fat.

Dr. John P. Pierce and his colleagues designed the diet and from the period between 1995 and 2000, they enrolled more than 3,000 women for a trial who were previously treated for breast cancer and then monitored them until 2006.

The women were randomly assigned to either the diet intervention group or a comparison group and the researchers found the special diet did not prevent breast cancer from returning and it did not improve survival.

Approximately 17 percent of patients in each group saw the return of their cancer and about 10 percent in each group died during follow-up.

It appears that though a healthy diet and regular exercise may give breast cancer survivors an extra boost, eating more than the daily recommended intake of five fruits and vegetables did not provide any added benefit.

The cost of new targeted cancer therapies , which can be as high as $10,000 per month , has generated substantial discussion and debate. "The economic implications of this food effect study are particularly remarkable. At the current price of $2,900 per month, this would have a cost savings of 60 percent or $1,740 per month, the commentary states. "As we enter an era of ,targeted, anticancer agents with a monthly cost measured in the thousands of dollars, we should view drug-drug or drug-food interactions as opportunities to lower costs."

The commentary states that rising cancer drug prices are encouraging researchers to explore such pharmacologic approaches to lowering costs. However, the authors urge that neither physicians nor patients consider changing lapatinib dose based on these findings, and that everyone strictly follow the prescribing label directions, which are based on the findings of rigorous clinical tests. The authors strongly emphasize that a formal pharmacokinetic study of a lower dose of lapatinib with food would need to confirm these findings before any change in dosage could be considered safe and effective.

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