The perfect diet for cancer patients and healthy nutrition have always been a hotly debated, controversial topic.
The Perfect Diet for Cancer Patients and Survivors: Does it Exist?
Recently, researchers have drawn attention to the issue of obesity in cancer outcomes. Excessive weight increases your chances of developing cancer. Weight gain as a result of cancer treatment, or while being in survivorship, can increase your odds of developing new primary, or recurring tumors (Sierpina et al., 2015).
Obesity and the Tumor Microenvironment
Obesity affects healthy nutrition because of changes to insulin, energy, and fat metabolism. Cancer patients and survivors might struggle with altered taste sensations, mucositis, fatigue, and xerostomia (Sierpina et al., 2015).
The tumor microenvironment is getting attention these days. It was also briefly covered in our mindful eating article. Cancer researchers, rather than focusing exclusively on DNA damage as a primary cause of cancer, are focusing increasingly on the epigenome and epigenetics in oncology.
The epigenome responds to the environment. Thus, stress, behavior, toxins, nutrition and diet can regulate gene expression. Epigenetics’ premise is that most cancers are a result of a cells’ interaction with the environment (Baena Ruiz & Salinas Hernández, 2014; Sierpina et al., 2015).
Studying tumors epigenetically, researchers can now claim that only a small fraction of tumors are the result of inherited genetic mutations. Researchers believe that somewhere between 3% to 5% of cancers are a result of genetic factors. That leaves 95% to 97% of tumors’ development subject to cues from the environment. Out of those 95% to 97% of tumors, roughly a third (30% to 35%) are thought to be due to diet (Baena Ruiz & Salinas Hernández, 2014).
Based on this information, your body’s environment is thus a primary target for cancer therapies. Let me illustrate this point with an example.
Crosstalk Between Fat Cells and Tumor Cells
De novo fatty acid synthesis (for the purpose of this article – how fat cells nourish tumor growth) is just one example how the microenvironment can affect tumor growth.
Fat cells (adipocytes) support and promote rapid growth of tumor cells. Cross talk between tumor cells and fat cells initiates de novo fatty acid synthesis within the tumor microenvironment, which sets the stage for aggressive tumor growth (Kwan et al., 2014). For example
- In breast cancer, fat cells support invasion, proliferation, and tumor growth of breast cancer cells (Kwan et al., 2014).
- In colon cancer, fat cells may support proliferation of colon cancer cells (Kwan et al., 2014).
- In melanoma, fat cells can protect melanoma cells from DNA-damaging cancer drugs (Kwan et al., 2014).
- In prostate cancer, fat cells can promote androgen independent and androgen-dependent prostate cancer growth (Kwan et al., 2014).
While only a few, these examples illustrate the need to strive for, and support optimum body weight before, during and after cancer.
Formulating an ideal diet for cancer patients, and survivors present unique challenges. Optimum diet varies from client to client. Showing a person how important healthy eating for cancer patients is should be a top priority. Especially when you consider the role of poor lifestyle and how it factors in overall disease progression.
A sedentary lifestyle, poor diet, and obesity are correlated to negative survivorship outcomes. Sierpina and colleagues report on a sizable US prevention study connecting obesity to 20% of all cancer deaths in women. In men, 14% of all cancer deaths can be traced back to obesity (Sierpina et al., 2015).
Getting Help from an Expert in Nutrition
As your treatment nears completion, you need to think of weaning yourself off your health care team. You will find that you have to adopt a variety of self-care regimens. These self-care practices need to address diet, exercise, stress management and maintaining a healthy body weight. Making appropriate self-care a priority, while no guarantee, could prevent a recurrence of cancer, prevent new primary tumors, and prevent chronic disease (Sierpina et al., 2015).
However, while you are trying to become an informed health care consumer pertaining your unique survivorship needs, you may find yourself lost in obscure cancer information. Perhaps you feel overwhelmed by the overabundance of misinformation on diet and nutrition and the noise around the best cancer-fighting foods touted in mainstream media (Sierpina et al., 2015).
On a daily basis, you probably meet friends, relatives, total strangers, store clerks, and other self-appointed nutrition experts who want to counsel you on cancer-causing foods as well as foods that fight cancer. They’ll lecture you on the latest anti-cancer supplements that have the ability to melt tumors away almost overnight.
Before you heed the advice of well-meaning people in your life, ask yourself if they have a good grasp on the complexity of your situation. To start with, you need to account for your body’s altered metabolic needs. Most likely you also suffer from chronic conditions that go with your bout with cancer, such as diabetes, heart disease, etc. (Sierpina et al., 2015).
It quickly becomes clear that a person’s healthy nutrition needs are unique to them. The complexity of the situation requires a systematic approach to finding a workable solution(s) to meet your nutritional needs. Below is a general overview of what you can expect if you decide to enlist our help in integrating nutritional therapy for cancer.
Toward a Diet for Cancer Patients and Integrative Nutritional Approaches
First Appointment (ca. 1 hour to 1.5 hours)
We will take an extensive client history and assess your nutritional status. We’ll also weigh you, measure your waist circumference, hip circumference, and height. Those biometrics will allow us to assess Body Mass Index (BMI) and Waist to Hip Ratio (WHR). BMI and WHR will offer a starting point from which to move and to set realistic goals and to develop a healthy nutrition plan for you.
At the end of the first appointment, we’ll provide you with general guidance for healthy nutrition; nothing too specific yet.
Interlude: Developing a Diet for Cancer Patients and Our Approach to Integrative Cancer and Survivorship Care
Between the first and the second appointment, a comprehensive search of the literature will be undertaken to discern a best course of action based on your unique situation. If needed, experts in the field will be consulted as well.
A six-pronged approach we have picked up from Henry Dreher (2012), a former researcher at the Cancer Research Institute comes in handy here. In order to develop a diet for cancer patients and to tell clients about the importance of healthy nutrition, it is imperative that the diet and nutrition information be based on all facets of current and past treatment. This systematic approach will give some confidence that recommendations are based on good, evidence-based information.
While not addressed in great detail below, but subject of future articles, restoring your gut function will always be a top priority. Whenever possible, your gut microbiome needs to be made viable again to mediate optimum metabolism of nutrients that enter your stomach and to restore homeostasis to your immune system. Yes, a large part of a healthy immune system depends on the bacteria in your gut (Blaser, 2014).
A Systematic Search of the Literature Based on the PICO Model
Dreher (2012) provides a framework for what domains to include in a database search from an integrative perspective. However, we will use the PICO model to define exact goals of the search in terms of the specific problem our client presents with, to aid in finding clinically relevant evidence in the literature.
Search 1: Mainstream Cytotoxic Treatments
First we will undertake a database search to investigate mainstream cytotoxic (cancer killing) treatments. This search will give you a general idea of what to expect when just starting active treatment. This search will unearth the latest surgical options, chemo, and radiation options, we’ll look for clinical trials that might be accessible to you as well. You will also get a pretty good idea of potential treatment side effects that may be of concern to you.
Search 2: Alternative Cytotoxic Treatments
This search will focus on latest cutting-edge or experimental oncology pertaining to
- Pharmaceuticals that may be considered alternative,
- Alternative Immune therapies
- Immunoaugmentation Therapy
Search 3: Integrative Cancer Strategies with Reported Cytotoxicity
This database search may produce a list of herbs, vitamins, nutrients and phytotherapy with reported cytotoxic actions in humans.
Search 4: Complementary Drugs
This database search will involve a search for “Off-label” drugs that have anti-tumor, anti-angiogenic or other relevant biologic activities.
Search 5: Integrative Host Defense Builders
This search will focus on nutrients and botanicals that boost efficacy of mainstream therapies and cut toxicity. The results could include immune-enhancing diets and supplements, anti-angiogenic as well as anti-inflammatory nutrients and herbs.
Search 6: Integrative Mind-Body Medicine Stress Management and Host Defense Builders
Integrative medicine would not be complete if it didn’t address the potential psychosocial issues you are dealing with and experiencing.
ACEF offers instructions in mind-body medicine for which there is quality scientific evidence of safety and efficacy to cancer survivors and caregivers. Cancer survivors and caregivers who seek our services are empowered to integrate mind-body medicine modalities safely into cancer survivorship.
Second Appointment: Addressing the Big Picture (ca. 1 hour)
Once the database search is complete, a report will be compiled. The recommendations are personalized just for you and your unique needs. This report will also include a list of citations (if applicable) that you need to share with your oncologist. That way he/she can discuss with you an acceptable course of action and make the proper decisions for your care.
If you are no longer in treatment, it is still recommended that you check in with your healthcare team to let them know that you have taken an active role to reclaim your health and wellness.
We will sieve through this document together to make sure you understand everything contained in the report.
A diet for cancer patients and a healthy nutrition plan for cancer survivors needs to discuss and optimize caloric intake and macro- and micronutrient absorption.
Your care should focus on a therapeutic nutritional approach that is tailored to your unique needs. Healthy nutrition needs to take into account potential anti-angiogenic and anti-inflammatory nutrients, herbs and phytochemicals to ensure long time survivorship without the development of new, primary or secondary tumors. A diet for cancer patients needs to be designed to take into account chronic, comorbid conditions also.
Integrating mind-body medicine can act as a host defense builder, by addressing survivorship issues and excessive stress. Managing stress through mind-body medicine is another approach to successfully managing your survivorship care and to optimize the goals of your treatment outcome (Sierpina et al., 2015).
Your clinical team has the very complex task of developing pharmaceutical, dietary and exercise strategies during treatment and survivorship. Your team aims to maximize the effects and potency of treatment. That is why your oncologist must know of any potential factors that may affect your treatment in a positive or negative way.
We believe that this systematic approach to your health and wellness can give many answers you yearn for, but are unable to find on your own. Could you benefit from such a comprehensive approach to health and wellness in cancer survivorship?
If so, consider making an appointment today to get some clarity on what else you can do for best possible survivorship outcomes.
Side Note: This systematic approach is applicable for just about any chronic condition that you might find yourself entangled with, not just cancer.
Baena Ruiz, R., & Salinas Hernández, P. (2014). Diet and cancer: Risk factors and epidemiological evidence. Maturitas, 77(3), 202–208. doi:10.1016/j.maturitas.2013.11.010
Blaser, M. J. (2014). The microbiome revolution. Journal of Clinical Investigation, 124(10), 4162–4165. doi:10.1172/JCI78366
Dreher, H. (2012, October). Fundamentals of Integrative Care. PowerPoint Presentation presented at the Cancer Guides, OMEGA Institute.
Kwan, H. Y., Chao, X., Su, T., Fu, X.-Q., Liu, B., Tse, A. K. W., … Yu, Z.-L. (2014). Dietary lipids and adipocytes: Potential therapeutic targets in cancers. The Journal of Nutritional Biochemistry. doi:10.1016/j.jnutbio.2014.11.001
Sierpina, V., Levine, L., McKee, J., Campbell, C., Lian, S., & Frenkel, M. (2015). Nutrition, Metabolism, and Integrative Approaches in Cancer Survivors. Seminars in Oncology Nursing, 31(1), 42–52. doi:10.1016/j.soncn.2014.11.005