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The Role of Nutrition in Cancer Treatment and Management

Posted by James on 08/18/2018 | Comment

One in three women, and one in two men will develop cancer during their lifetime (1)

In 2018, an estimated 1.7 million new cases of cancer will be diagnosed in the United States (2).

25% of American deaths are due to cancer, making it the 2nd most common cause of death (1).

Cancer, by definition, is a disease of pathological hyperplasia, or uncontrolled cell growth in its extreme form, which created masses of tumors hat invades organs and destroys normal tissues (1)

Why is there a greater prevalence of cancer today compared to a century ago (1)?

  • Cancer is an age-related disease. With people living longer, there is a greater risk of developing cancer and other age-related diseases. For example, the risk of breast cancer is about 1 in 400 for a 30-year-old woman and increases to 1 in 9 for a 70-year-old.
  • Longevity is the most important contributor to the prevalence of cancer in the early 20th century. Today, life expectancy is 78 years old, which is 31 years more than what it was in 1900. Contributing factors to increased life expectancy include better hygiene, introduction of modern refrigeration, pharmaceutical discoveries, such as penicillin, antibiotics and anti-polio, and the opening of many hospitals. Previously, the most common cause of death was tuberculosis, then pneumonia, diarrhea and gastroenteritis, with cancer being the 7th most common cause of death. Now, as previously mentioned, cancer is the 2nd most common cause of death.
  • Our capacity to detect cancer earlier and earlier, and our ability to attribute deaths to cancer accurately, has also dramatically increased in the last century.
  • Changes in the structure of modern life have radically shifted the spectrum of cancers by increasing the incidence of some, decreasing the incidence of others.


Primary Care Prevention (3)

  • Achieve and maintain a healthy weight
  • Be physically active
  • Eat a healthy, primarily plant-based diet
  • Limit your intake of alcohol


What enables cancer cells to survive and to be so deadly (1)?

Cancer cells…

  • Acquire an autonomous drive to multiply
  • Inactivate tumor suppressor genes, that normally inhibit growth
  • Suppress and inactivate genes and pathways that normally enable cells to die
  • Have a limitless replicative potential
  • Acquire the capacity to draw out their own supply of blood
  • Acquire the capacity to migrate to other organs, invade other tissues, and colonize these organs, resulting in their spread throughout the body


Cancer Therapies (3)

Cancer therapies include surgery, chemotherapy, radiation therapy, endocrine therapies, and immunotherapies. There are also diet therapies, such as the ketogenic and macrobiotic diet, and noninvasive integrative medicine practices, such as massage therapy, aromatherapy, and movement therapies.

Surgery (1)

Surgery effects the body through metabolic and physiologic changes, having the most profound mechanical effect on the alimentary canal. Gastrointestinal cancers often result in profound changes in food intake, digestion and tolerance. With that being said, dietary supplementation may be necessary to achieve proper nutrient needs.

Chemotherapy (1)

Chemotherapy is a common form of cancer treatment, which utilizes drugs to destroy cancer cells. It is often used, either alone or with surgery or radiation therapy, to treat cancer that has spread or recurred, or when there is a strong chance that it could recur.

Chemotherapy drugs are most effective when given in combination. The rationale for combination chemotherapy is to use drugs that work by different mechanisms, thereby decreasing the likelihood that resistant cancer cells will develop. When drugs with different effects are combined, each drug can be used at its optimal dose, without intolerable side effects.

Factors to consider when choosing which drugs to use include the type and stage of the cancer, as well as the age and overall health of the patient.

Radiation (1)

Radiation therapy is “the use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors,” (4). Radiation therapy is typically given for 10 minutes, 5 days per week, for 2-8 weeks.

Select Steroid and Endocrine Therapies

Steroid therapy is a type of cancer “treatment with corticosteroid drugs to reduce swelling, pain, and other symptoms of inflammation,” while endocrine therapy is a type of cancer “treatment that adds, blocks, or removes hormones,” (4).

Immunotherapies (1)

Immunotherapy is a type of cancer treatment designed to boost the body’s natural defenses to fight cancer. Specifically, it uses substances to improve or restore immune system function.

Survivorship (3)

Over 14 million in US, or roughly 1:4 Americans survive from cancer

Nutrition Objectives for Cancer Management (3)

  1. Overcome side effects of treatment
  2. Prevent detrimental weight loss or weight gain
  3. Correct existing weight loss and malnutrition
  4. Provide appropriate macro-micronutrient needs
  5. Palliation* and enhancement of Quality of Life (QOL)


*Palliative care is to improve quality of life by reducing tumor burden and relieving cancer-related symptoms (1)


Macronutrient Needs (3)

Evidence-Based Benefits of Micronutrients

Vitamin D

A prospective study found high doses of vitamin D supplementation to restore 25-(OH)-vitamin D and iPTH values, which are frequently disturbed after gastric cancer resection (5).

Long Chain & Omega-3 Fatty Acids

Cancer often induces cachexia, which refers to a progressive loss of body fat and lean body mass, accompanied by profound weakness, anorexia, and anemia. However, omega-3 fatty acid supplementation has been shown to improve cancer cachexia by increasing skeletal muscle mass in bile duct or pancreatic cancer patients undergoing chemotherapy (6).

Additional Resources

National Cancer Institute (www.cancer.gov)

American Cancer Society (www.cancer.org)

American Institute for Cancer Research (www.aicr.org)

The Academy of Nutrition and Dietetics (www.eatrightpro.org)


(1) Mukherjee S. The emperor of all maladies: A biography of cancer. New York, NY: Scribner; 2011.

(2) Cancer Statistics. National Cancer Institute Web site. https://www.cancer.gov/about-cancer/understanding/statistics Updated April 27, 2018. Accessed August 15, 2018.

(3) Hamilton KK. Prevention and Medical Nutrition Therapy in Cancer Care. 2017 [PowerPoint].

(4) NCI Dictionary of Cancer Terms. National Cancer Institute Web site. https://www.cancer.gov/publications/dictionaries/cancer-terms. Accessed August 15, 2018.

(5) Climent M, Pera M, Aymar I, Ramón JM, Grande L, Nogués X. Bone Health in Long-Term Gastric Cancer Survivors: A Prospective Study of High-Dose Vitamin D Supplementation Using an Easy Administration Scheme. Journal of Bone and Mineral Metabolism. 2018; 36(4):462–69.

(6) Kyohei A, Uwagawa T, Haruki K, Takano Y, Onda S, Sakamoto T, Gocho T, Yanaga K. Effects of ω-3 Fatty Acid Supplementation in Patients with Bile Duct or Pancreatic Cancer Undergoing Chemotherapy. Anticancer Research. 2018; 38(4):2369–75.


Written by Nicole Lindel, MS in Nutrition Education from Columbia University