Nutrition Critical to Cancer Treatment

While diet and nutrition has maintained an untouchable status among cancer treatment, new research is finding that a cancer patient’s choice of diet is critical to their chances of survival.

Cancer and nutrition

Researchers from Philadelphia’s Thomas Jefferson University have confirmed that diet and nutrition choices are critical in cancer treatment.

The researchers investigated the use of nutrition and diet during cancer treatment – not as a primary treatment, but as supportive treatment – also called “palliative cancer care.”

Utilizing decades of research that have shown that particular types of diets and foods help prevent cancer, the researchers determined that there are several topics of concern when considering diet during cancer treatment:

• Eliminating foods linked to increasing cancer reccurrence
• Eliminating those diets associated with increased cancer risk
• Reducing inflammation, insulin resistance, and oxidative stress
• Making sure the diet provided enough calories for energy consumption
• Making sure the diet contains nutrients that have been lined to preventing cancer

While palliative care in cancer is often associated improving quality of life and reducing pain, increasingly research is finding that ones dietary choices play a significant role in not only the contraction of cancer, but in the determination of whether cancer goes into remission.

Ensuring enough calories yet preventing problems with glucose control – which encourages metastasis – comes with new research that glucose control is related specifically to whether the carbohydrates in the diet come in the form of whole foods or refined, processed carbohydrates, according to the researchers:

“… and such an approach may not only satisfy caloric requirements but also positively impact secondary problems related to sugar consumption, insulin resistance, inflammation, and others …”

What diets are best for cancer patients?

This has been summarized from the American Cancer Society’s guidelines regarding diet:

“choosing whole grains instead of refined grain products”

The researchers also investigated the role of red meat and processed meats in cancer care. They reviewed the research which has linked these foods with cancer, and found that prevailing cancer care advice has advised patients to lower red meat and processed meat intake, as recommended by the American Cancer Society:

“limiting the amount of processed and red meat eaten”

The researchers also acknowledged the research associated with reduced cancer and remission risk with greater consumption of fruits and vegetables, and again this has been recommended by the ACS:

“eating at least two and a half cups of vegetables and fruits each day”

The researchers also found that increased consumption of refined carbohydrates, and refined fructose (such as high-fructose corn syrup). The research suggests that refined carbs “has been associated with cancer in general” and refined fructose has been linked with greater obesity – which they and most other clinicians discourage in cancer care.

The issue of weight control is important in cancer care, because, as stated by the researchers:

“However, many patients are overweight at the time of diagnosis or become so after treatment.”

They also acknowledged that:

“Women diagnosed with early-stage breast cancer might improve overall prognosis and survival by adopting more healthful dietary patterns.”

With regard to certain diets, the researchers stated that:

“Red and processed meat consumption has consistently gained a reputation as a contributor to disease, including cancer. Data is emerging that red and processed meats may influence disease recurrence and mortality as well, for example, for colorectal cancer survivors. Evidence shows that consumption of red meat can activate cancer genes in the colon such as the MDM2 and ubiquitin genes as well as the WNT gene signaling pathway which is involved in epithelial proliferation and differentiation. Such genetic modulation can facilitate cellular progression to colon cancer.”

The research has also supported the implementation of healthy lifestyles:

“Prospective observational studies have shown that increased exercise after diagnosis and avoidance of a Western pattern diet (high intake of red and processed meats and refined grains) are associated with a reduced risk of cancer recurrence and improved overall survival in early-stage colorectal cancer after standard therapy.”

The researchers also clarified that red meat stimulates inflammation and cancer. Here is their statement:

“The data also suggests that red meat, in particular, is pro-inflammatory and procarcinogenic. For example, the European Prospective Investigation into Cancer and Nutrition-Potsdam study of 2,198 men and women found that the consumption of red meat was significantly associated with higher levels of the inflammatory markers GGT and hs-CRP when adjusted for potential confounding factors related to lifestyle and diet. Another study showed that when people were given a 7-day dietary red meat intervention, fecal water genotoxicity significantly increased in response to the red meat intake. These effects included modifications in DNA damage repair, the cell cycle, and apoptosis pathways.”

Noting the data, the researchers made a direct recommendation:

“Thus, red meat should be minimized or eliminated from the diet of palliative care patients.”

The researchers also linked red meat intake with bladder cancer and bladder cancer survivorship.

Evidence shows diets increase survival rates

The researchers recommendations were confirmed by a study of breast cancer survivors from the Life After Cancer Epidemiology Study. Here 1,901 patients who were diagnosed with early stage breast cancer were followed. Two eating patterns were found among the patients: One had increased consumption of fruits, vegetables, whole grains, and poultry (called the “Prudent pattern”). The other, called the “Western pattern – increased consumption of red and processed meats with refined grains.

The researchers found that those who adhered the closest with the “Prudent pattern” had lower rates of death from breast cancer or any other cause. Meanwhile those in the “Western pattern” suffered higher incidence of recurrent breast cancers, greater incidence of death from their breast cancer, and increased risk of death from any cause.

The researchers summarized their findings:

“Overall, the cumulative data suggests that refined carbohydrate and red meat consumption should be avoided or significantly reduced in the diet of patients with cancer as there are many other healthier sources of caloric intake. Achievement and maintenance of a healthy body composition via a plant-based diet high in fruits, vegetables, and whole grains and low in saturated fats and red or processed meats should be the guidelines imparted to patients from their health care providers.”

Diets that reduce inflammation and oxidative stress

The researchers also investigated dietary choices that reduced inflammation in the body, and minimized free radicals – referred to as oxidative stress – stating:

“The literature indeed shows more studies exploring the link between cancer and inflammation. Inflammation itself is associated with high levels of oxidative stress that can damage most of the body’s tissues and genetic material which ultimately can lead to cancer formation.”

The researchers then investigated different diets found in the research to be anti-inflammatory, particular Ayurvedic diet:

“Ancient cultures also developed and used anti-inflammatory diets, such as in Ayurvedic (a system of traditional medicine native to the Indian subcontinent that stresses plant based treatment), which are now investigated using modern criteria.”

A study supporting this in 2012 investigated the use of the Ayurvedic diet in cancer therapy. The research, from the Indian Institute of Technology of Madras, found that Ayurvedic diets offered several avenues for reducing inflammation and halting the “Shared Pathology” between cancer and pro-inflammatory diets.

Anti-inflammatory components of the Ayurvedic diet highlighted included triterpenes, which included betulinic acid, boswellic acid, diosgenin, madecassic acid, maslinic acid, momordin, saikosaponins, ursolic acid, and withanolide. These of course are derived from some of the herbs and spices found among Ayurvedic diets, including turmeric, ginger, boswellia and ginseng.

Other areas of interest in palliative cancer treatment that were highlighted by the researchers included vitamin D, probiotics and prebiotics, multivitamins and antioxidants including polyphenols and others.

REFERENCES:

Anthony J. Bazzan, Andrew B. Newberg, William C. Cho, and Daniel A. Monti, “Diet and Nutrition in Cancer Survivorship and Palliative Care,” Evidence-Based Complementary and Alternative Medicine, vol. 2013, Article ID 917647, 12 pages, 2013. doi:10.1155/2013/917647.

Kwan ML, Weltzien E, Kushi LH, Castillo A, Slattery ML, Caan BJ. Dietary patterns and breast cancer recurrence and survival among women with early-stage breast cancer. J Clin Oncol. 2009 Feb 20;27(6):919-26. doi:10.1200/JCO.2008.19.4035.

Venil N. Sumantran and Girish Tillu, “Cancer, Inflammation, and Insights from Ayurveda,” Evidence-Based Complementary and Alternative Medicine, vol. 2012, Article ID 306346, 11 pages, 2012. doi:10.1155/2012/306346.