Nutrition in Cancer Support

Most of have been touch by cancer in our lives. Whether it is a mother, daughter, cousin or friend, at some point we will all have a loved one diagnosed with cancer. According the the National Cancer Institute, it was estimated that 1,735,350 new cases of cancer were diagnosed in 2018. The most commonly diagnosed cancers in the United States are breast cancer, lung and bronchus cancer, prostate cancer, colon and rectum cancer, melanoma of the skin, bladder cancer, non-Hodgkin lymphoma, kidney and renal pelvis cancer, endometrial cancer, leukemia, pancreatic cancer, thyroid cancer, and liver cancer. Approximately 38% of Americans will be diagnosed with cancer in their lifetimes. 

Nutrition in the treatment and prevention of cancer is important to better outcome success. Nutritional dysfunction can be caused by the disease, or be related to previous health issues and lifestyle, or be a complication of chemotherapy and other drug use in treatment. In either case, proper nutrition is paramount in treatment and prevention of relapse.

Malnutrition in the US

A preexisting nutritional deficiency is not unlikely when working with cancer support. In the United States, the rate of nutritional deficiencies has, surprisings, gone up in decades. 

• >80% of American do not consume the RDA for Vegetables
• >70% of Americans do not consume the RDA for Fruits
• >60% of Americans do not consume the RDA for Healthy Fats
• >60% of American consume an excess amount of Sugar
• >60% of American consume an excess of Saturated Fats
• >80% of American consume an excess of Processed Sodium

Antioxidants help to fight free radicals in the body and prevent oxidative stress. For more on Oxidative Stress, please read my article by clicking here. Oxidative stress activates inflammatory pathways leading to transformation of a normal cell to tumor cell. Most dietary antioxidants are found in fruits and vegetables, and more than 80% of us are not consuming enough. 

In addition, the excess sugar in the American diet can fuel cancer growth. Long term abuse of dietary sugar causes insulin resistance and diabetes. Cancer risks increase when a person is diabetes or insulin resistant. 

If the typical American is not consume adequate amounts of fruits and vegetables, and an excess of foods that increase oxidative stress, such as sugar and certain saturated fats, their risk of cancer development is greater. 

One study looked at the prevalence of malnourished of cancer patients prior to chemotherapy treatment, at the first oncology visit. Of the patients enrolled in the study, 51% had nutritional impairment, 9% were overtly malnourished, and 43% were borderline malnourished. Severeity of malnutrition was directly related with the stage of cancer.  

If left unchanged, these dietary patterns not only increase the risk of cancer, but the risk of relapse as well as a decrease in treatment success.

Nutrition During Treatment

Most cancer treatment is a combination of surgery, chemotherapy, and radiation. The type of treatment used depends on the type and severity of the cancer. Chemotherapy is one of the most commonly used treatment methods for cancer. It can be highly effective, but has several side effects, and is associated with nutritional deficiencies. Deficiencies of vitamin D, vitamins B1, B2, and K and of niacin, folic acid, and thymine also may result from chemotherapy. If a patient's diet was inadequate prior to the start of treatment, these deficiencies can be worsened throughout the course of treatment leading to more side effects and possibly less effective treatment.

​Certain vitamins can actually make chemotherapy treatments work more efficiently as well. Vitamin D, for example, has been shown to increase the effects of the chemotherapy drug paclitaxel. The vitamin D hormone, yes it is a hormone, elicits anti-tumor effects mainly through the induction of cancer cell apoptosis, cell cycle arrest, differentiation, angiogenesis and the inhibition of cell evasiveness by a number of mechanisms. 

Other vitamins help to alleviate chemotherapy side effects. Vitamin E, for example, is a well known antioxidant that has been studied for its ability to alleviate chemotherapy side effects without interfering with the drugs function.

Sometimes the deficiencies caused by the chemotherapy, such as the deficiencies in B vitamins, can be part of the cause of the side effects. B vitamin deficiencies, specifically B6 and B12, are common with chemotherapy treatment, as well as the progression of neuropathy. Treatment of B vitamin deficiency, and anemia, in chemotherapy patients reduces the neuropathy symptoms. 

Diet & Nutrition to Prevent Relapse

 Every day, each of us as a level of mutated cells in our body that is considered normal. Whether these cells become neutralized and removed by the immune system, or become cancer cells depends on a large array of factors; lifestyle, stress, environmental exposure, and diet all play a role in the development of cancer. The American Cancer Society states that diets high in fruits and vegetables help prevent cancer, but it is bigger than just eating your veggies. 

The European Prospective Investigation into Cancer and Nutrition (EPIC) study, is to date, the largest study conducted on the affects of nutrition on cancer prevention. It was designed to address a combination of diet, nutritional status, lifestyle, and environmental factors to the incidence of cancer. In this study, the found a higher correlation with diets high in red meat and low in vegetables with an overall increased risk of cancer. Diets higher in vegetables and fish intake had an overall decreased risk of cancer. Why? Well nutrition, and nutritional deficiencies. 

The standard American diet, which tends towards High red meat and saturated fat, and Low fruits and vegetables is very nutrient poor. Which is why we see a surprising amount of nutritional deficiencies.

• ​​>90% of Adults over the age of 19 are deficient in Vitamin D
• >90% of Adults over the age of 19 are deficient in Vitamin E
• >60% of Adults over the age of 19 are deficient in Magnesium
• >50% of Adults over the age of 19 are deficient in Vitamin A
• >50% of Adults over the age of 19 are deficient in Calcium
• >40% of Adults over the age of 19 are deficient in Vitamin C

Many of these nutritional deficiencies are associated with a higher cancer risk, and increased relapse.
**Dietary intake information originally derived from the National Health and Nutrition Examination Survey (NHANES). 

If you, or someone you know, is looking for help in diet modification and education in the support of cancer, give my office a call. 

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My Sources

1. U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015–2020 Dietary
   Guidelines for Americans. 8th Edition. December 2015. Available at http://health.gov/dietaryguidelines/2015/guidelines/. 
2. ​Reuter S, Gupta SC, Chaturvedi MM, Aggarwal BB. Oxidative stress, inflammation, and cancer: how are they linked?. Free Radic Biol Med. 2010;49(11):1603–1616. doi:10.1016/j.freeradbiomed.2010.09.006
3. Muscaritoli M, Lucia S, Farcomeni A, et al. Prevalence of malnutrition in patients at first medical oncology visit: the PreMiO study. Oncotarget. 2017;8(45):79884–79896. Published 2017 Aug 10. doi:10.18632/oncotarget.20168
   
4. Dreizen S, McDredie KD, Keating MJ, Andersson BA. Nutritional Deficiencies in patients receiving cancer chemotherapy. Postgrad Med. 1990 Jan;87(1)163-7, 170. DOI:10.1080/00325481.1990.11704531
5. ​Yingyu Ma, Trump D, Johnson C. Vitamin D in combination with cancer treatment. Journal of Cancer. 2010 1:101-107.
6. Bhori M. Singh K. Exploring the effect of vitamin E in cancer chemotherapy—A biochemical and biophysical insight. Journal of Biophotonics. 2018 May, 16 https://doi.org/10.1002/jbio.201800104
7. Schloss J, Colosimo M. B Vitamin complex and chemotherapy induced peripheral neuropathy. Curr Oncol Rep. 2017 Oct 5;19(12):76. doi: 10.1007/s11912-017-0636-z.
8. World Health Organization Epic Study - https://epic.iarc.fr/highlights/highlights.php
9. National Institutes of Health Office of Dietary Supplements http://ods.od.nih.gov/factsheets/list-all/