More than 10 million persons in the United States are cancer survivors, and 65% of Americans diagnosed with cancer now live more than 5 years with a need for informed recommendations on nutrition and lifestyle, and yet the advice given by healthcare professionals is often conflicting. During diagnosis and treatment anorexia, early feelings of fullness, taste, smell, and gastrointestinal tract disturbances are common; and malnutrition and weight loss occur in more than 50% of the patients. After treatment, nutrition/exercise issues are still important in either preventing recurrence or improving a person's immune system.
The American Cancer Society recently updated previous guidelines on nutrition and exercise. These actions are summarized below:
Exercise:
• Evidence exists that moderate aerobic exercise decreases the risk of breast
and colon cancer.
• Obesity seems to play a role in some cancers; therefore, exercise may help
to maintain a normal body mass index
• Limited exercise may be beneficial to quality of life issues while undergoing
either chemotherapy or radiotherapy
• Patients who are immune compromised should avoid public gyms
• Chlorinated swimming pools should be avoided in patients undergoing
radiation therapy
• Exercise is safe, and may improve the quality of life. Depending upon the
type of cancer and/or treatment, patients should be careful about balance
issues to prevent falls.
Nutrition:
• More frequent meals and intake of nutrient-dense foods (either made or
bought) may increase caloric intake. Short term enteral or intervenous
feeding may help; although total parenteral nutrition is not encouraged.
• A low fat diet can improve survival for patients with breast and prostate
cancer. Avoidance of trans and saturated fats is encouraged.
• At least 5 servings of colorful fruits and vegetables are recommended daily
and considered protective for cancers which lie at a portal of entry (i.e. lung,
oral, esophageal, stomach and colon cancers).
• Sugars have no nutritional value and should be limited.
• Low microbial diets are recommended for transplant recipients, or others
who are immune compromised
• Foods high in soy are an excellent source of protein; however, breast cancer
patients who are estrogen positive should avoid or severely limit.
Supplements:
• High doses of Beta-Carotene may increase risk of lung cancer or recurrence
• Anti-oxidant therapy is still controversial while treatment is on-going, as
there may be interference in cellular death which is required to eliminate
cancer cells. When treatment has been finished, it is still unclear as to the
role of anti-oxidants; however, no more than 100% of the recommended
dose should be taken.
• The use of of calcium, folate, and selenium is still controversial in preventing
polyp recurrence in colon cancer patients
• Omega-3 fatty acids may have specific benefits for cancer survivors, including
reducing significant weight loss, improving quality of life, and perhaps
enhancing the effects of some forms of treatment.
• Adequate protein intake is essential during all stages of cancer treatment,
recovery, and long-term survival.
Alcohol:
• The role of alcohol in preventing recurrence of cancer is unclear. The
cardiovascular effect of alcohol; however, may be beneficial. In any case,
no more than 2 drinks for men, or 1 drink for women per day are
recommended.
• Patients with mucositis should avoid alcohol, as that may increase oral
irritation.
Other:
• Eight glasses of water a day is recommended.
• For obese patients, no more than 2 pounds per week should be lost.
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