Current nutritional issues in cancer treatment and survivorship

Nutritional factors can have an important role in the management of cancer, across the spectrum from the initial phases of treatment and recovery through the continuum of survivorship. The majority of Americans diagnosed with cancer survive more than 5 years, and more than 12 million people in the United States are now cancer survivors. Several important nutritional issues in this population are recognized. Cancer cachexia is a syndrome of progressive weight loss characterized by muscle wasting with or without loss of fat mass associated with cancer and cancer treatments. This is associated with poorer prognosis, particularly shorter median survival time. Nutritional support with an emphasis on adequate energy and protein intakes and as part of a multimodal treatment designed to counteract both reduced dietary intake and hypercatabolism appears to be the strategy most likely to improve body composition and physical function in managing cancer cachexia. The nervous system is particularly sensitive to micronutrient deficiencies associated either with tumor growth or with the use of antimetabolites, and complications associated with cancer or cancer treatments may affect either or both the central and peripheral nervous system. Current epidemiologic evidence suggests that concerns that soy food intake may adversely affect prognosis following the diagnosis and treatment of breast cancer may be unwarranted, although more preclinical and intervention studies are needed. Incorporating nutritional care into the management of the cancer patient, based on continued research, may contribute to increased quality and/or quantity of life for the millions of individuals who are diagnosed with cancer each year. This presentation was part of the program at the AICR Annual Research Conference in Washington, DC, November 3-4, 2011, which is an annual event organized by the American Institute for Cancer Research.