Ask Dr. Block: How Does A Patients Lifestyle And Diet Impact Cancer?

The data and studies looking at the relationship between nutrition and cancer are voluminous. However, there is a major disconnect between what is evidence based and supported by the literature, and what the average mainstream clinician is comfortable with when it comes to advising patients who are battling for their lives. For many years now, the American Cancer Society and other institutions have talked about the wise preventive strategy of cutting back on cancer promoting lifestyle choices. However, once a patient gets diagnosed with cancer, that message disappears and is replaced by the well-intentioned, though seriously misguided, “eat whatever you want.” This advice grows out of a mindset that encourages patients to eat foods which are calorically dense but nutrient poor – high in saturated fats and simple and refined carbohydrates – such as milk shakes, red meat, ice cream and canned and processed foods. This is particularly problematic when it comes to combating weight loss, a cancer-driven inflammatory condition that diminishes appetite, wastes muscle and promotes further malignant growth. Unfortunately, these calorically dense regimens can actually feed the patient’s cancer, promoting malnutrition, and contributing to the patient’s inability to tolerate treatment. In addition, if the malnutrition is not addressed, it can lead to a macronutrient deficit leading to a condition called “cachexia,” defined as a wasting syndrome that results in compromised immunity, weakness, and a loss of weight, body fat, and muscle.

As a starting point, our diets, our sedentary life, high levels of unrelieved stress, toxic relationships and sleep disruption all lay the groundwork for not only getting cancer, but for driving cancer forward. For example, there is good solid research for solid tumor cancers, showing that exercise and fitness – speed walking 45-60 minutes per day – can reduce cancer mortality by 50%! In years gone by, in my grandmother’s era certainly, and even throughout my own training, doctors told patients to “go home and rest.” I have resisted this thinking for nearly forty years. One needs a balance between activity and rest. You need to sleep well to have the vitality to be active during the day. And generally speaking, the more active you are doing the day, the better you will sleep at night.

Activity and rest cycles are essential for establishing a healthy optimal circadian rhythm. Additionally, since fatigue is so heavily associated with cancer and its treatments, strategies for improving circadian health are of utmost priority.

Regarding weight gain, for example, studies show that just 11 pounds of extra weight can increase mortality in breast cancer by 14%! (it should be noted that – with some cancers – it is not uncommon for people undergoing chemotherapy to gain weight. This weight gain is clearly associated with higher recurrence risk and poorer outcomes). In addition, patients who are obese, regardless of the type of cancer, generally have a higher mortality than patients who have normal body weight. Regarding the impact of diet, it is clear that the typical Western diet can drive the onset of malignancy. For example, red meat can increase colorectal cancer by 35% to 85%, and can increase the risk of pancreatic cancer by 25% – 75%, according to several studies. Also, high milk and calcium consumption are associated with up to a 200% increase in prostate cancer. And one randomized controlled trial showed that when breast cancer patients reduced their fat intake to 20% or lower, they reduced their risk of recurrence by an average of 24%! This is on par with Tamoxifen, which has shown a 25% reduction in recurrence rates after taking it for 5 years. Today, we tell patients with hormonal sensitive cancers to take hormonal blockers for 10 plus years, and that they will get a 50% reduction of recurrence, but no one has done a comparable study with dietary intake to see about the reduction of recurrence if you are eating healthfully for 10 years. There is also impressive data showing that if you shift to a whole grain, legume based, vegetable and fruit diet, you cut cancer risk dramatically, yet there is probably less than a 3% chance that your cancer specialist will bring up a discussion about diet with you! This is remarkable, given the supporting evidence for making dietary changes. Another example: 25 grams of flax per day will cut your Ki67 – a proliferation marker for cancer – by 34%. There is also evidence to suggest that 25 grams of flaxseed per day can induce apoptosis by 30%. Yet, we don’t talk about nutrition specificity as a medical culture.

We can counter the risk of cancers by controlling and countering exposure to growth stimulants. We know that body weight, dietary fats and refined flours and sugars will drive up insulin growth factors, and increase the surge of insulin and insulin resistance, driving cancers forward. Additionally, various stressors can lead to insulin resistance, thus raising the output of insulin with potential growth-inducing consequences.

Even basic things like a drop in albumin and protein levels are associated with the inability of cancer patients to fight off infections. If you look at the low albumin levels of cancer patients in any hospital, you would find a large percentage suffer from marked albuminemia. Most conventional medicine doctors would say “Well, many of these patients are late stage, we can’t feed them”. I don’t buy it! We have taken many patients who, when they first came to us, had moderate to marked cachexia and laboratory-confirmed inflammatory problems, in large part because they were fed high caloric “corporate shakes,” which are loaded with both refined sugars and the wrong fats. This drives a pro-inflammatory condition even further, leading to muscle wasting and appetite suppression. If you change those fats to healthier fats and add complex carbohydrates, you change the inflammatory cascade and suddenly these patients are able to start eating again. You rebuild their proteins, their albumin level and muscle mass and they’ll become active again. It does not happen all at once or for all patients, but I can tell you from firsthand experience, a large percentage of these patients will respond and turn around. I think our ignorance and lack of attention to nutrition and integrative care in general hastens not only the disease process, but the dying process.

I would argue nutritional therapy should be standard of care, but supplementation must be designed from careful clinical evaluation and from comprehensive terrain and metabolic laboratory panels, enabling individualized recommendations for each patient.