I can confidentially say that 99% of the cancer patients I see in my practice tend to carry similar confusion when it comes to the lack of recommendations given from their oncologists about diet and what to eat before, during or following conventional cancer treatment. Aside from the absolute minority, when patients ask their oncologist about what they should or should not eat, the overwhelming response goes something like this: “It doesn’t matter. Diet doesn’t make a difference. Eat what you want and as much as you want. It’s all about consuming maximal calories in order to prevent weight loss”. Most times, these patients are also guided to eat unlimited amounts of foods such as ice cream, pudding, processed lunch meat on white bread, and the like. So why do many oncologists still feel that diet doesn’t matter, refuse to recognize its clinical value, and outright ignore the science? Here are the overwhelmingly factual reasons why, as well as why eating healthy does really matter throughout your cancer diagnosis and treatment.
Lack of Nutritional Education
First and foremost, as much as I’d love to see medical schools educate their doctors in the realm of nutrition, unfortunately it just doesn’t happen. Over the course of a doctors (and oncologists) medical education, there is literally next to zero hours spent on learning about nutrition, let alone on how specific nutrients or diets impact the course of cancer treatment (positively or otherwise). This in itself is scary. I can appreciate, at an institutional level, this critical gap likely won’t change for years to come, however what I can’t appreciate is when an absolutely brilliant doctor, who’s oncological practice is based on evidence, simply ignores the evidence, provides patient recommendations on unfounded subjective bias, or chooses not to invest time to at least acknowledge that there is scientific evidence that food can impact cancer treatment and disease. Thankfully for many cancer patients, naturopathic and well as integrative doctors spend hundreds of medical educational hours learning and understanding the evidence and science behind how and why diet is a safe and effective critical intervention over the course of a cancer diagnosis.
Lack of Time
As is obvious, medical oncologists are busy. I get it. But so are we all. Thankfully, for licensed naturopathic doctors and other integrative cancer doctors, there is more time spent with patients, and thus more time to understand and appreciate the individuality and dietary value in relation to cancer. From a completely basic level, it’s well established that over consuming sodium can increase blood pressure and suppress the immune system. When it comes to sugar, increased fatigue, blood sugar levels, lower sleep quality and immune functioning are all basic physiological implications of eating too much. So even from a basic (almost elementary) level, medical oncologists should be educating their patients on these simple, every day facts to help guide toward better overall quality of life and treatment responses during cancer care. Oncologists may not have time to fully explain the details of how a higher fibre diet can improve bowel function and regularity during chemotherapy treatment, but these fundamental general health recommendations need to be conveyed.
Overemphasized But Undervalued
Cancer patients often hear contradictory comments on diet when it comes to what to eat and what not to eat. On one hand, oncologists tells their patient that diet doesn’t matter, so eat whatever you want (usually poor food choice recommendations), yet on the other hand, an oncologist also tells their patient to strictly avoid antioxidants and other healthy foods (such as garlic, fish, ginger, onions, tea, and other foods), based on the unfounded idea that these foods may somehow interfere with patient treatment. So on one hand doctors are telling their patients that food doesn’t matter, so eat anything, yet on the other hand, when it comes to healthy food, oncologists feel healthy foods may have a negative effect on therapy. So which is it? Food can impact disease and treatment, or it can’t? In reality, there’s a lot to know about diet when it comes to certain cancer drugs and therapies, but in one breath saying that food doesn’t make a difference, while in the next breath confusing the patient by saying food may interfere with these drugs or therapies (but only the healthy foods) confirms that a clear, unscientific bias exists when it comes to a lack of knowledge and appreciation for diet and how nutrition and food impacts a patient with cancer.
Lack of Interest
All in all, there is a lack of interest in nutrition, diet and healthy eating within the scope of medical oncology. Naturopathic and integrative cancer doctors appreciate that chemotherapy regimens lead as a priority when it comes to conventional care, however when it comes to a patients health and best interests, disputing the value of diet as an adjunctive care measure just doesn’t make sense. There is enough scientific study and evidence supporting a variety of dietary approaches in conjunction with conventional cancer care. Such approaches like calorie restricted diets (yes, that’s right, restricting calories in cancer patients to make room for more nutrient dense foods) has been shown in research and clinical value to improve better tolerance to cancer therapies, quality of life, longevity, and better treatment outcomes. Patients who simply eat to consume calories tend toward higher blood glucose and cancer growth factor markers, more inflammation, a worse quality of life, poor sleep, and other parameters showing detriment toward the cancer patient. We also see that both pre and post cancer therapy diet applications, such as introducing specific nutrients, will improve radiation therapy, immunotherapies, surgeries and other chemotherapies in terms of not only how a patient fares throughout treatment, but also how the biology of cancer cells respond (and are destroyed) by standard care approaches. Cancer therapies also readily deplete necessary vitamins, minerals and other nutritional compounds, so safely helping patients replete these measures have shown independent improvement in many of the areas mentioned above.
All in all, oncology is not nearly up to par when it comes to cancer and nutrition. Medical oncology still preserves the old, debunked approach that eating more, of any food, healthy or not, is beneficial for all cancer patients. This needs to change. It’s not about storing extra calories, putting weight on patients, or simply ignoring the scientific evidence when it comes to diet. It is however about specific nutrition, understanding that nutrient density trumps empty calories, at bare minimum, acknowledging that a healthy diet does play a critical role in cancer therapy, and that poor eating habits likely only contribute to disease and poor health progression. Luckily, naturopathic doctors (like those at Cornerstone Naturopathic Inc.) who are expert in integrative cancer care are available to fill this gap. In order to reap the benefits of conventional cancer care, a cooperative approach to diet and patient care needs to exist as one.