From the Guidelines
The most effective method for reducing tumor size or achieving weight loss in cancer patients is through a combination of nutritional therapy, physical activity, and medical management, with a focus on maintaining or gaining muscle mass, as recommended by the most recent and highest quality study 1.
Key Considerations
- The goals of nutritional and metabolic therapy should prioritize maintenance or gain of muscle mass, as muscle mass below certain values is strongly associated with mortality in cancer patients, as well as complications of cancer surgery and dose-limiting toxicity during systemic anti-cancer therapy 1.
- A caloric deficit can be achieved through a combination of reduced calorie intake and increased physical activity, aiming for 1-2 pounds of weight loss per week, with a reduction of 500-1000 kcal/d when appropriate 1.
- Nutritional therapy should aim to limit weight loss to between 5% and 10% of initial body weight, increase dietary quality with nutrient-dense foods, and reduce simple sugars and added fats, consistent with clinical practice guidelines for the overweight and obese and with recommendations for cancer survivors 1.
Recommended Dietary Intake
- Cancer patients should consume 5-9 servings/d of fruits and vegetables to ensure sufficient intake of antioxidants and fiber through diet, with a focus on foods rich in b-carotene and vitamins A, E, and C 1.
- Sources of animal protein, such as meat, eggs, and low-fat dairy, should be consumed moderately (1-2 times/wk each), and fish, poultry, turkey, and pork tenderloin should be made priorities because of their low fat content 1.
- A daily protein intake of 1.2-1.5 g protein/kg-1/d-1 is suggested to maintain fat-free mass and reduce the risk of overall survival (OS) in cancer patients 1.
Importance of Physical Activity
- Moderate physical activity during and after treatment may help survivors maintain lean muscle mass while avoiding excess body fat, and is recommended as part of a comprehensive approach to weight management and tumor size reduction 1.
- Physical activity should be combined with nutritional therapy to optimize the efficacy of nutrition therapy and promote muscle anabolism or control inflammation or insulin resistance 1.
From the Research
Reducing Tumor Size or Achieving Weight Loss
- There are several methods that have been studied for reducing tumor size or achieving weight loss, including:
- Lifestyle modifications such as a healthy diet and exercise, which have been shown to ameliorate inflammation and reduce the risk of cancer-related deaths 2
- Consumption of anti-inflammatory drugs, including aspirin, which can significantly reduce cancer risk 2
- Targeting pro-inflammatory genes or transcription factors, which is believed to be a good strategy for the development of anti-cancer agents 3
- Using anti-inflammatory agents, including non-steroidal anti-inflammatory drugs, corticosteroids, statins, metformin, embelin, and some natural products, which can interfere with the tumor microenvironment and increase cell apoptosis 3
- Inflammation-targeted agents have been shown to demonstrate potential in suppressing cancer development and improving the efficacy of other therapeutic modalities 4
- Corticosteroids are commonly used in oncology to manage symptoms, anti-cancer effects, and immune-related adverse events, but their use may have an impact on immunotherapy activity 5
- Signaling pathways such as NF-kB, JAK-STAT, TLR, cGAS/STING, and MAPK, as well as inflammatory factors and metabolites, have been identified as pivotal regulators of inflammation in cancer therapy, and targeting these pathways may be a potential strategy for reducing tumor size or achieving weight loss 6