“Nutrition Is Crucial”: Enhancing Cancer Treatment and Survivorship Through Dietary Strategies

"DNA helix made of healthy food" by Adobe, Adobe Firefly, 2024

March is Nutrition Awareness Month, and for patients with cancer, nutrition plays a large role in prevention, treatment, and survivorship. While the connection between diet and cancer is widely acknowledged, emerging evidence and nuanced strategies are reshaping how oncologists and patients approach nutrition.

Nutrition During Treatment

According to Marleen I. Meyers, MD, a breast medical oncologist at NYU Langone Health, it is important that nutrition strategies align with the patient’s treatment trajectory. For those undergoing active treatment, adverse events like nausea, taste alterations, and appetite loss can make eating a challenge.

Proactive management of treatment-related toxicities is essential. This includes the use of antiemetic medications, as well as dietary modifications to mitigate such nausea and taste alterations. Frequently, small meals are often better tolerated than large meals. Additionally, dietary recommendations should prioritize easily digestible foods while avoiding those known to exacerbate symptoms.¹

“We recommend frequent, small meals instead of large ones, antinausea medications, and avoiding certain foods that exacerbate symptoms,” Meyers explained in an exclusive interview with Targeted Oncology^TM.

Maintaining stable weight and supporting tissue repair are key goals for patients with cancer. A high-calorie, high-protein diet may be indicated, even if it deviates from standard healthy eating guidelines. This approach is particularly relevant for patients experiencing cachexia or significant weight loss.

Some examples of calorie- and protein-dense foods include dairy products such as milk, cream, and cheese; cooked eggs; sauces and gravies; and healthy fats. Adequate hydration and micronutrient intake are also essential for overall physiological function and recovery.

Marleen I. Meyers, MD

When feasible, it is important to also encourage patients to engage in light exercise, as it can help stimulate appetite and improve digestion. Once active treatment is completed, the focus shifts to long-term health optimization and recurrence risk reduction. Notably, a Mediterranean-style diet, which is rich in vegetables, whole grains, and lean proteins, is often recommended for its potential to improve overall health and reduce the risk of chronic diseases.

“It takes a whole score of people. I feel like the medical oncologist, their role [has] mainly been recommendations and things, but having that sort of support team to talk about nutrition [is critical],” Premal Thaker, MD, David & Lynn Mutch Distinguished Professor of Obstetrics & Gynecology; Chief of Gynecologic Oncology, Interim; Director of Gynecologic Oncology Clinical Research; and Professor in Gynecologic Oncology at Washington University School of Medicine, told Targeted Oncology^TM.

The Role of Nutrition in Cancer Prevention

Obesity and poor dietary habits are well-established risk factors for several cancers. Meyers highlighted the growing evidence linking highly processed foods and excessive alcohol consumption to increased cancer risk.

“We’re learning that nutrition plays a much larger role in cancer prevention than we once thought,” she said.

For prevention, Meyers advocated for a “colorful diet” that includes a variety of fruits and vegetables. “You do not want to just eat broccoli—it is great, but you also need those yellows, oranges, and reds to get a full spectrum of nutrients,” she advised.

Not only does this approach reduce cancer risk, but it also supports cardiovascular health and overall well-being.

Premal Thaker, MD

The Evolving Role of Nutrition in Cancer Research and Care

Not only are diet and nutrition important in cancer prevention, but they are also critical in treatment and survivorship. According to a study published in Nutrients, having an unbalanced diet can lead to an increased risk of cancer onset, while malnutrition can negatively impact the efficacy of cancer treatment.²Epidemiologic research has identified lifestyle and genetic factors associated with cancer prevention, and advancements in molecular therapies have revolutionized treatment strategies.²

The management of survivors of cancer has continued to gain increasing attention over the years, particularly regarding the role of diet and nutrition in long-term health. However, much of the research on cancer and nutrition to date has focused primarily on prevention, leaving significant gaps in understanding its role during treatment and survivorship.^1,2

Emerging studies are now addressing this imbalance, offering promising insights into how diet and nutrition can influence cancer outcomes. For example, preclinical studies on triple-negative breast cancer have explored the role of the mycobiome and folate, providing novel avenues for improving outcomes in this patient population.

Other research has shown the importance of a balanced diet in reducing cancer risk. One study found that diet quality significantly lowers the risk of lung cancer, while another explored the potential of isoflavones in breast cancer prevention.^3,4 Ongoing research is assessing gene-diet interactions, and large cohort studies are investigating interactions that could reshape the understanding of nutrition’s role in cancer prevention and treatment.²

Beyond surgical and pharmacological interventions, tailored nutrition strategies can improve quality of life and treatment outcomes, even for cancers with poor prognosis, such as pancreatic cancer.

As Meyers emphasized, “Nutrition is a crucial part of cancer treatment and survivorship. It is not just about getting through treatment—it is about optimizing long-term health.”

"close-up on fruits and vegatables held by an oncologist," by Adobe, Adobe Firefly, 2025

Debunking Nutrition Myths in Oncology

One of the most well-known myths is that sugar “feeds” cancer.⁵ While there is a lot of information online about sugar and cancer, not much of it is based on scientific evidence. Meyers clarified that while sugar is not beneficial for overall health, it does not selectively fuel cancer cells.

“Cancer cells grow quickly and may uptake sugar more rapidly, but cutting out sugar entirely won’t starve the cancer,” she explained. Instead, she recommends moderation and focusing on nutrient-dense foods.

Though cutting out sugar does not prevent or treat cancer, healthcare professionals still encourage patients with cancer to cut down on sugary foods as there is an indirect link between cancer risk and sugar. Consuming a large amount of foods with sugar over time can cause weight gain, and being overweight or obese increases the risk of 13 different types of cancer. After smoking, this is the biggest cause of cancer.

While the evidence is not universally conclusive and additional research are needed, public health guidelines still emphasize reducing added sugar consumption and promoting a balanced diet rich in natural foods for cancer prevention and management.⁶

Another common misconception is the fear of soy products among patients with breast cancer.⁷ This myth to avoid soy foods after the diagnosis of some cancers, including breast and prostate cancer, began by individuals believing that isoflavones, natural plant compounds found in soy foods, act the same as human estrogen. However, there has been research in cancer survivors that confirms there are no harmful effects from soy foods, showing that they can be part of a healthy diet.

“Soy foods like tofu, edamame, and miso are safe and can be part of a healthy diet,” Meyers said.

However, she cautions against soy supplements, which lack purity and consistency. It is important to choose whole soy if adding this into your diet as it has a lot of beneficial nutrients, including protein, isoflavones, and fiber.

Further, Meyers emphasized that adopting sustainable dietary changes can feel overwhelming for patients and survivors, and recommends starting small.⁸

“Decrease portions by 15% to 20% and choose one less-healthy food to limit or replace,” she suggested. For example, if a patient loves bacon, they might enjoy it as a weekly treat rather than a daily staple.

These incremental changes, combined with regular physical activity, can lead to significant long-term benefits. “It’s not about perfection,” Meyers stressed. “It’s about progress and consistency.”

“I feel like sometimes we forget about [this], because we are so focused on treating the cancer that we forget that there are so many other aspects to that treatment,” added Thaker.

Nutrition in Survivorship: Beyond Cancer Prevention

Survivorship programs, like the one Meyers directs at NYU Langone Perlmutter Cancer Center, integrate nutrition education to improve long-term outcomes.

“We focus on maintaining a healthy weight, minimizing alcohol, and eating a balanced diet to reduce the risk of recurrence and other chronic diseases,” she said.

Myers also highlighted the psychological aspect of dietary changes. “Survivors often have an ‘aha moment’ after treatment, wanting to optimize their health. But like New Year’s resolutions, these goals can be hard to sustain. That’s why we emphasize evidence-based strategies and ongoing support.”

Myers emphasized the importance of balancing patient autonomy with evidence-based nutritional guidance. Recognizing that patients may present with pre-existing beliefs about supplements or alternative diets, it is important for healthcare professionals to foster open and respectful dialogues grounded in scientific evidence.

Collaborative care, specifically integrating registered dietitians into the multidisciplinary oncology team, is essential for optimizing patient outcomes, which ranges from effective management of treatment-related adverse events to comprehensive support for long-term survivorship. Even during active treatment, it is important that oncologists help by laying the groundwork for lifelong healthy habits for their patients.

Nutrition is not a one-size-fits-all solution. It is a dynamic, evolving component of cancer care that requires personalized strategies, patient education, and a commitment to evidence-based practices to help improve outcomes and quality of life—not just during treatment, but for years before and after.

“Rome wasn’t built in a day,” Meyers concluded. “Small, consistent changes can lead to lasting benefits. That’s the message we want to leave with our patients and colleagues this month—and every month.”

REFERENCES:

1. Nutrition services for cancer patients. Stanford Medicine Cancer Center. Accessed March 20, 2025. https://tinyurl.com/3n5z4pxf

2. Narimatsu H, Yaguchi YT. The Role of Diet and Nutrition in Cancer: Prevention, Treatment, and Survival. Nutrients. 2022;14(16):3329. Published 2022 Aug 14. doi:10.3390/nu14163329

3. Coleman MF, O'Flanagan CH, Pfeil AJ, et al. Metabolic Response of Triple-Negative Breast Cancer to Folate Restriction. Nutrients. 2021;13(5):1637. Published 2021 May 13. doi:10.3390/nu13051637

4. Hossain F, Majumder S, David J, Bunnell BA, Miele L. Obesity Modulates the Gut Microbiome in Triple-Negative Breast Cancer. Nutrients. 2021;13(10):3656. Published 2021 Oct 19. doi:10.3390/nu13103656

5. Sugar and cancer - what you need to know. Cancer Research UK. Accessed March 20, 2025. https://tinyurl.com/5n6h75jd

6. Hasan N, Yazdanpanah O, Khaleghi B, Benjamin DJ, Kalebasty AR. The role of dietary sugars in cancer risk: A comprehensive review of current evidence. Cancer Treat Res Commun. Published online February 3, 2025. doi:10.1016/j.ctarc.2025.100876

7. Soy and breast cancer: myths and misconceptions. American Institute for Cancer Research. October 8, 2024. Accessed March 20, 2025. https://tinyurl.com/t9tyn4sd

8. Diet & nutrition for cancer survivors. Cancer Support Community. March 20, 2025. https://tinyurl.com/w7pa27zz