Lahey Hospital and Medical Center, Burlington, MA
Kalyani Murthy , Dana Kamenetsky , Krishna Soujanya Gunturu
Background: Diet and nutrition play a key role in the maintenance of health-related quality of life. Studies indicate cancer survivors evince a great interest in learning about nutrition and are willing to initiate life-style changes at the time of diagnosis. However recent survivor data indicates a lack of professional advice on nutrition. Given current guidelines by the American Cancer Society on increasing healthy eating awareness, we present a narrative review of published literature and discuss options for information dissemination. Methods: PubMed search from 2012-2017 was conducted. Studies on outcomes related to diet and nutrition in cancer survivors were included. We excluded general reviews, case reports, pediatric and complementary medicine abstracts. Results: Our initial search yielded 355 abstracts. We focused our review on 33 studies in breast, prostate and colo-rectal cancer care. Diet rich in saturated and trans-fats was detrimental in survivors (≈24%). Low-fat diet improved recurrence rates and overall mortality in 18% studies. Despite this high fat and dairy rich diet were noted in ≈18% studies. Data from studies (18%) incorporating fruits and vegetables indicated improvement in cognitive scores, post-cancer related fatigue and survival benefit. Adherence rates based on healthy-eating-index scores were low in survivors in a recent national survey. Vitamin D repletion is an area of debate. Studies have shown improvement in survival and mortality rates in breast and prostate cancer survivors. Conclusions: Data on survivor dietary preferences, changes and subsequent results are heterogeneous. Evidence suggests improvement in diet quality is positively associated with cancer and unrelated mortality. It is crucial to enforce the importance of healthy dietary changes to cancer survivors. Enabling access to key nutritional information to providers caring for survivors forms a major crux in this endeavor to empower survivors towards better health. Tools such as e-learning could be harnessed for this purpose. Ultimately recognition of optimal strategies and guidelines to assist, educate and motivate survivor adherence to such changes long-term needs further evaluation.
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