What diet should oncologists recommend?
The Best Diet for Cancer Patients
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
Our lifetime risk of developing an invasive cancer, not some superficial skin cancer or ductal carcinoma of the breast, but serious cancer, is about 40 percent. Two in five of us are going to get a cancer diagnosis in our lifetimes. What can we do to reduce our risk? Only about 5 percent of cancers are caused by problem genes we inherited from our parents. The other 95 percent are caused by mutations in our DNA we acquire in our lifetimes. For example, based on a genetic analysis of lung cancer, smokers may acquire an average of one DNA mutation for every 15 cigarettes smoked. Smoking is bad, but the number one cause of these mutations is our diet––and that’s not even including the cancers attributed to obesity.
I’ve got tons of videos on dietary approaches to prevent cancer. But what if you already have it? Well-meaning professionals sometimes counsel cancer patients to “Eat whatever you want.” Given the time constraints that doctors face, it may be understandable that the treating oncologist––the treating cancer doctor––may be reluctant to engage in a conversation about nutrition. But given the critical role that diet may play, perhaps it should be “a critical part of [their] job to be able to answer patients’ questions about nutrition before and after cancer treatment and not default to the unhelpful ‘it doesn’t really matter, eat what you want’ which may not be in the best interest of the patient.”
The official recommendation of the American Institute for Cancer Research, a leading authority on diet and cancer, is that those with cancer should follow the same diet that helps prevent cancer from taking root in the first place. That means more whole grains, vegetables, fruits, and beans, while limiting fast food, processed food, meat, soda, and alcohol. Similar recommendations have been put forth by other cancer authorities: more fruit, vegetables, whole grains, and beans, and less salt, sugar, meat, and alcohol.
Cancer survivors adhering to these guidelines do seem to live significantly longer––or at least older female cancer survivors, the only group in which it’s been looked at so far.
They add that that are certain foods that may be beneficial in cancer care including: beans, berries, cruciferous vegetables, flax seed, garlic, green tea, tomatoes, and others, but emphasize it’s not about a single magic bullet food or component, but the combination of foods in a predominantly plant-based diet.
Here’s how some popular diets used by cancer patients stack up. The so-called alkaline diet gets high marks for being vegetable-focused, and encouraging people to cut down on animal foods. The keto diet does the worst, though they get points for keeping people away from refined grains, alcohol, and soft drinks. Macrobiotic diets win the day, being closest to a whole food, plant-based diet, centered around whole grains, vegetables, and beans, though may not be advising enough fruit. Paleo diets are a mixed bag, with insufficient whole grains, beans, and too much meat. The vegan diet starts out strong, but doesn’t necessarily preclude all manner of vegan junk food. Have any of these diets been put to the test?
I’ve done a video Is Keto an Effective Cancer-Fighting Diet? on the abject failure of the keto diet. The alkaline diet was tried on eleven lung cancer patients. They lived an average of 28 and a half months, which is about 40 percent longer than most patients have historically lived, but there was no direct control group. The only diet proven in a randomized controlled trial to reverse the progression of cancer was Dr. Dean Ornish’s whole food plant-based lifestyle program, which I’ve covered before in my video How Not to Die from Cancer.
Most randomized controlled trials to date on diet and cancer are like this: feasibility studies just to see if we can even get cancer patients to eat healthier, period. Otherwise, what’s the point of even running the study? In one study, researchers did find they could get patients with head and neck cancer to ramp up green leafy and cruciferous vegetable intake to nine cups a week. So, it’s at least something you could test. But we don’t yet have outcome data. But why wait? What’s the downside of trying to eat healthier? It may even save your life another way.
Cardiovascular disease competes with breast cancer as the leading cause of death for older women diagnosed with breast cancer. Researchers followed more than 60,000 women diagnosed with breast cancer over the age of 65 for an average of nine years, by which time half had died. And the number one cause of death was actually cardiovascular disease, edging out the breast cancer. And so, choosing a healthy diet centered around whole plant foods––the only diet ever proven to reverse heart disease in the majority of patients––may save your life, whether you have cancer or not.
Please consider volunteering to help out on the site.
- Frenkel M, Sierpina V, Sapire K. Effects of complementary and integrative medicine on cancer survivorship. Curr Oncol Rep. 2015;17(5):445.
- Longo VD, Lieber MR, Vijg J. Turning anti-ageing genes against cancer. Nat Rev Mol Cell Biol. 2008;9(11):903-910.
- Whitman MM. The starving patient: supportive care for people with cancer. Clin J Oncol Nurs. 2000;4(3):121-5.
- Wallace TC, Bultman S, D’Adamo C, et al. Personalized Nutrition in Disrupting Cancer — Proceedings From the 2017 American College of Nutrition Annual Meeting. J Am Coll Nutr. 2019;38(1):1-14.
- Coussens LM, Zitvogel L, Palucka AK. Neutralizing Tumor-Promoting Chronic Inflammation: A Magic Bullet? Science. 2013;339(6117):286-291.
- Pleasance ED, Stephens PJ, O’Meara S, et al. A small-cell lung cancer genome with complex signatures of tobacco exposure. Nature. 2010;463(7278):184-190.
- Inoue-Choi M, Robien K, Lazovich D. Adherence to the WCRF/AICR Guidelines for Cancer Prevention Is Associated with Lower Mortality among Older Female Cancer Survivors. Cancer Epidemiol Biomarkers Prev. 2013;22(5):792-802.
- World Cancer Research Fund/American Institute for Cancer Research. Diet, Nutrition, Physical Activity and Cancer: a Global Perspective. Continuous Update Project Expert Report 2018.
- Hamaguchi R, Okamoto T, Sato M, Hasegawa M, Wada H. Effects of an Alkaline Diet on EGFR-TKI Therapy in EGFR Mutation-positive NSCLC. Anticancer Res. 2017;37(9):5141-5145.
- Ornish D, Weidner G, Fair WR, et al. Intensive lifestyle changes may affect the progression of prostate cancer. J Urol. 2005;174(3):1065-9.
- Zick SM, Snyder D, Abrams DI. Pros and Cons of Dietary Strategies Popular Among Cancer Patients. Oncology (Williston Park, NY). 2018;32(11):542-7.
- Vernieri C, Nichetti F, Raimondi A, et al. Diet and supplements in cancer prevention and treatment: Clinical evidences and future perspectives. Crit Rev Oncol Hematol. 2018;123:57-73.
- Crowder SL, Frugé AD, Douglas KG, et al. Feasibility Outcomes of a Pilot Randomized Clinical Trial to Increase Cruciferous and Green Leafy Vegetable Intake in Posttreatment Head and Neck Cancer Survivors. J Acad Nutr Diet. 2019;119(4):659-671.
- Patnaik JL, Byers T, DiGuiseppi C, Dabelea D, Denberg TD. Cardiovascular disease competes with breast cancer as the leading cause of death for older females diagnosed with breast cancer: a retrospective cohort study. Breast Cancer Res. 2011;13(3).
- Esselstyn CB. A plant-based diet and coronary artery disease: a mandate for effective therapy. J Geriatr Cardiol. 2017;14(5):317-320.
Motion graphics by Avo Media
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
Our lifetime risk of developing an invasive cancer, not some superficial skin cancer or ductal carcinoma of the breast, but serious cancer, is about 40 percent. Two in five of us are going to get a cancer diagnosis in our lifetimes. What can we do to reduce our risk? Only about 5 percent of cancers are caused by problem genes we inherited from our parents. The other 95 percent are caused by mutations in our DNA we acquire in our lifetimes. For example, based on a genetic analysis of lung cancer, smokers may acquire an average of one DNA mutation for every 15 cigarettes smoked. Smoking is bad, but the number one cause of these mutations is our diet––and that’s not even including the cancers attributed to obesity.
I’ve got tons of videos on dietary approaches to prevent cancer. But what if you already have it? Well-meaning professionals sometimes counsel cancer patients to “Eat whatever you want.” Given the time constraints that doctors face, it may be understandable that the treating oncologist––the treating cancer doctor––may be reluctant to engage in a conversation about nutrition. But given the critical role that diet may play, perhaps it should be “a critical part of [their] job to be able to answer patients’ questions about nutrition before and after cancer treatment and not default to the unhelpful ‘it doesn’t really matter, eat what you want’ which may not be in the best interest of the patient.”
The official recommendation of the American Institute for Cancer Research, a leading authority on diet and cancer, is that those with cancer should follow the same diet that helps prevent cancer from taking root in the first place. That means more whole grains, vegetables, fruits, and beans, while limiting fast food, processed food, meat, soda, and alcohol. Similar recommendations have been put forth by other cancer authorities: more fruit, vegetables, whole grains, and beans, and less salt, sugar, meat, and alcohol.
Cancer survivors adhering to these guidelines do seem to live significantly longer––or at least older female cancer survivors, the only group in which it’s been looked at so far.
They add that that are certain foods that may be beneficial in cancer care including: beans, berries, cruciferous vegetables, flax seed, garlic, green tea, tomatoes, and others, but emphasize it’s not about a single magic bullet food or component, but the combination of foods in a predominantly plant-based diet.
Here’s how some popular diets used by cancer patients stack up. The so-called alkaline diet gets high marks for being vegetable-focused, and encouraging people to cut down on animal foods. The keto diet does the worst, though they get points for keeping people away from refined grains, alcohol, and soft drinks. Macrobiotic diets win the day, being closest to a whole food, plant-based diet, centered around whole grains, vegetables, and beans, though may not be advising enough fruit. Paleo diets are a mixed bag, with insufficient whole grains, beans, and too much meat. The vegan diet starts out strong, but doesn’t necessarily preclude all manner of vegan junk food. Have any of these diets been put to the test?
I’ve done a video Is Keto an Effective Cancer-Fighting Diet? on the abject failure of the keto diet. The alkaline diet was tried on eleven lung cancer patients. They lived an average of 28 and a half months, which is about 40 percent longer than most patients have historically lived, but there was no direct control group. The only diet proven in a randomized controlled trial to reverse the progression of cancer was Dr. Dean Ornish’s whole food plant-based lifestyle program, which I’ve covered before in my video How Not to Die from Cancer.
Most randomized controlled trials to date on diet and cancer are like this: feasibility studies just to see if we can even get cancer patients to eat healthier, period. Otherwise, what’s the point of even running the study? In one study, researchers did find they could get patients with head and neck cancer to ramp up green leafy and cruciferous vegetable intake to nine cups a week. So, it’s at least something you could test. But we don’t yet have outcome data. But why wait? What’s the downside of trying to eat healthier? It may even save your life another way.
Cardiovascular disease competes with breast cancer as the leading cause of death for older women diagnosed with breast cancer. Researchers followed more than 60,000 women diagnosed with breast cancer over the age of 65 for an average of nine years, by which time half had died. And the number one cause of death was actually cardiovascular disease, edging out the breast cancer. And so, choosing a healthy diet centered around whole plant foods––the only diet ever proven to reverse heart disease in the majority of patients––may save your life, whether you have cancer or not.
Please consider volunteering to help out on the site.
- Frenkel M, Sierpina V, Sapire K. Effects of complementary and integrative medicine on cancer survivorship. Curr Oncol Rep. 2015;17(5):445.
- Longo VD, Lieber MR, Vijg J. Turning anti-ageing genes against cancer. Nat Rev Mol Cell Biol. 2008;9(11):903-910.
- Whitman MM. The starving patient: supportive care for people with cancer. Clin J Oncol Nurs. 2000;4(3):121-5.
- Wallace TC, Bultman S, D’Adamo C, et al. Personalized Nutrition in Disrupting Cancer — Proceedings From the 2017 American College of Nutrition Annual Meeting. J Am Coll Nutr. 2019;38(1):1-14.
- Coussens LM, Zitvogel L, Palucka AK. Neutralizing Tumor-Promoting Chronic Inflammation: A Magic Bullet? Science. 2013;339(6117):286-291.
- Pleasance ED, Stephens PJ, O’Meara S, et al. A small-cell lung cancer genome with complex signatures of tobacco exposure. Nature. 2010;463(7278):184-190.
- Inoue-Choi M, Robien K, Lazovich D. Adherence to the WCRF/AICR Guidelines for Cancer Prevention Is Associated with Lower Mortality among Older Female Cancer Survivors. Cancer Epidemiol Biomarkers Prev. 2013;22(5):792-802.
- World Cancer Research Fund/American Institute for Cancer Research. Diet, Nutrition, Physical Activity and Cancer: a Global Perspective. Continuous Update Project Expert Report 2018.
- Hamaguchi R, Okamoto T, Sato M, Hasegawa M, Wada H. Effects of an Alkaline Diet on EGFR-TKI Therapy in EGFR Mutation-positive NSCLC. Anticancer Res. 2017;37(9):5141-5145.
- Ornish D, Weidner G, Fair WR, et al. Intensive lifestyle changes may affect the progression of prostate cancer. J Urol. 2005;174(3):1065-9.
- Zick SM, Snyder D, Abrams DI. Pros and Cons of Dietary Strategies Popular Among Cancer Patients. Oncology (Williston Park, NY). 2018;32(11):542-7.
- Vernieri C, Nichetti F, Raimondi A, et al. Diet and supplements in cancer prevention and treatment: Clinical evidences and future perspectives. Crit Rev Oncol Hematol. 2018;123:57-73.
- Crowder SL, Frugé AD, Douglas KG, et al. Feasibility Outcomes of a Pilot Randomized Clinical Trial to Increase Cruciferous and Green Leafy Vegetable Intake in Posttreatment Head and Neck Cancer Survivors. J Acad Nutr Diet. 2019;119(4):659-671.
- Patnaik JL, Byers T, DiGuiseppi C, Dabelea D, Denberg TD. Cardiovascular disease competes with breast cancer as the leading cause of death for older females diagnosed with breast cancer: a retrospective cohort study. Breast Cancer Res. 2011;13(3).
- Esselstyn CB. A plant-based diet and coronary artery disease: a mandate for effective therapy. J Geriatr Cardiol. 2017;14(5):317-320.
Motion graphics by Avo Media
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The Best Diet for Cancer Patients
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Content URLDoctor's Note
Just a few weeks ago, I did another video you might also be interested in: Diet and Lifestyle for Cancer Prevention and Survival.
What exactly constitutes an “alkaline” diet? I recently did a video on that, too. See: Do Alkaline Diets Help Athletic Performance?.
For more on that Ornish study, see Prostate Cancer Survival: The A/V Ratio.
Thought the “feasibility” studies were a little weird? It’s no joke. See Changing a Man’s Diet After a Prostate Cancer Diagnosis.
Does Astragalus Have Benefits for Life Extension and Fighting Cancer? Check out the video.
NOTE: when I say “ductal carcinoma of the breast” in the video, I obviously mean DCIS (ductal carcinoma in situ) not ICD (invasive ductal carcinoma).
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