The Effect of Dietary Patterns on Survival in Patients with Stage 4 Cancer

The role of lifestyle factors such as diet, body weight, and physical activity in cancer risk and the course of the disease is attracting increasing attention. Previous studies have shown that healthier diets may reduce recurrence and mortality risk in patients with early-stage (stage 1 and 2) cancer. However, metastatic (stage 4) disease has been the subject of very little research showing how specific dietary patterns may affect outcomes.

A study of diet in advanced cancer

Erin Van Blarigan and her team at the University of San Francisco conducted a study to investigate how important diet is in metastatic patients. Within four weeks of starting treatment, patients completed a questionnaire covering their food intake over the preceding three months. The study evaluated 2 dietary patterns (Western-style and safe diet) and 3 diet quality scores (AHEI, AMED, and Dietary Approaches to Stop Hypertension), determined using a food consumption questionnaire.

• Western-style diet contains large amounts of processed grains, dairy products, red meat, spices, sugar, and sweets.
• Safe diet contains large amounts of legumes, vegetables, and fruit.
• The Alternative Healthy Eating Index (AHEI) is scored from 0-110. It includes vegetables (excluding potatoes), fruit, whole grains, nuts, legumes, long-chain n-3 fatty acids, polyunsaturated fatty acids, and consumption of sugary drinks, alcohol, red and processed meat, trans fat, and sodium.
• Alternative Mediterranean Diet Index (AMED) is scored between 0 and 9. It includes vegetables, fruit, nuts, whole grains, legumes, fish, red and processed meat, monounsaturated fatty acids, and alcohol.
• Dietary Approaches to Stop Hypertension is scored from 0-45. It includes vegetables, fruit, nuts, legumes, low-fat dairy products, whole grains, sodium, red and processed meat, sugary drinks, and sweets.

Patients were followed for an average of 73 months. The team then examined their dietary scores and patterns. Jama Network Open published the study, whose results showed that metastatic colorectal cancer patients had no association between diet quality and overall survival. However, in these same patients, physical activity was associated with longer survival.

Conclusion & Commentary

It is very important to support patients as well as possible throughout treatment and develop feasible dietary patterns. Treatment may require individualized assessment. Involuntary weight or muscle loss in some patients may necessitate dietary changes. You can seek support from your doctor or dietitian.

Making lifestyle changes is difficult, especially while dealing with a cancer diagnosis and treatment. Patients may wish to focus their energy on the change that can help them most. Available data suggest that prioritizing a more active lifestyle during and after treatment may be more beneficial. Regular daily walks or being more active at home can be a good start. Patients should, of course, not overlook the importance of healthy eating. Establishing healthy eating habits before metastases are detected would be much more beneficial. In addition, for a patient diagnosed with advanced cancer, foods they enjoy may be prioritized rather than strict diets.