Pet Health and Nutrition: Cancer Diet Redux: When is the "Cancer ...

When should the "cancer diet" not be fed to veterinary cancer patients? We should begin by determining when the "cancer diet" *should* be fed to cancer patients. It is fairly universally recognized now that cancer cells exhibit increased glucose utilization compared to normal cells, and this metabolic defect is the basis for research to determine whether lowering glucose concentrations (by limiting simple carbohydrates in the diet) can improve cancer survival. Every cancer is different, and test tube studies on human cancer cells suggest that different cancers respond differently to various nutritional profiles in their media. And we still don't have definitive proof as to the best diet for cancer patients. In people, it is recommended that they eat the diet that helps prevent cancer - low in animal fat, high in vegetables, full of variety - and people should continue to get exercise. And while there is plenty of evidence in people that excess weight *loss* during cancer treatment worsens the prognosis, there is now emerging evidence that being obese while undergoing cancer treatment also worsens prognosis. So the "low carb diet" for cancer patients is usually quite high in meat (which contains a lot of fat), low in starches and sugars, and contains added fat. A logical conclusion is that for pets with cancer only - no pancreatitis, no advanced renal disease, no obesity, etc - a low carb, moderate protein, high fat food makes sense. But for patients with these other disorders, the diet can not only worsen the prognosis but even make death from the other disease more imminent than death from cancer. Hence the new evidence that some obese human cancer patients have worse outcomes than people of normal weight. This has been shown most frequently in breast, prostate and colon cancer (Ramos 2010, Sinicrope 2010, Komaru 2010, Siegel 2010, de Azambuja 2010, Lange 2008, Nitori 2009). Additionally, some recent trials suggest that overweight patients undergoing controlled weight loss during cancer treatment experienced improved prognosis (Freedland 2009). I see many people who request the 'cancer diet' for their pet with cancer, and a few who refuse to believe that it is inappropriate for their particular pet. We have an increasing number of studies in people to suggest that customizing the diet for an obese patient improves survival, and only 1 study in dogs suggesting that the high fat low carb diet makes a difference in survival. The veterinary oncologist that investigated the low carbohydrate diet for veterinary cancer patients has repeatedly written "no one diet is right for every cancer patient". de Azambuja E, McCaskill-Stevens W, Francis P, Quinaux E, Crown JP, Vicente M, Giuliani R, Nordenskjöld B, Gutiérez J, Andersson M, Vila MM, Jakesz R, Demol J, Dewar J, Santoro A, Lluch A, Olsen S, Gelber RD, Di Leo A, Piccart-Gebhart M.The effect of body mass index on overall and disease-free survival in node-positive breast cancer patients treated with docetaxel and doxorubicin-containing adjuvant chemotherapy: the experience of the BIG 02-98 trial. Implications of body mass index in Japanese patients with prostate cancer who had undergone radical prostatectomy. Cancer Control 2010;