Many cancer institution websites lack nutritional guidance, others give mixed messages

March 26, 2013

Radiation oncologists at Thomas Jefferson University Hospital are stressing the need for evidence-based, standardized guidelines on dietary recommendations for cancer patients—and with good reason. A new analysis revealed that online dietary recommendations for cancer patients, if even present on an institution's website, appear to be consistently inconsistent.

A review of all 21 of the National Comprehensive Cancer Network (NCCN) member institutions found that only four provided nutritional guidelines, with seven linking to external sites. What's more, many of the sites with recommendations contradicted each other.

The results were published online March 26 in Nutrition and Cancer: An International Journal.

Given that recent data reveals that dietary factors may influence outcomes in patients undergoing cancer treatment, and that over 60 percent of patients head to the Internet for guidance on diet, it's imperative that information is as accurate and uniform as possible, says senior author Colin Champ, M.D., a resident in the Department of at Jefferson .

"More and more patients are coming to their doctors and asking for nutritional recommendations before and after treatment, but there is really no standard direction to send them," said Dr. Champ. "So we started looking at sources where people may go to see what information they were digesting."

There were . Half the information presented or linked to on NCCN sites contradicted the other half.

Half promoted a low-fat, high-carbohydrate diet, and half promoted weight maintenance during treatment, endorsing a 1:1 ratio of carbohydrate to fat. Of the four external sites that provided , half favored a low-fat, high-carbohydrate diet, and half favored high- to maintain weight.

What's more, the information is not always cancer-site specific, more general recommendations for all cancers are noted. And the weight maintenance recommendations are really less for survivorship and more about not losing weight during treatment, Dr. Champ said.

But depending on cancer type and stage, one might expect different weight changes attributed to these concerns. For instance, recommendations for patients with locally advanced head and neck cancer may diverge dramatically from nutritional recommendations appropriate for patients with localized breast or prostate cancer.

Studies show that the majority of women gain weight during adjuvant treatment for breast cancer, and prospective trials have shown a similar detriment in survival outcomes in obese men during prostate cancer treatment. Promoting low-fat, high-protein diets may cause patients to turn to a high-carbohydrate diet and compound any other weight issues.

It is likely that recommendations favoring calorie-dense diets and therefore weight maintenance are in response to previous findings on weight and . Weight loss during has been associated with a detrimental impact on quality of life, poorer treatment outcomes, and decreased survival time.

Such contradictory information may cause problems for some patients. The lack of data and consistency in recommendations could drastically alter a patient's dietary habits during treatment depending on which site they access.

Many centers, even high-quality institutions such as those reviewed in this study, do not even offer recommendations, and the external referenced websites advocate a variety of nutritional approaches that are inconsistent with each other and NCCN member websites.

"These findings demonstrate an urgent need for consistent, evidence-based nutritional guidelines for patients, and potentially for additional research in this domain," said Dr. Champ.

Explore further: Guidelines say diet, exercise, weight control improve odds after cancer diagnosis

Related Stories

Guidelines say diet, exercise, weight control improve odds after cancer diagnosis

April 26, 2012
New guidelines from the American Cancer Society say for many cancers, maintaining a healthy weight, getting adequate physical activity, and eating a healthy diet can reduce the chance of recurrence and increase the likelihood ...

Intermittent, low-carbohydrate diets more successful than standard dieting

December 9, 2011
An intermittent, low-carbohydrate diet was superior to a standard, daily calorie-restricted diet for reducing weight and lowering blood levels of insulin, a cancer-promoting hormone, according to recent findings.

Full weight-Based chemo doses recommended for obese

April 6, 2012
(HealthDay) -- The American Society of Clinical Oncology Clinical Practice Guideline on Appropriate Chemotherapy Dosing for Obese Adult Patients With Cancer recommends using full weight-based cytotoxic chemotherapy doses ...

Oral nutritional interventions improve nutritional intake and QOL in malnourished cancer patients

February 15, 2012
Oral nutritional interventions help increase nutritional intake and improve some aspects of quality of life (QOL) in malnourished cancer patients or those who are at nutritional risk, but do not effect mortality, according ...

Many advanced breast cancer patients do not receive recommended treatment

June 27, 2011
Radiation after a mastectomy for women with advanced breast cancer saves lives, but almost half of these patients do not receive it. That is the conclusion of a new study published early online in CANCER, a peer-reviewed ...

Recommended for you

Shooting the achilles heel of nervous system cancers

July 20, 2017
Virtually all cancer treatments used today also damage normal cells, causing the toxic side effects associated with cancer treatment. A cooperative research team led by researchers at Dartmouth's Norris Cotton Cancer Center ...

Molecular changes with age in normal breast tissue are linked to cancer-related changes

July 20, 2017
Several known factors are associated with a higher risk of breast cancer including increasing age, being overweight after menopause, alcohol intake, and family history. However, the underlying biologic mechanisms through ...

Immune-cell numbers predict response to combination immunotherapy in melanoma

July 20, 2017
Whether a melanoma patient will better respond to a single immunotherapy drug or two in combination depends on the abundance of certain white blood cells within their tumors, according to a new study conducted by UC San Francisco ...

Discovery could lead to better results for patients undergoing radiation

July 19, 2017
More than half of cancer patients undergo radiotherapy, in which high doses of radiation are aimed at diseased tissue to kill cancer cells. But due to a phenomenon known as radiation-induced bystander effect (RIBE), in which ...

Definitive genomic study reveals alterations driving most medulloblastoma brain tumors

July 19, 2017
The most comprehensive analysis yet of medulloblastoma has identified genomic changes responsible for more than 75 percent of the brain tumors, including two new suspected cancer genes that were found exclusively in the least ...

Novel CRISPR-Cas9 screening enables discovery of new targets to aid cancer immunotherapy

July 19, 2017
A novel screening method developed by a team at Dana-Farber/Boston Children's Cancer and Blood Disorders Center—using CRISPR-Cas9 genome editing technology to test the function of thousands of tumor genes in mice—has ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.