Does nutrition for cancer patients feed the tumour? A clinical perspective

[Display omitted] •Glucose dependency is present in most tumours; especially in the nervous system, head and neck and squamous cell lung cancer.•Adoption of a ketogenic diet can only be proposed to patients with high 18F-FDG captation tumours.•Oncologists should be aware of the poor rationale for ca...

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Bibliographic Details
Published in:Critical reviews in oncology/hematology 2020-09, Vol.153, p.103061-103061, Article 103061
Main Authors: Bozzetti, F., Stanga, Z.
Format: Article
Language:English
Subjects:
Calorie restricted diet
Calorie restriction
Cancer cell metabolism
Ketogenic diet
Nutrition and tumour growth
Nutrition of cancer patients
Nutritive substrates of the cancer cell
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Summary:[Display omitted] •Glucose dependency is present in most tumours; especially in the nervous system, head and neck and squamous cell lung cancer.•Adoption of a ketogenic diet can only be proposed to patients with high 18F-FDG captation tumours.•Oncologists should be aware of the poor rationale for caloric restriction in malnourished cancer patients.•There is evidence that malnutrition is a negative predictive and prognostic indicator and can be prevented with a multimodal approach. This review aims to answer to two basic questions: a) Which substrates does a tumour utilize and is there a regimen that might potentially favour the host over the tumour? and b) Does nutritional intervention disproportionally affect tumour growth? Literature to date focuses on humans; although some references to molecular mechanisms regulating cancer cells metabolism derive from studies on experimental tumours and cell biology. Literature shows that some tumours, especially those of the brain and head/neck and lung, are glucose-dependent, and patients with these tumours could benefit from a normocaloric ketogenic diet provided these tumours exhibit high fluorodeoxyglucose (18F-FDG) captation. A high fat-protein, low carbohydrate diet appears to better fulfil the nutritional requirements of the cancer patient. Current evidence shows no improvement in tumoral response after restricting patients' caloric intake; whereas malnutrition is acknowledged as an important negative predictive and prognostic factor in all cancer patients.
ISSN:1040-8428
1879-0461
DOI:10.1016/j.critrevonc.2020.103061