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Review
Published: 07-03-2022

Importantes aspectos da Nutrologia e suas aplicações nos pacientes oncológicos

Associação Brasileira de Nutrologia, Catanduva, SP, Brasil
neoplasms epidemiology neoplasm/ prevention & control mortality vitamins/administration & dosage vitamins/therapeutic use dietary supplements

Abstract

Global estimates show that the incidence of cancer all over the world has been increasing and, consequently, the mortality related to this diagnosis. Several cancer-related risk factors have been identified, such as smoking, overweight, western diets and physical inactivity. Robust scientific evidence shows that most cancers can be prevented with behavioral measures. Despite extensive knowledge of cancer-related modifiable risk factors, the implementation of prevention measures is still incipient. Interventions aiming at weight control, diet customization and physical activity stimulation can improve the quality of life and some outcomes related to cancer and its treatment. The present article aims to review the impacts of these variables on the diagnosis, treatment and mortality of cancer patients. In addition, it discusses the main recommendations of the specific nutritional aspects of this population.

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References

  1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018; 68 (06) 394-424
  2. Siegel R, Ward E, Brawley O, Jemal A. Cancer statistics, 2011: the impact of eliminating socioeconomic and racial disparities on premature cancer deaths. CA Cancer J Clin 2011; 61 (04) 212-236
  3. Wolin KY, Carson K, Colditz GA. Obesity and cancer. Oncologist 2010; 15 (06) 556-565
  4. Harvard Report on Cancer Prevention Volume 2: Prevention of Human Cancer. Cancer Causes Control 1997; 8: S1
  5. Grundy A, Poirier AE, Khandwala F, Grevers X, Friedenreich CM, Brenner DR. Cancer incidence attributable to lifestyle and environmental factors in Alberta in 2012: summary of results. CMAJ Open 2017; 5 (03) E540-E545
  6. Ezzati M, Lopez AD, Rodgers A, Vander Hoorn S, Murray CJ. Comparative Risk Assessment Collaborating Group. Selected major risk factors and global and regional burden of disease. Lancet 2002; 360 (9343): 1347-1360
  7. Harvard Report on Cancer Prevention Volume 2: Prevention of Human Cancer. Cancer Causes Control 1997
  8. Ford ES, Bergmann MM, Kröger J, Schienkiewitz A, Weikert C, Boeing H. Healthy living is the best revenge: findings from the European Prospective Investigation Into Cancer and Nutrition-Potsdam study. Arch Intern Med 2009; 169 (15) 1355-1362
  9. Wiseman M. The second World Cancer Research Fund/American Institute for Cancer Research expert report. Food, nutrition, physical activity, and the prevention of cancer: a global perspective. Proc Nutr Soc 2008; 67 (03) 253-256
  10. Colditz GA, Wolin KY, Gehlert S. Applying what we know to accelerate cancer prevention. Sci Transl Med 2012; 4 (127) 127rv4
  11. Chlebowski RT, Aiello E, McTiernan A. Weight loss in breast cancer patient management. J Clin Oncol 2002; 20 (04) 1128-1143
  12. Galvão DA, Newton RU. Review of exercise intervention studies in cancer patients. J Clin Oncol 2005; 23 (04) 899-909
  13. Chlebowski RT, Blackburn GL, Thomson CA. et al. Dietary fat reduction and breast cancer outcome: interim efficacy results from the Women's Intervention Nutrition Study. J Natl Cancer Inst 2006; 98 (24) 1767-1776
  14. Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med 2003; 348 (17) 1625-1638
  15. Larsson SC, Wolk A. Body mass index and risk of non-Hodgkin's and Hodgkin's lymphoma: a meta-analysis of prospective studies. Eur J Cancer 2011; 47 (16) 2422-2430
  16. Kant P, Hull MA. Excess body weight and obesity--the link with gastrointestinal and hepatobiliary cancer. Nat Rev Gastroenterol Hepatol 2011; 8 (04) 224-238
  17. Anderson GL, Neuhouser ML. Obesity and the risk for premenopausal and postmenopausal breast cancer. Cancer Prev Res (Phila) 2012; 5 (04) 515-521
  18. Aune D, Greenwood DC, Chan DS. et al. Body mass index, abdominal fatness and pancreatic cancer risk: a systematic review and non-linear dose-response meta-analysis of prospective studies. Ann Oncol 2012; 23 (04) 843-852
  19. Fair AM, Montgomery K. Energy balance, physical activity, and cancer risk. Methods Mol Biol 2009; 472: 57-88
  20. Protani M, Coory M, Martin JH. Effect of obesity on survival of women with breast cancer: systematic review and meta-analysis. Breast Cancer Res Treat 2010; 123 (03) 627-635
  21. Cao Y, Ma J. Body mass index, prostate cancer-specific mortality, and biochemical recurrence: a systematic review and meta-analysis. Cancer Prev Res (Phila) 2011; 4 (04) 486-501
  22. Bray GA. The Battle of the Bulge: A History of Obesity Research. Dorrance; Pittsburgh: 2007
  23. Pan H. Effect of obesity in premenopausal ER+ early breast cancer: EBCTCG data on 80,000 patients in 70 trials. American Society of Clincial Oncology Annual Meeting. Chicago, IL: 2014
  24. Sestak I, Distler W, Forbes JF, Dowsett M, Howell A, Cuzick J. Effect of body mass index on recurrences in tamoxifen and anastrozole treated women: an exploratory analysis from the ATAC trial. J Clin Oncol 2010; 28 (21) 3411-3415
  25. Pfeiler G, Königsberg R, Fesl C. et al. Impact of body mass index on the efficacy of endocrine therapy in premenopausal patients with breast cancer: an analysis of the prospective ABCSG-12 trial. J Clin Oncol 2011; 29 (19) 2653-2659
  26. Sparano JA, Wang M, Zhao F. et al. Obesity at diagnosis is associated with inferior outcomes in hormone receptor-positive operable breast cancer. Cancer 2012; 118 (23) 5937-5946
  27. Fowke JH, Motley SS, Concepcion RS, Penson DF, Barocas DA. Obesity, body composition, and prostate cancer. BMC Cancer 2012; 12: 23
  28. Discacciati A, Orsini N, Wolk A. Body mass index and incidence of localized and advanced prostate cancer--a dose-response meta-analysis of prospective studies. Ann Oncol 2012; 23 (07) 1665-1671
  29. Pettersson A, Lis RT, Meisner A. et al. Modification of the association between obesity and lethal prostate cancer by TMPRSS2:ERG. J Natl Cancer Inst 2013; 105 (24) 1881-1890
  30. Ebot EM, Gerke T, Labbé DP. et al. Gene expression profiling of prostate tissue identifies chromatin regulation as a potential link between obesity and lethal prostate cancer. Cancer 2017; 123 (21) 4130-4138
  31. Rock CL, Doyle C, Demark-Wahnefried W. et al. Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin 2012; 62 (04) 243-274
  32. Kroenke CH, Neugebauer R, Meyerhardt J. et al. Analysis of Body Mass Index and Mortality in Patients With Colorectal Cancer Using Causal Diagrams. JAMA Oncol 2016; 2 (09) 1137-1145
  33. Schmid D, Leitzmann MF. Association between physical activity and mortality among breast cancer and colorectal cancer survivors: a systematic review and meta-analysis. Ann Oncol 2014; 25 (07) 1293-1311
  34. Willett WC. Nutritional Epidemiology, 2nd ed. Oxford University Press; New York: 1998
  35. Schwedhelm C, Boeing H, Hoffmann G, Aleksandrova K, Schwingshackl L. Effect of diet on mortality and cancer recurrence among cancer survivors: a systematic review and meta-analysis of cohort studies. Nutr Rev 2016; 74 (12) 737-748
  36. Meyerhardt JA, Niedzwiecki D, Hollis D. et al. Association of dietary patterns with cancer recurrence and survival in patients with stage III colon cancer. JAMA 2007; 298 (07) 754-764
  37. Meyerhardt JA, Sato K, Niedzwiecki D. et al. Dietary glycemic load and cancer recurrence and survival in patients with stage III colon cancer: findings from CALGB 89803. J Natl Cancer Inst 2012; 104 (22) 1702-1711
  38. Willett WC. Diet and cancer: one view at the start of the millennium. Cancer Epidemiol Biomarkers Prev 2001; 10 (01) 3-8
  39. Hori S, Butler E, McLoughlin J. Prostate cancer and diet: food for thought?. BJU Int 2011; 107 (09) 1348-1359
  40. Davies NJ, Batehup L, Thomas R. The role of diet and physical activity in breast, colorectal, and prostate cancer survivorship: a review of the literature. Br J Cancer 2011; 105 (01) (Suppl. 01) S52-S73
  41. Berkow SE, Barnard ND, Saxe GA, Ankerberg-Nobis T. Diet and survival after prostate cancer diagnosis. Nutr Rev 2007; 65 (09) 391-403
  42. Van Patten CL, de Boer JG, Tomlinson Guns ES. Diet and dietary supplement intervention trials for the prevention of prostate cancer recurrence: a review of the randomized controlled trial evidence. J Urol 2008; 180 (06) 2314-2321 , discussion 2721–2722
  43. Demark-Wahnefried W, Polascik TJ, George SL. et al. Flaxseed supplementation (not dietary fat restriction) reduces prostate cancer proliferation rates in men presurgery. Cancer Epidemiol Biomarkers Prev 2008; 17 (12) 3577-3587
  44. Meyer F, Bairati I, Shadmani R, Fradet Y, Moore L. Dietary fat and prostate cancer survival. Cancer Causes Control 1999; 10 (04) 245-251
  45. Strom SS, Yamamura Y, Flores-Sandoval FN, Pettaway CA, Lopez DS. Prostate cancer in Mexican-Americans: identification of risk factors. Prostate 2008; 68 (05) 563-570
  46. Grosso G, Bella F, Godos J. et al. Possible role of diet in cancer: systematic review and multiple meta-analyses of dietary patterns, lifestyle factors, and cancer risk. Nutr Rev 2017; 75 (06) 405-419
  47. Benetou V, Trichopoulou A, Orfanos P. et al; Greek EPIC cohort. Conformity to traditional Mediterranean diet and cancer incidence: the Greek EPIC cohort. Br J Cancer 2008; 99 (01) 191-195
  48. Couto E, Boffetta P, Lagiou P. et al. Mediterranean dietary pattern and cancer risk in the EPIC cohort. Br J Cancer 2011; 104 (09) 1493-1499
  49. Le LT, Sabaté J. Beyond meatless, the health effects of vegan diets: findings from the Adventist cohorts. Nutrients 2014; 6 (06) 2131-2147
  50. Brennan SF, Cantwell MM, Cardwell CR, Velentzis LS, Woodside JV. Dietary patterns and breast cancer risk: a systematic review and meta-analysis. Am J Clin Nutr 2010; 91 (05) 1294-1302
  51. Fiolet T, Srour B, Sellem L. et al. Consumption of ultra-processed foods and cancer risk: results from NutriNet-Santé prospective cohort. BMJ 2018; 360: k322
  52. Vastag B. Nutrients for prevention: negative trials send researchers back to drawing board. J Natl Cancer Inst 2009; 101 (07) 446-448 , 451
  53. Coulter ID, Hardy ML, Morton SC. et al. Antioxidants vitamin C and vitamin e for the prevention and treatment of cancer. J Gen Intern Med 2006; 21 (07) 735-744
  54. NIH State-of-the-Science Panel. National Institutes of Health State-of-the-science conference statement: multivitamin/mineral supplements and chronic disease prevention. Ann Intern Med 2006; 145 (05) 364-371
  55. Lin J, Cook NR, Albert C. et al. Vitamins C and E and beta carotene supplementation and cancer risk: a randomized controlled trial. J Natl Cancer Inst 2009; 101 (01) 14-23
  56. Neuhouser ML, Wassertheil-Smoller S, Thomson C. et al. Multivitamin use and risk of cancer and cardiovascular disease in the Women's Health Initiative cohorts. Arch Intern Med 2009; 169 (03) 294-304
  57. Park SY, Murphy SP, Wilkens LR, Henderson BE, Kolonel LN. Multivitamin use and the risk of mortality and cancer incidence: the multiethnic cohort study. Am J Epidemiol 2011; 173 (08) 906-914
  58. Gaziano JM, Sesso HD, Christen WG. et al. Multivitamins in the prevention of cancer in men: the Physicians' Health Study II randomized controlled trial. JAMA 2012; 308 (18) 1871-1880
  59. Huang HY, Caballero B, Chang S. et al. The efficacy and safety of multivitamin and mineral supplement use to prevent cancer and chronic disease in adults: a systematic review for a National Institutes of Health state-of-the-science conference. Ann Intern Med [Research Support, U.S. Gov't, P.H.S. Review Systematic Review]. 2006 Sep 5; 145 (05) 372-385
  60. Fortmann SP, Burda BU, Senger CA, Lin JS, Whitlock EP. Vitamin and mineral supplements in the primary prevention of cardiovascular disease and cancer: An updated systematic evidence review for the U.S. Preventive Services Task Force. Ann Intern Med 2013; 159 (12) 824-834
  61. Qiao YL, Dawsey SM, Kamangar F. et al. Total and cancer mortality after supplementation with vitamins and minerals: follow-up of the Linxian General Population Nutrition Intervention Trial. J Natl Cancer Inst 2009; 101 (07) 507-518
  62. Moyer VA. U.S. Preventive Services Task Force. Vitamin, mineral, and multivitamin supplements for the primary prevention of cardiovascular disease and cancer: U.S. Preventive services Task Force recommendation statement. Ann Intern Med 2014; 160 (08) 558-564
  63. Chung M, Lee J, Terasawa T, Lau J, Trikalinos TA. Vitamin D with or without calcium supplementation for prevention of cancer and fractures: an updated meta-analysis for the U.S. Preventive Services Task Force. Ann Intern Med 2011; 155 (12) 827-838
  64. Freedman DM, Looker AC, Abnet CC, Linet MS, Graubard BI. Serum 25-hydroxyvitamin D and cancer mortality in the NHANES III study (1988-2006). Cancer Res 2010; 70 (21) 8587-8597
  65. Steevens J, van den Brandt PA, Goldbohm RA, Schouten LJ. Selenium status and the risk of esophageal and gastric cancer subtypes: the Netherlands cohort study. Gastroenterology 2010; 138 (05) 1704-1713
  66. Vinceti M, Dennert G, Crespi CM. et al. Selenium for preventing cancer. Cochrane Database Syst Rev 2014; 30 (03) CD005195
  67. Vinceti M, Filippini T, Del Giovane C. et al. Selenium for preventing cancer. Cochrane Database Syst Rev 2018; 1: CD005195
  68. Larsson SC, Håkansson N, Giovannucci E, Wolk A. Folate intake and pancreatic cancer incidence: a prospective study of Swedish women and men. J Natl Cancer Inst 2006; 98 (06) 407-413
  69. Larsson SC, Giovannucci E, Wolk A. Folate intake, MTHFR polymorphisms, and risk of esophageal, gastric, and pancreatic cancer: a meta-analysis. Gastroenterology 2006; 131 (04) 1271-1283
  70. Clarke R, Halsey J, Lewington S. et al; B-Vitamin Treatment Trialists' Collaboration. Effects of lowering homocysteine levels with B vitamins on cardiovascular disease, cancer, and cause-specific mortality: Meta-analysis of 8 randomized trials involving 37 485 individuals. Arch Intern Med 2010; 170 (18) 1622-1631
  71. Larsson SC, Orsini N, Wolk A. Vitamin B6 and risk of colorectal cancer: a meta-analysis of prospective studies. JAMA 2010; 303 (11) 1077-1083
  72. van Asperen IA, Feskens EJ, Bowles CH, Kromhout D. Body iron stores and mortality due to cancer and ischaemic heart disease: a 17-year follow-up study of elderly men and women. Int J Epidemiol 1995; 24 (04) 665-670
  73. Knekt P, Reunanen A, Takkunen H, Aromaa A, Heliövaara M, Hakulinen T. Body iron stores and risk of cancer. Int J Cancer 1994; 56 (03) 379-382
  74. Bardia A, Tleyjeh IM, Cerhan JR. et al. Efficacy of antioxidant supplementation in reducing primary cancer incidence and mortality: systematic review and meta-analysis. Mayo Clin Proc 2008; 83 (01) 23-34
  75. Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group. The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med 1994; 330 (15) 1029-1035
  76. Omenn GS, Goodman GE, Thornquist MD. et al. Effects of a combination of beta carotene and vitamin A on lung cancer and cardiovascular disease. N Engl J Med 1996; 334 (18) 1150-1155
  77. Blot WJ, Li JY, Taylor PR. et al. Nutrition intervention trials in Linxian, China: supplementation with specific vitamin/mineral combinations, cancer incidence, and disease-specific mortality in the general population. J Natl Cancer Inst 1993; 85 (18) 1483-1492
  78. Martínez ME, Marshall JR, Giovannucci E. Diet and cancer prevention: the roles of observation and experimentation. Nat Rev Cancer 2008; 8 (09) 694-703
  79. Schmitz KH, Courneya KS, Matthews C. et al; American College of Sports Medicine. American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc 2010; 42 (07) 1409-1426
  80. Meyerhardt JA, Mangu PB, Flynn PJ. et al; American Society of Clinical Oncology. Follow-up care, surveillance protocol, and secondary prevention measures for survivors of colorectal cancer: American Society of Clinical Oncology clinical practice guideline endorsement. J Clin Oncol 2013; 31 (35) 4465-4470

How to Cite

Zylberberg, R. (2022). Importantes aspectos da Nutrologia e suas aplicações nos pacientes oncológicos. International Journal of Nutrology, 13(3), 69–80. https://doi.org/10.1055/s-0040-1718994