Two Studies Link Healthy Habits to Increased Colon Cancer Survival

By Julie Grisham,

Various kinds of nuts
Summary

People who maintain a healthy lifestyle after surgery and chemotherapy for colon cancer are more likely to have a favorable outcome after treatment. Findings from two studies demonstrating this are being presented at the ASCO meeting.

Highlights
  • One study found that consumption of tree nuts is associated with a reduced risk of cancer recurrence and increased survival.
  • Another study looked at healthy habits overall, including diet and exercise. It found that healthier people fare better after cancer treatment.
  • Both studies used data from a clinical trial led by MSK medical oncologist Leonard Saltz.

Two analyses from a clinical trial show that people who maintain a healthy lifestyle after surgery and chemotherapy for colon cancer are more likely to have a favorable outcome. One evaluation looked at maintaining healthy habits overall. The other looked specifically at the link between a favorable outcome and eating nuts as a regular part of the diet. The new analyses, led by investigators from Dana-Farber Cancer Institute and conducted in collaboration with Memorial Sloan Kettering’s Leonard Saltz, are being presented at the annual meeting of the American Society of Clinical Oncology.

“This whole series of studies on how lifestyle impacts outcome — of which these two are just the latest — is very empowering to people with cancer,” says Dr. Saltz, Chief of the Gastrointestinal Oncology Service. “My patients always ask me, ‘What else can I do to fight my cancer?’ The answer is that one important thing you can do is adopt a healthy lifestyle.”

The original phase III trial, which was reported by Dr. Saltz in 2007, included more than 1,200 participants. It was designed to test whether adding the drug irinotecan (Camptosar®) to chemotherapy after surgery would extend survival for people with stage III colon cancer. The study did not find any benefit from the additional drug.

As part of that research, participants also completed detailed surveys at three months and at 12 months after surgery. Among the questions asked were those about diet and lifestyle habits, including exercise, smoking, and alcohol and drug use.

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Nuts to You: Tree Nuts Associated with Better Outcomes

One of the new analyses focused on the consumption of tree nuts, such as walnuts, cashews, pecans, pistachios, hazelnuts, and almonds. People who reported eating two or more servings of nuts per week had a 46% lower risk that their cancer would return. Interestingly, they also had a 53% lower risk of dying from any cause, not just from colon cancer, during the time of the study. Eating peanuts, which are actually a legume and not a nut, and peanut butter did not correlate with a favorable outcome.

“We think that the healthy unsaturated fats and antioxidants in tree nuts contribute to an overall healthy diet,” Dr. Saltz explains. He says that the benefits from nuts are likely similar to those from other foods that are considered healthful, such as olive oil, vegetables, and whole grains.

What we can say [based on this study] is that a healthy diet improves the overall chance of a favorable outcome when receiving appropriate anticancer therapy.
Leonard Saltz
Leonard Saltz medical oncologist

“It’s likely not strictly the nuts that confer the lower risk of colon cancer,” he says. “While they are healthy, they are also more likely to be consumed more often by people eating a range of healthful foods.”

In addition, he adds, consuming nuts requires healthy teeth, and good dental health has been associated with good overall health outcomes in numerous studies.

“No one should misinterpret this study as saying that instead of undergoing medical treatment, you should just eat nuts,” Dr. Saltz says. “What we can say is that a healthy diet improves the overall chance of a favorable outcome when receiving appropriate anticancer therapy.”

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Eat Healthier, Exercise More

The second analysis presented at the meeting also examined data from Dr. Saltz’s original trial. It used the American Cancer Society’s Nutrition and Physical Activity Guidelines to set up five groups, from people who followed the recommendations most closely to those who followed them the least. These guidelines include maintaining a healthy body weight and getting regular physical activity. They advocate a diet rich in vegetables, fruits, and whole grains and low in red and processed meats, as well as low in alcohol consumption.

Maintaining healthy habits is important for everyone but particularly for people who have a history of cancer.
Leonard Saltz
Leonard Saltz medical oncologist

The investigators found that during the seven-year follow-up period, those in the most healthy lifestyle group had a 51% lower risk of death than those in the bottom fifth. The healthiest group’s risk of cancer recurrence was 42% lower.

Previous analyses from the same 2007 trial looked at other components of the diet:

  • A 2014 report showed that consuming two or more 12-ounce servings of soda or other sugar-sweetened beverages every day was connected with a 67% increased risk of cancer recurrence, compared with the risk in those who consumed fewer than two servings per month.
  • A 2016 report showed that people who drank four or more cups of caffeinated coffee daily had a rate of disease recurrence that was 42% lower than those who didn’t drink coffee. Those coffee drinkers were also 33% less likely to die of any cause.

“Maintaining healthy habits is important for everyone but particularly for people who have a history of cancer,” Dr. Saltz says. “We’re not talking about training for a triathlon or going on a strict diet. There are effects from getting regular aerobic activity and exercise; adjusting what you eat to eliminate excess sugar and refined carbs, like white flour; reducing red meat consumption; and adding more vegetables, whole grains, and seafood to your diet.

“We want people with cancer to cultivate the same healthy lifestyle that every doctor wants every patient to maintain,” he concludes. “We don’t need to be totally black and white about this. Diets are made to be broken every now and again. It’s just that foods like a cannoli or a cheeseburger should be a rare treat, not a regular part of an everyday diet.”

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This research was funded by the National Institutes of Health.

Comments

I am a nine year survivor of bladder cancer. I have been taking a tablespoon full of certified raw ORGANIC honey each day. Is that good to have? Your reply is appreciated. Thank you for your concern.

Dear Diane, we recommend that you discuss the use of any dietary supplements with your doctor. Thank you for your comment, and best wishes to you.

I would have to agree.
Dx in 2011 with stage 3B rectal cancer I went through the neoadjuvent treatment process followed by spinchter a sparing LAR. Healthy lifestyle prior to my dx, continued exercise in moderation during treatment and a fitness plan post surgery were incredibly helpful for both mind and body. I believe I was able to endure a rigorous treatment and surgical plan because I was in good physical condition.
Although, I did have a locally metastatic recurrence in 2015, I did not have a distant met. Several of my Drs attribute this to my lifestyle choices. Something kept this adneocarcinoma in check enough to remain local / regional.
Still mindblowing and life changing to have a recurrence but exercise has remained part of my daily life.
Coffee (a necessity), limited meat, refined sugar and processed food consumption are all paramount for me.
Nuts... pecans are a fan favorite! I add them to everything.
I am please to see studies that help us, as patients, take hold of our treatmemt once our oncologist loosens the grip - LOL.
Life in general truly is garbage in, garbage out I'm not saying ever CRC patient should run a marathon and become a vegan but little changes go a long, long way. Any leg up we can have against this monster is a win for the team.

Dear Kimberlie, thank you for sharing your story. We're glad to hear you're doing well. Best wishes to you!

I have stage 2 breast cancer have not done any surgery yet or chemotherapy what are the foods i should be eating more and what supplements or herbal teas should i take

Dear Keena, we're sorry to hear about your diagnosis. We recommend that you discuss the use of any supplements with your healthcare team. You may also want to ask your doctor for a referral to a nutritionist if you are concerned about your diet during treatment. Thank you for your comment, and best wishes to you.

Hi. NSCLC stage IV dx in Sept 2017. I do run marathons and ultras, so I was extremely happy to be able to get back to training in November after surgery to remove a brain met and targeted pill chemotherapy (still ongoing). I thought the exercise would be good for me but it's good to see that backed up by science. I'm also happy about the caffeine as I've always been a coffee drinker. Have to eat more nuts now!

Not sure if or how these contribute but my onco docs have me on some other supplements. Namely bifido probiotic and fucoidan extract. Both for improved immune function but not to treat the cancer.

Anyway, nice to see the science behind the diets. Eating well isn't always easy but it always pays off.

Dear Garth, you are an inspiration! Thank you for sharing your story, and best wishes to you.

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