Addressing Nutrition in Patients with Kidney Cancer

While diet and exercise are a growing concern being addressed in all malignancies, its focus in kidney cancer is still lacking, according to Dr. Roberto Pili.

“There is an unmet need to integrate nutritional support for kidney cancer patients” Pili, from the Indiana Genitourinary Cancers Research Consortium and the Experimental and Developmental Therapeutics Program at Indiana University Melvin and Bren Simon Cancer Center, said at A Vision of Hope: A Kidney Cancer Educational Symposium, hosted by the Judy Nicholson Kidney Cancer Symposium and Penn Medicine Abramson Cancer Center.

“Our overall goals are to integrate immune-based therapies and dietary interventions for kidney cancer,” he added. “and to improve patient quality of life and implement survivorship initiatives for patients with recurrent or advanced kidney cancer.”

Defined as nourishment or energy that is obtained from food consumed or the process of consuming the proper amount of nourishment and energy, nutrition plays a key role for patients with kidney cancer.

This is where a cancer dietitian can come into play. These individuals are focused on identifying goals of healthy eating for cancer survivorship and also risks for malnutrition, and gaining tools to gradually change a patient’s eating habits. A “cancer diet” depends on these goals, the treatment that specific patient is receiving, the current side effects they are experiencing, as well as their appetite.

Pili noted that health care teams should integrate dietitians into the multidisciplinary approach as a personal trainer.

“Patients need different counseling depending on the stage of their cancer: early-stage disease patients may benefit (from a dietitian) for weight loss, while later-stage disease patients may need weight maintenance,” he said.

Goals of nutrition while a patient is on treatment should include weight maintenance, adequate hydration, avoidance of nutrition-related treatment breaks and maintenance of skin integrity.

One area to particularly beware of is malnutrition — which can occur in 50% to 80% of patients during treatment and is associated with increased morbidity, mortality and decreased responses to therapy. However, nutrition support can help prevent or diminish this side effect and its progression.

Pili recommends for patients to try eating a plant-based diet that is high in vitamins, minerals and fiber. This entails:

• Eating more vegetables and fruit
• Changing the way one thinks about meat and limit intake to less than 10 ounces per week
• Using beans as a protein source
• Eating seafood twice a week
• Using healthy fats in cooking and eating, like extra virgin olive oil, nuts, seeds and avocados
• Switching to whole grains
• Avoiding simple/processed sugars

Moreover, to reduce inflammation during treatment with immunotherapy, Pili recommends the following:

• Avoid dairy products and red meat
• Increase plant-based proteins and fibers
• Increase cruciferous vegetables, like broccoli, cauliflower and cabbage
• Eat more fish

He also only recommends taking vitamin D or C supplements, and for patients to integrate dietary changes in with regular physical activity.