Healthy Diet and Lifestyle May Improve Survival Rates for Patients With Stage 3 Colon Cancer

Positive diet and lifestyle modifications may significantly lower the risk for recurrence and improve survival rates in patients with stage 3 colon cancer, according to recent study results.

The results highlight that diet and lifestyle really matter for patients with colon cancer, according to an expert.

“(This study) is important because it’s an additional opportunity to enhance the outcome of patients. I think it allows patients to be empowered, to do things beyond obviously agreeing to do the treatments we recommend. I think it’s providing some really important insights on the biology of the disease,” Dr. Charles S. Fuchs, senior vice president and global head of hematology oncology product development at Genentech and Roche and an adjunct professor at Yale School of Medicine, said in an interview with CURE®.

Currently, the tools to predict survival outcomes in patients with colon cancer rely primarily on clinical and pathological (such as age, sex, positive lymph nodes and T-stage) characteristics which are nonmodifiable. However, new evidence has demonstrated diet and lifestyle may influence patient outcomes. Fuchs and researchers wanted to look more broadly at this and what patients can do to improve their outcomes.

To do so, researchers evaluated disease-free survival (the time from treatment to recurrence, metastasis or death) and overall survival (time from diagnosis or treatment start when patients are still alive) in 1,024 patients (median age, 60 years; mostly male). At a median follow up of 7.3 years, there were 394 disease-free survival events, 350 recurrences and 311 deaths.

Self-reported diet and lifestyle factors, when added to clinical and pathological characteristics, meaningfully improved prediction models. Additionally, results found that aspirin and COX-2 inhibitor use, coffee, nuts, dark meat fish (like mackerel, sardines and salmon), lycopene-rich vegetables (like tomatoes) and BMI were significantly associated with disease-free survival. Overall survival was significantly associated with physical activity, nuts, dark meat fish and BMI.

Fuchs explained that these results mean diet and lifestyle, in addition to pathological characteristics, can clinically change the likelihood of cancer recurrence.

“For somebody who had features in their tumor that predicted a somewhat higher risk of recurrence, taking (up) a healthy diet and lifestyle significantly improves their chances of cure. And that was true across all risk groups — high, medium, low — based on the clinical data,” he said.

When researchers added diet and lifestyle to prediction models, they improved five-year disease-free survival of all patients and by 6.3%, 21.4%, and 42.6% for those with good-risk, average-risk, and poor-risk clinical and pathological features, respectively. Fuchs said that these numbers are both statistically significant and clinically meaningful for patients.

“I think, whether it be 6%, 21% or 43%, that's clinically meaningful. I think that's the kind of numbers that we approve drugs for. If it's a matter of exercising or eating right, that seems worthwhile,” he explained.

Fuchs understands that for patients this can be hard to start a healthy diet and lifestyle on top of the treatments, but these meaningful results should empower them to do so.

“It tells patients that diet and lifestyle matter, and that's not easy. Doing surgery, doing chemotherapy, this is hard. And frankly, changing your approach to diet and lifestyle is hard. I'm not minimizing it. But what it avails to patients (is) an opportunity to really be empowered to do these things,” he added.

To begin a healthy diet and lifestyle, Fuchs suggests patients first talk to their medical care team, and he is hoping these results stimulate that conversation. He recommends taking it slow and not having too many drastic changes at once — a little bit of exercise each week, or changing up the meal plans is a good place to start.

“I say this as a practitioner, not as a patient — I only have that perspective, but as a practitioner, I think that it's got to be difficult for a patient because, yes, you hopefully trust your doctor and your nurse, and you're confident they're giving you sound recommendations, but they're telling you what to do. You do this, and you'll be better off for it. But here's an opportunity where patients can look at these data and say, OK these are the things I'm going to do. And I think that can be empowering and healthy, both physically and mentally,” he concluded.

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