The National Cancer Institute defines neoadjuvant therapy as treatment given as a first step to shrink a tumor before the main treatment, often surgery. Examples of neoadjuvant therapy, according to NCI, are chemotherapy, radiation therapy and hormone therapy.
Nutrition and herbal therapies aren't part of NCI's definition of neoadjuvant therapy, but there's a growing cadre of practitioners who would like to broaden the definition beyond its decades-old constraints.
They see that even though drugs and surgery have improved outcomes for some cancer patients, there are gaping holes in care that can be plugged with nutritional and lifestyle support, including diet modification, targeted supplementation and help with cooking and healthful food preparation.
People desperately need assistance navigating the health care system and enlisting other support services.
Nutritional practitioners often don't start collaborating with clients until conventional neoadjuvant therapies have begun or ended. I sometimes consult individuals who are receiving chemo, hormonal therapy or surgery who have not changed their diets a bit, let alone made the most of a cohesive nutritional program to help slow cancer progression. Many say they feel powerless and financially stressed.
It would seem ideal if, before neoadjuvant therapy begins, people embraced a program of modified diet and individualized supplementation of herbs and nutrients, as well as lifestyle support, including exercise, sleep optimization and stress reduction. This would provide an opportunity to build patients up and, sometimes, shrink tumors without drugs or surgery.
When nutrition is optimized, energy is enhanced, diminished blood counts, anemia and marrow suppression can be mitigated and weight is better stabilized. "Chemo brain" and the nerve pain of neuropathy are less likely to strike.
When people go on a solid nutritional and herbal program along with chemotherapy and other conventional approaches, they routinely experience fewer side effects and better outcomes from the drugs while potentially reducing chemoresistance, a point at which cancer cells no longer respond to a given drug or drugs.
Various compounds that can help achieve improved outcomes and quality of life include fatty acids, B vitamins and specific, plant-based nutrients, such as curcumin from turmeric root, polyphenols from green tea and amino acids, including L-arginine and L-glutamine, which help the cardiovascular and digestive systems.
Though some newly diagnosed people receive nutritional counseling before starting conventional cancer therapies, they are the rare exceptions. With advances in genetic testing and tumor-sensitivity testing and a clearer understanding emerging about the relationship between diet, environment and our genes, that may change.
Michael Altman is a nutritionist at Ventana Wellness and teaches at Southern Oregon University. Email him at firstname.lastname@example.org.