Long-term nutritional support as an adjunct to chemotherapy for breast cancer

In recent years, the concept of nutritional support as a part of a comprehensive cancer management program has gained increasing acceptability. However, little data is available in regard to the effect of nutritional support programs on the chronic disease state represented by recurrent or persistent cancer that characterizes patients undergoing systemic chemotherapy. In 1977 we undertook to study this problem in a randomized prospective study designed to evaluate the effects of long-term (12 months) enteral nutritional support in a group of ambulatory breast cancer patients undergoing a standard cytotoxic chemotherapy treatment program, in an adjuvant or therapeutic setting. The results of this study suggest that patients with breast cancer are overweight as compared to the general population and that any significant change in initial body weight, either a gain or a loss, is associated with an increased risk of recurrent disease. Data are presented which show little or no correlation between standard parameters of nutritional assessment and risk of disease recurrence and/or response to chemotherapy. These data also suggest that until we better understand the relationship between tumor and host in breast cancer patients, we offer nutritional support programs only in situations where there are specific clinical indications for such interventions.