Cancer is the second leading cause of death in the United States for adults. While everyone diagnosed with cancer reacts differently, the diagnosis is often associated with fear, anger, hopelessness, and a range of other emotions. The American Cancer Society states that as many as one third of cancer deaths in the United States could be prevented if Americans consumed a diet rich in plants and maintained a healthy body weight.1 Scientific evidence has shown consumption of a diet that consists mostly of plant-based foods such as vegetables, fruits, whole grains, and legumes together with restricting intake of saturated and trans fats and added sugars, and maintaining a body mass index (BMI) < 25, is associated with a reduced risk for chronic diseases such as cancer.1 Evidence strongly suggests that obesity is associated with an increased risk for breast, colorectal, endometrial, esophageal, and kidney cancer; obesity is also linked with cancers of the cervix, gallbladder, ovary, pancreas, and thyroid; multiple myeloma, Hodgkin’s lymphoma, and aggressive prostate cancer are also associated with excess body fat.1 Alcohol consumption is associated with cancers of the mouth, larynx, pharynx, esophagus, and liver. Smoking is the leading cause of lung cancer, laryngeal and oral cavity and pharyngeal cancers; cancers of the mouth, esophagus, kidney, bladder, cervix, pancreas, and acute myelogenous leukemia are also linked with tobacco use.2 Inadequate physical activity is strongly associated with the risk for developing many types of cancer. Sun exposure is another lifestyle habit influencing the risk for cancer. The World Health Organization (WHO) expects worldwide cancer rates to continue increasing because of lifestyle choices, including poor dietary intake and the increasing incidence of overweightness, obesity, physical inactivity, and tobacco use.3

The number of cancer survivors in the United States is over 11 million people4; therefore, healthcare clinicians are likely to care for someone with cancer or who has had cancer. Many cancer survivors become interested in changing their diets and lifestyle habits after being diagnosed with cancer. During treatment for cancer, many face a number of challenges, including trying to consume adequate food or liquid in order to maintain nutrition and hydration status. After treatment, some survivors continue to struggle with intake while others strive to improve their diets to promote recovery and prevent cancer recurrence.

Because of the significant relationship between lifestyle and cancer, it is imperative for healthcare providers to serve as knowledgeable resources. This book is written by a variety of clinicians who not only care for cancer survivors and their caregivers but are also experts in the field of nutritional oncology. The goal of this text is to provide all clinicians interacting with cancer survivors with information to help their patients make informed choices and improve long-term outcomes. The chapters provide nutritional management recommendations for care prior to, during, and after treatment. Given the prevalence of widely available misinformation regarding nutrition and cancer, this text also serves as a reliable and accurate resource. Our hope is that the information provided by this text will assist all clinicians caring for cancer survivors to promote not only survivorship but also optimal quality of life.

Mary Marian and Susan Roberts REFERENCES 1 2 3 4 1 2 3 4

1. The American Cancer Society. Nutrition and Cancer. Accessed September 21, 2008.

2. Centers for Disease Control and Prevention 2008. New Report Estimates More than 2 million Cases of Tobacco-related Cancers Diagnosed in the United States During 1999-2004. Accessed September 21, 2008.

3. World Health Organization. Global cancer rates could increase by 50% to 15 million by 2020. Accessed September 20, 2008.

4. The National Cancer Institute. Science Serving People: Why Cancer Research is Important. Accessed September 20, 2008.