The Underlying Relationship between Lung Cancer and Nutrition

Literature Review
Jessica Kinsey
Introduction
Lung cancer is the leading cause of cancer-related mortality (Slatore, C. et al, 2001).
Lung cancer can develop from a combination of risk factors including environmental exposures
to air pollution, genetics, or even lifestyle, in regards to physical activity and tobacco smoking
(Papathomas, M. et al, 2011). The overall lifetime risk of lung cancer in women is essentially 1
in 16 and for men the risk is 1 in 13. This type of cancer is one of the most challenging to treat,
however surgical resection, platinum-based chemotherapy, and/or radiation therapy is commonly
used to combat the disease. Patients with lung cancer have approximately 5 years overall, with
a survival rate of 15 percent. Regardless of the fact that treatments are being implemented, the
survival rate has not changed over the past 30 years (Cagle, P., and Chirieac, L., 2012).
Although these types of treatment may be the most common pertaining to lung cancer,
nutrition may also be used as a treatment technique. Victoria Clinic, of the British Columbia
Cancer Agency, administered a research program in order to compare the costs of lung cancer
treatments. In the interest of treating lung cancer, the study showed that $60,173 was spent on
nutrition. Approximately 1, 165 patients visited the clinic, in hopes of being alleviated of this
disease through nutrition therapy. Nutrition therapy was the most cost effective, compared to
drug treatment, radiation, and other miscellaneous tactics (Coy, P. et al, 1994). But, as this
method is exposed more often to the public, patients question the technique and treatment. The
American Institute for Cancer Research and the World Cancer Research Fund estimate that 301

40 percent of all cancers can be prevented by appropriate diets, physical activity, and
maintenance of body weight (Donaldson, M., 2004).
Various foods may be implemented into the diet in order to increase or decrease the risk
of developing lung cancer. In order to decrease the risk of lung cancer, fruits and vegetables
should be consumed, according to multiple studies. These foods are associated with a reduced
risk due to the presence of antioxidants and various vitamins. Despite the fact that research
shows benefits from certain foods in regards to lung cancer, some foods may increase the risk of
lung cancer. Research shows that consumption of red meat, processed meat, and meat mutagens
may contribute to lung cancer. Not only do foods contribute to an increased risk, but some
beverages do as well.
Foods that Increase the Risk of Lung Cancer
Lung cancer and southern foods were compared in a study conducted by Mohr. The
study showed that foods rich in saturated fat, like bacon, eggs, sausage, biscuits, and gravy
nearly doubled the risk of lung cancer (Mohr, D. et al, 1999). Furthermore, a study in HongKong discovered that patients who ate more than two servings of meat per day doubled the risk
of lung cancer, due to high saturated fat content. Red meat, poultry, and seafood were all
examined in this study. It has been confirmed that the type of fat correlates with cancer risk,
rather than the amount of fat consumed (Chiu, Y. et al, 2010).
Red meat, which is high in saturated fat, has been acknowledged the most in regards to
lung cancer risk. A study in Canada was completed in order to find the correlation between meat
and various types of cancers. The study showed that total meat intake, processed meat, and meat
mutagens are associated with the risk of lung cancer. Red meat and lung cancer correlation was
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notably stronger in men, smokers, and obese subjects (Hu, J. et al, 2008). Not only was there
correlation between saturated fat and lung cancer, there was a connection with meat mutagens as
well. De Stefani (2009) found high risks due to intake of meat mutagens, specifically
heterocyclic amines, nitrosamines, and benzoapyrene. The study explained that red meat and
processed meat are sources of saturated fat, cholesterol, iron, and the mutagens listed above. The
meat mutagens were significantly responsible for squamous cell carcinoma and adenocarcinoma
(De Stefani, E. et al, 2009). Heterocyclic amines are produced when the meat is cooked at high
temperatures, specifically in pan-frying or grilling. The mutagens produced and the fat content
of the product combine to form the carcinogenic process, which explains why cooking methods
were found to contribute to lung cancer. Sinha (1998) performed a study in order to determine a
relationship between well-cooked or fried meat consumption and cancer. The risk was notably
higher in frequent meat consumers, as well as consumers of meat cooked at high temperatures.
Well-done meat increases the risk of developing lung cancer by about eight percent per ten
grams of meat, while fried meat is stated to increase the risk by nine percent per ten grams
(Sinha, R. et al, 1998).
Processed meats were found to contribute to lung cancer in addition to fresh meat.
Luncheon meat and beef stew appeared to be associated with the increased risk of lung cancer
due to the presence of nitrates and polycyclic aromatic hydrocarbons (Sinha, R. et al, 1998).
These mutagens are present in tobacco smoke as well (De Stefani, E. et al, 2009). Therefore,
research shows a strong correlation between meat consumption, smoking, and lung cancer.
Poultry and fish were present in many of the studies noted above, but they did not contribute to
lung cancer (Hu, J. et al, 2008).

Beverage consumption is equally important as food consumption in regards to the risk of

lung cancer. Many people believe that alcohol consumption contributes to the development of
lung cancer. Despite these assumptions, a study conducted by National Cancer Center, found no
correlation between alcohol intake and lung cancer. It was not an independent risk factor, but the
risk may increase with a combination of smoking and drinking (Shimazu, T. et al, 2008). The
Hong-Kong study examined the effects of coffee on lung cancer and determined that increasing
coffee consumption elevates the risk of lung cancer. However, decaffeinated coffee may be
consumed in small amounts to provide protection against lung cancer (Chiu, Y. et al, 2010).
Foods that Decrease the Risk of Lung Cancer
Multiple studies concluded that food and beverages may contribute to lung cancer.
Although this may be true, some diets are being transformed in order to decrease the risk of
developing lung cancer. Fruits and vegetables are stated to be beneficial, in regards to
preventing and treating lung cancer. The European Prospective Investigation into Cancer and
Nutrition study evaluated the effects of fruits and vegetables on histological subtypes of lung
cancer. The research described four major subtypes of lung cancer; adenocarcinoma, small cell
carcinoma, large cell carcinoma, and squamous cell carcinoma. The results showed that the
consumption of fruits and vegetables can reduce the risk of lung cancer, particularly squamous
cell carcinoma (Bchner, F. et al, 2010). Multiple research studies found a positive effect of
greater fruit and vegetable consumption, in relation to lung cancer (Yun, Y. et al, 2008)
(Donaldson, M. 2004). A statistical analysis experiment was also completed in the Netherlands,
which demonstrated benefits from the intake of fruits as well (Jansen, M. et al, 2004).
Consequently, research showed that low fruit and vegetable intake did contribute to the increased
risk of lung cancer (Mohr, D. et al, 1999).
4

Fruits and vegetables are a good source of vitamin A. Research conducted in Taiwan
determined that foods rich in Vitamin-A, alpha carotene, and beta carotene reduced the risk of
lung cancer. A specifically noted food included sweet potato leaves (Jin, Y. et al, 2007). A
study in Hawaii focused on flavonoids, which are powerful antioxidants. The study showed that
foods rich in flavonoids may protect against certain types of lung cancer and decrease
bioactivation of carcinogens by inhibition of CYP1A1. Quercetin and naringin were also noted
to protect against lung cancer. Onions, which are particularly strong in fighting squamous cell
carcinoma, and apples are a great source of quercetin and white grapefruit is a source of naringin
(Le Marchand, L. et al, 2000).
Certain diets may decrease the risk of lung cancer in addition to consumption of fruits
and vegetables. The Mediterranean diet was stated as a protective method against lung cancer
due to various foods, specifically, olive oil and fresh herbs. A study was implemented by the
International Agency for Research on Cancer to identify the effects of this specific diet. The
research concluded that a Mediterranean diet did in fact reduce the risk of lung cancer, as a result
of various antioxidants. (Fortes, C. et al, 2003). It has been concluded that fruits, vegetables,
and foods rich in flavonoids and vitamins are protective against lung cancer.
Conclusion
Multiple studies show that there is a significant relationship between nutrition and lung
cancer. Various foods have been considered beneficial in regards to this chronic disease. Fruits
and vegetables have been proven to help in many studies, specifically, onions, apples, grapefruit,
and sweet potatoes. Vitamins and antioxidants are major factors in reducing the risk of lung
cancer. Although nutrition is used to combat lung cancer, research also shows that red meat,

processed meat, and meat mutagens increase the risk of lung cancer. The risk was also found to
increase with excessive coffee intake. Despite the fact that there are numerous studies in relation
to lung cancer and nutrition, more research should be conducted in order to expand the results.

References
Bchner, F., Bueno-de-Mesquita, H., Linseisen, J., Boshuizen, H., Kiemeney, L., Ros, M., & ...
Riboli, E. (2010). Fruits and vegetables consumption and the risk of histological subtypes
of lung cancer in the European Prospective Investigation into Cancer and Nutrition
(EPIC). Cancer Causes & Control: CCC, 21(3), 357-371.
Cagle, P., & Chirieac, L. (2012). Advances in treatment of lung cancer with targeted therapy.
Archives Of Pathology & Laboratory Medicine, 136(5), 504-509.
Chiu, Y., Wang, X., Qiu, H., & Yu, I. (2010). Risk factors for lung cancer: a case-control study
in Hong Kong women. Cancer Causes & Control: CCC, 21(5), 777-785.
Coy, P., Schaafsma, J., Schofield, J., & Nield, J. (1994). Comparative costs of lung cancer
management. Clinical And Investigative Medicine. Mdecine Clinique Et Experimentale,
17(6), 577-587.
De Stefani, E., Boffetta, P., Deneo-Pellegrini, H., Ronco, A., Aune, D., Acosta, G., & ... Ferro,
G. (2009). Meat intake, meat mutagens and risk of lung cancer in Uruguayan men.
Cancer Causes & Control: CCC, 20(9), 1635-1643.
Donaldson, M. (2004). Nutrition and cancer: a review of the evidence for an anti-cancer diet.
Nutrition Journal, 319.
Fortes, C., Forastiere, F., Farchi, S., Mallone, S., Trequattrinni, T., Anatra, F., & ... Perucci, C.
(2003). The protective effect of the Mediterranean diet on lung cancer. Nutrition And
Cancer, 46(1), 30-37
Hu, J., La Vecchia, C., DesMeules, M., Negri, E., & Mery, L. (2008). Meat and fish
consumption and cancer in Canada. Nutrition And Cancer, 60(3), 313-324.
Jansen, M., Bueno-de-Mesquita, H., Feskens, E., Streppel, M., Kok, F., & Kromhout, D. (2004).
Quantity and variety of fruit and vegetable consumption and cancer risk. Nutrition And
Cancer, 48(2), 142-148
Jin, Y., Lee, M., Lee, J., Hsu, H., Lu, J., Chao, S., & ... Ger, L. (2007). Intake of vitamin A-rich
foods and lung cancer risk in Taiwan: with special reference to garland chrysanthemum
and sweet potato leaf consumption. Asia Pacific Journal Of Clinical Nutrition, 16(3),
477-488.
Le Marchand, L., Murphy, S., Hankin, J., Wilkens, L., & Kolonel, L. (2000). Intake of
flavonoids and lung cancer. Journal Of The National Cancer Institute, 92(2), 154-160.
Mohr, D., Blot, W., Tousey, P., Van Doren, M., & Wolfe, K. (1999). Southern cooking and lung
cancer. Nutrition And Cancer, 35(1), 34-43.

Papathomas, M., Molitor, J., Richardson, S., Riboli, E., & Vineis, P. (2011). Examining the joint
effect of multiple risk factors using exposure risk profiles: lung cancer in nonsmokers.
Environmental Health Perspectives, 119(1), 84-91.
Shimazu, T., Inoue, M., Sasazuki, S., Iwasaki, M., Kurahashi, N., Yamaji, T., & Tsugane, S.
(2008). Alcohol and risk of lung cancer among Japanese men: data from a large-scale
population-based cohort study, the JPHC study. Cancer Causes & Control: CCC, 19(10),
1095-1102.
Sinha, R., Kulldorff, M., Curtin, J., Brown, C., Alavanja, M., & Swanson, C. (1998). Fried, well
done red meat and risk of lung cancer in women (United States). Cancer Causes &
Control: CCC, 9(6), 621-630.
Slatore, C., Gould, M., Au, D., Deffebach, M., & White, E. (2011). Lung cancer stage at
diagnosis: Individual associations in the prospective VITamins and lifestyle (VITAL)
cohort. BMC Cancer, 11228.
Yun, Y., Lim, M., Won, Y., Park, S., Chang, Y., Oh, S., & Shin, S. (2008). Dietary preference,
physical activity, and cancer risk in men: national health insurance corporation study.
BMC Cancer, 8366.