Weitzman S
Division of Hematology-Oncology, Hospital for Sick Children, Toronto, Canada.
Int J Cancer Suppl. 1998;11:69-72.
Increasing attention is being paid to the role of nutrition in cancer. Dietary measures, such as decreased consumption of calories, fat, alcohol and smoked or pickled foods have been shown to reduce the incidence of specific "adult" cancers, while increased dietary fiber appears to have a protective role. However, no clear scientific evidence exists that dietary manipulation is a successful primary therapy for established cancer. A significant percentage of adult and child cancer patients take unproven therapies during their illness. Alternative nutritional therapies, of which there is a wide variety, are the commonest of these reflecting current public interest in "natural" remedies. The efficacy and potential toxicity of commonly utilized dietary therapies are here reviewed, in particular the macrobiotic philosophy, the Gerson diet, the Livingstone diet, and the use of vitamin and mineral therapy. While details may differ, most alternative approaches involve fresh whole foods, with strong emphasis on low-fat vegetarian diet. Most are nutritionally adequate, at least for adults. No anti-cancer diet has been shown to cure established cancers, even those whose incidence is decreased by dietary changes. Careful dietary manipulation may at least improve quality of life for adult cancer patients, and, together with conventional therapy, may prolong survival in selected cancer patients. Assessment by carefully controlled prospective clinical trials is essential; those in pediatric patients must be controlled very strictly, since tumors in children have not been shown to be influenced by diet, and the diets described may be inadequate for children with malignant disease.
营养在癌症中的作用正受到越来越多的关注。饮食措施，如减少热量、脂肪、酒精以及烟熏或腌制食品的摄入，已被证明可降低特定“成人”癌症的发病率，而增加膳食纤维的摄入似乎具有保护作用。然而，尚无明确的科学证据表明饮食调控是已确诊癌症的成功主要治疗方法。相当一部分成年和儿童癌症患者在患病期间会采用未经证实的治疗方法。其中种类繁多的替代营养疗法是最常见的，这反映了当前公众对“天然”疗法的兴趣。本文综述了常用饮食疗法的疗效和潜在毒性，特别是宏观营养哲学、格森疗法、利文斯通疗法以及维生素和矿物质疗法的使用。虽然细节可能有所不同，但大多数替代方法都涉及新鲜的天然食物，特别强调低脂素食饮食。大多数方法在营养上是充足的，至少对成年人来说是这样。没有一种抗癌饮食已被证明能治愈已确诊的癌症，即使是那些发病率因饮食改变而降低的癌症。精心的饮食调控至少可以改善成年癌症患者的生活质量，并且与传统疗法一起，可能会延长部分癌症患者的生存期。通过严格控制的前瞻性临床试验进行评估至关重要；儿科患者的试验必须非常严格地进行控制，因为尚未表明儿童肿瘤会受到饮食的影响，而且所描述的饮食可能对患有恶性疾病的儿童来说并不足够。
