by Dt Umi Laila
Nutritional support remains vital at every stage of colorectal cancer treatment and recovery. It enhances the body’s ability to withstand physiological stress, prevents malnutrition, and contributes to improved clinical outcomes.
Colorectal cancer ranks as the third most commonly diagnosed cancer worldwide and stands as the second leading cause of cancer-related deaths. A particularly concerning development is the global increase in early-onset colorectal cancer, defined as colorectal malignancies occurring in individuals under the age of 50. The causes of this rise remain largely unclear, especially among younger adults.
Certain external risk factors have been associated with the disease, though evidence varies across studies. These include processed meat, sugary beverages, alcohol intake, excess body weight, physical inactivity, tobacco use, and adherence to a Western-style diet. Of these, dietary habits marked by high fat and calorie intake, alongside low consumption of vegetables, fruits, and dietary fibre, pose a notable concern.
The absence of regular physical activity and the use of tobacco compounds the risk. A sedentary lifestyle, devoid of sufficient movement, further increases susceptibility to colorectal malignancies. In recent years, attention has turned to the gut microbiome, with growing evidence suggesting that disruptions in microbial balance play a crucial role in the development and progression of colorectal cancer.
A diet abundant in fibre contributes to the maintenance of a stable gut environment. Dietary fibres serve as a source of short-chain fatty acids, such as butyrate, known for their antitumour properties. A fibre-rich diet is therefore considered a protective factor.
In light of the adverse effects often associated with conventional cancer treatments, interest has grown in alternative therapeutic strategies. These include faecal microbiota transplantation, postbiotics, and prebiotics, which aim to restore microbial health and reduce cancer risk.
Research suggests that changes in diet and lifestyle could prevent or delay the onset of colorectal neoplasia in up to half of all cases. High fibre intake, in particular, has been shown to counteract the harmful effects of meat consumption by accelerating intestinal transit, diluting carcinogenic compounds, and enhancing the production of fermentation byproducts such as butyrate.
Moreover, diets rich in fibre offer additional protective benefits by providing antioxidants such as vitamins C and E. Certain micronutrients—including vitamin D, selenium, and calcium—have also been associated with a reduced risk of colorectal cancer. The protective mechanisms of dietary fibre range from the dilution of harmful agents in stool to the regulation of complex cellular processes influenced by fermentation products. A lower faecal pH resulting from fibre fermentation has also been found to decrease the formation of bacterial carcinogens that stem from bile acid metabolism.
Nutritional support remains vital at every stage of colorectal cancer treatment and recovery. It enhances the body’s ability to withstand physiological stress, prevents malnutrition, and contributes to improved clinical outcomes. Malnutrition is widespread among individuals undergoing treatment for colorectal cancer and has been linked to diminished survival rates, impaired quality of life, and reduced efficacy of oncological therapies.
Monitoring nutritional status throughout treatment is therefore essential, allowing for timely intervention and the implementation of appropriate dietary strategies. These measures help improve treatment response, reduce the severity of side effects, and support the healing process.
During anticancer therapy, nutritional approaches should prioritise easily digestible, low-fat foods. In some instances, dietary restrictions may include the elimination of lactose and gluten-containing products. Individualised dietary planning is often required to address specific needs, and this may involve the inclusion of oral nutrition supplements. Given that cancer therapies frequently strain the body to its functional limits and diminish appetite, additional nutritional support is frequently necessary to maintain general health and physical resilience.
Diet, therefore, holds a central role not only in the prevention but also in the ongoing management of colorectal cancer. A diet rich in fibre, alongside key micronutrients, can lower the risk of the disease. Equally, personalised nutritional interventions offer essential support to those undergoing treatment and those in recovery. Continued research into the gut microbiome and emerging therapeutic strategies may yet reveal further opportunities to prevent and treat colorectal cancer.
(The author holds a BSc and MSc in Nutrition from Lovely Professional University, Jalandhar. She is currently working as a Consultant Nutritionist and Dietician at Centre For Breast And Colorectal Cancers And Non-Cancer Disorders-CBCCD. Ideas are personal.)
