# Nutrition in non-small cell lung cancer
Nutritional status and treatment outcomes
Research shows that the nutritional status of patients with non-small cell lung cancer can influence how well treatments work and recovery.
ProveniIncluded in official guidelines, or approved by EMA or FDA
There is strong evidence that poor nutritional status (with lower protein intake and loss of muscle mass) is associated with worse outcomes after surgery and with immunotherapy. This applies to both patients undergoing surgery and those receiving chemotherapy or immunotherapy.
This does not mean that nutrition can cure diseases, but it does mean that the body needs nutrition to go into treatments stronger and recover better. Many patients find that they eat less during and after treatment or experience changes in taste; this can further worsen nutritional status.
Muscle mass and general strength
Recent research focuses on so-called 'sarcopenia': a loss of muscle mass that can be independent of weight loss.
ResearchediPositive results in clinical studies, not yet standard treatment
Patients with lower muscle mass experience more side effects during concurrent chemoradiotherapy and recover less well. This suggests that maintaining muscle mass is important, although it is not yet clear whether targeted nutritional interventions can prevent this.
Protein is the main focus of research here. Adequate protein intake helps the body maintain muscle mass. This may be relevant, especially for patients facing surgery or undergoing prolonged treatments. A dietitian can advise which food sources are suitable for you.
Inflammatory markers and nutrition
Patients with non-small cell lung cancer often have elevated inflammatory markers in the blood.
ResearchediPositive results in clinical studies, not yet standard treatment
It has been shown that certain combinations of nutritional and inflammatory values in the blood are associated with how well immunotherapy (PD-1/PD-L1 inhibitors) works. This helps doctors gain insight into risks, but it is not static — research is ongoing.
Specific dietary choices to influence inflammatory markers have not been studied enough in this population. It is generally assumed that a healthy, varied diet with plenty of vegetables and whole grains is beneficial, but this has not been specifically established for lung cancer.
Immunonutrition: supportive nutrition around surgery
'Immunonutrition' refers to nutrition with certain substances (such as amino acids, vitamins and minerals) that can support the immune system.
ResearchediPositive results in clinical studies, not yet standard treatment
Some studies suggest that nutrition with these components around the time of surgery can help with recovery and fewer complications, but the evidence is not strong enough yet to become standard practice.
If you are facing surgery, your team can discuss whether such interventions may be relevant for you. However, this is not standard treatment and varies by hospital.
Weight loss and food intake during treatment
Many patients lose weight or have difficulty eating due to nausea, fatigue or changed taste.
ProveniIncluded in official guidelines, or approved by EMA or FDA
Weight loss and low food intake are associated with less favorable outcomes.
Practical adjustments can help:
- Smaller, more frequent meals
- Food that tastes pleasant at the moment (taste can change)
- Adequate fluids
- Energy-rich snacks when regular meals are difficult
A dietitian can discuss these adjustments with you and monitor whether your food intake is sufficient.
Interactions between nutrition and medication
Some medicines used for lung cancer have interactions with certain foods or supplements.
ProveniIncluded in official guidelines, or approved by EMA or FDA
Certain nutrients can reduce the absorption of medicines. This applies, for example, to certain tyrosine kinase inhibitors (targeted therapies), which must be taken differently with or without food.
For immunotherapy, many interactions have been studied, but it is less clear. It is important to discuss this with your doctor, especially if you take many supplements.
Supplements and complementary substances
UnproveniNo scientific evidence that it works
Many supplements (vitamins, antioxidants, herbal extracts) are promoted for cancer patients. Although some substances seem interesting in laboratory settings, there is a lack of good evidence that they benefit you in practice. Some supplements can even interfere with treatment.
Advised againstiProven ineffective or harmful, or dangerous in combination with your treatment
Very high doses of antioxidants are not recommended, as they may reduce the effectiveness of certain chemotherapies or immunotherapies. Discuss all supplements with your team before taking them.
Nutrition in metastases, especially bone
In advanced disease with bone metastases, nutrition also plays a role.
ResearchediPositive results in clinical studies, not yet standard treatment
Research suggests that nutritional status and inflammation markers are related to prognosis, but concrete nutritional guidelines for this situation are still being developed.
Calcium intake and vitamin D may be relevant for bone health, although this has not been specifically studied in lung cancer. This is something to discuss with your doctor and dietitian.
Practical guidance
For questions about what you specifically need to eat, which supplements are safe, or how to better meet your nutritional needs during and after treatment: a dietitian with experience in cancer patients can guide you individually. Many hospitals have these specialists on staff or can refer you to one.
---
_This information never replaces a doctor's judgment. Always discuss your situation with your own healthcare provider._