ABSTRACT
The critical questions for future research in nutrition and cancer revolve around the need to integrate the increasingly comprehensive understanding of nutrition science and the future promise of personalized nutrition with the advances in precision oncology and immunotherapy. This future fusion of research efforts in two separate but related fields will lead to the demonstration and effective application of foods and dietary supplements in cancer prevention, cancer treatment, and the prevention of cancer recurrence. Epidemiologic research over the last 100 years has brought to light many potential interactions of chemicals, nutrients, dietary patterns, behaviors, and physical activity that are associated with either an increase or decrease in the risk for cancers and cancer recurrence. Basic research has pointed to many interactions of nutrients and chemicals with metabolic pathways and genes involved in the multistep processes of carcinogenesis. It is vital to note that cancer patients are more than simply genes and cells. Tumors live within a microenvironment and systemic environment that is influenced by nutrition, metabolism, the immune system, and the microbiome. In fact, 99% of the genetic information in the human body is carried by gut microbiota. Both our human and bacterial genomes are influenced by nutrition, environment, and lifestyle choices. Much has been learned about the complex metabolic and immune microenvironment in which tumor cells grow and metastasize. However, human behavior influences physiology at all levels and changing human behavior remains a challenge. Taken together the basic science and epidemiological insights on nutrition and cancer has increased enthusiasm for basic and clinical research in Nutritional Oncology. The evolution of research in personalized nutrition and precision oncology means that integrated approaches to cancer prevention and treatment are ready to be explored. This chapter will explore some of the critical questions that remain in nutrition and cancer research for researchers now and in the future. It is hoped that advances in knowledge can contribute to the prevention of common forms of cancer, better support the cancer patient, and prevent cancer recurrence in the cancer survivor utilizing all the available and developing scientific approaches to nutrition and cancer.
