Can a Vitamin-Rich Diet Improve Outcomes for Mesothelioma Patients?

Good nutrition is important for everybody, but especially for patients dealing with the challenges of malignant mesothelioma. While nutrition should not take priority over medical treatments, studies have shown that eating foods rich in certain vitamins can help reduce the side effects of treatments like chemotherapy, improve quality of life, and may even help boost the impact of certain protocols.

The Link Between Mesothelioma and Nutrition

Malignant mesothelioma is a rare and aggressive form of cancer that can affect the pleural lining of the lungs and the lining of the cavity that holds the abdominal organs. Patients being treated for this illness undergo treatments like chemotherapy, radiation, and surgery, which — when combined with the disease’s symptoms of fatigue, weight loss, decreased appetite, and impaired nutrient absorption — lead to unique nutritional challenges. 

Researchers specializing in nutrition oncology have found evidence suggesting that strategic dietary interventions, and particularly a vitamin-rich diet, can improve the effectiveness of standard cancer treatments while reducing their disruptive side effects.[1] 

While focusing on specific vitamins won’t cure mesothelioma, patients may be able to improve their quality of life and improve their outcomes by focusing on specific nutrients that support healing processes, maintain functional status, and potentially create a physiological environment that helps the body fend off cancer progression.

The findings of studies conducted to date reflect a collaboration between oncologists, registered dietitians, and other healthcare providers. They offer mesothelioma patients an opportunity to take an educated approach to nutrition that can support them in their journey. The relationship between specific nutrients and cancer is only now beginning to be understood, but more and more experts believe that nutritional strategies have the potential to provide real benefits for patients facing this challenging diagnosis.[1]

The Nutritional Needs of Mesothelioma Patients

Patients diagnosed with malignant pleural mesothelioma and malignant peritoneal mesothelioma face nutritional challenges unique to where their tumors form, as well as several shared nutritional challenges: 

Nutritional Challenges Specific to Pleural Mesothelioma[2]

• Respiratory Limitations – Patient may experience dyspnea (shortness of breath) or fatigue from the respiratory effort involved in eating. These physical compromises may mean they need to eat smaller, more frequent meals. They also may become dependent on supplemental oxygen while eating.  
• Chest Pain Impact – Tumors and surgical incisions may result in chest pain that limits the size of the meals they can consume or may create discomfort while sitting upright for meals. Post-surgical thoracic pain may limit their mobility, restricting their ability to eat comfortably, and pain medications can cause constipation or nausea, limiting appetite. 
• Post-pleurodesis Considerations – Pleurodesis requires recovery, increasing metabolic demands and the need for more protein. Pain management medications can affect digestion, and pain may limit mobility for eating and staying upright to eat.
• Potential Esophageal Compression – If the mesothelioma patient’s tumors impact the esophageal area, it may be difficult or painful to swallow. There is also a risk of aspiration, requiring modifications to the texture of foods being provided. Patients may be restricted to thickened liquids, and this may limit the enjoyment of food.

Nutritional Challenges Specific to Peritoneal Mesothelioma

• Abdominal Discomfort and Early Satiety – The physical pressure from peritoneal tumors and excess fluid accumulation (ascites) on digestive organs can lead to patients feeling full despite only minimal intake, discomfort when sitting for a meal, and pain after eating that discourages patients from taking in enough food.
• Malabsorption Issues – The involvement of the peritoneal organs in peritoneal mesothelioma can compromise the absorption of nutrients, including fat-soluble vitamins. Cancer treatments can also alter patients’ gut microbiomes, leading to the need for enzyme supplementation.
• Bowel Motility and Obstruction Concerns – Peritoneal mesothelioma patients are vulnerable to intermittent or partial bowel obstructions requiring adjustments to diet, including a low-fiber diet or parenteral nutrition. Patients are also at risk for constipation or diarrhea.
• HIPEC-Specific Challenges – Patients who undergo Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy (CRS-HIPEC) frequently experience digestive dysfunction. The reintroduction of foods must be done slowly, and there is a risk of temporary malabsorption of nutrients during bowel recovery at the same time that patients have heightened nutritional needs to facilitate healing.[3]
• Ascites Management – The risk of fluid accumulation requires restriction of sodium intake and potential fluid restrictions. Discomfort from the abdominal distention that is characteristic of ascites frequently limits food intake, leading to a need for nutrient-dense foods.

Shared Nutritional Challenges

Both pleural and peritoneal mesothelioma patients face several common nutritional challenges, including the following:

• Cancer Cachexia – This progressive, involuntary weight loss and muscle wasting is due to inflammatory cytokines impacting metabolism: Resting energy expenditures increase despite decreased nutritional intake, and this means that patients need to take in more protein.[4]
• Treatment-Related Side Effects – Chemotherapy’s well-known side effects include nausea, vomiting, and altered taste perception, and both this and fatigue following treatment limit patients’ interest in food or ability to absorb nutrients. Mucositis is another side effect that impacts the ability to chew and swallow comfortably.
• Compromised Immune Function – Patients undergoing chemotherapy are more susceptible to foodborne illnesses, and this means that food safety practices need to become a priority for caretakers. Raw food should be restricted.
• Psychological Impact – Anxiety, depression, and grief over the mesothelioma diagnosis can impact appetite.

Adopting a Comprehensive Approach to Nutritional Management

Whether a patient is diagnosed with pleural or peritoneal mesothelioma, a nutritional screening and assessment conducted shortly after diagnosis can provide significant benefit. By collaborating with a registered dietitian specializing in oncology, patients can learn proactive symptom management strategies and develop personalized nutrition care plans that target the vitamins they need (and the foods that contain them) to manage both the progression of their disease and the different treatment protocols they will undergo. Family members and caregivers should participate in this nutritional care planning if possible.

 The Vitamins That Best Support Mesothelioma Patients

• Antioxidants (Vitamins A, C, & E)

Vitamins A, C, and E all have antioxidant properties that neutralize the unstable molecules known as free radicals that can damage cellular DNA and potentially contribute to mesothelioma tumor progression. 

Vitamin A (found in liver, eggs, dairy, and as beta-carotene in orange/yellow vegetables) offers the benefits of supporting immune system function and cellular differentiation. Studies have shown that it may limit the impact of treatment-related mucositis by helping maintain mucosal tissue integrity, and some studies have suggested that Vitamin A may have anti-proliferative effects on certain cancer cell lines.

Vitamin C (found in citrus fruits, berries, peppers, and leafy greens) has long been viewed as a highly useful nutrient. It offers multiple potential benefits for cancer patients, including acting as an antioxidant to help protect cells from oxidative damage. Its ability to support the formation of collagen may help speed healing after surgery, and some studies suggest that it can enhance the effectiveness of some chemotherapy drugs while also reducing side effects. Researchers are exploring dosing cancer patients with high-dose intravenous Vitamin C as a complementary therapy.

Vitamin E (found in nuts, seeds, plant oils, and leafy greens) helps by protecting cellular membranes from oxidative damage and reducing some side effects of radiation therapy. It may also help modulate the immune system. 

Before increasing your intake of these and other antioxidant foods, it’s important to note that the same oxidative mechanisms these nutrients use to protect healthy cells may interfere with certain mesothelioma treatments that target cancer cells. It’s important to discuss any dietary modifications with your physician during active treatment.

• B Vitamins

B vitamins are critical to cellular metabolism, energy production, and DNA synthesis/repair. These processes are all important for patients undergoing treatment for mesothelioma. 

Folate (B9) supports genetic repair and red blood cell formation and may help minimize chemotherapy side effects.

Vitamin B6 helps the body metabolize protein and improves immune function. It has also been shown to help manage treatment-related neuropathy (tingling and numbness).

Vitamin B12 aids in red blood cell formation and may help treatment-related anemia. 

For mesothelioma patients, optimizing B vitamin intake may improve energy levels and boost cellular repair mechanisms challenged by both the disease and its treatments.

• Vitamin D 

Vitamin D has recently emerged as particularly important for asbestos-related diseases, as it becomes a hormone called calcitriol that helps with bone strength, cell growth, muscle strength, and immunity.  It has been associated with better outcomes in several types of cancer. Though the human body can manufacture its own Vitamin D, it requires exposure to sunlight to do that, and many mesothelioma patients have limited time outside, so attention to Vitamin D-containing foods (fatty fish including salmon and sardines, liver, egg yolks, beef, pork, chicken, milk, orange juice, cereals, and mushrooms) is important.

Vitamins that Minimize the Side Effects of Mesothelioma Treatments

Though advances in medicine have diminished some of chemotherapy’s well-known side effects, many patients still suffer from them. Consuming foods that are high in specific vitamins may help minimize treatment-related challenges:

– Ginger and other foods high in Vitamin B6 help offset nausea 

– Foods high in Vitamin C and zinc aid wound healing after surgery

– Foods rich in B vitamins offset fatigue

– Foods that are high in Vitamin E and omega-3s may reduce the impact of radiation fibrosis

Should Mesothelioma Patients Get Their Vitamins from Supplements? 

Nutritional experts agree that the optimal way of taking in nutrients is eating whole foods, but the realities of a mesothelioma diagnosis may make that difficult. Nutritional deficiencies revealed by a blood test or inability to eat may tempt patients to supplement, but this should only be done after consulting with your physician or a dietitian. There is a real risk of exceeding safe upper limits, and some supplements can interact negatively with chemotherapy medications. 

Emerging Research and Future Directions 

There’s still much to be learned about how nutrition interacts with mesothelioma and other cancers. There are several promising areas of research, including the following:[5]

• Precision Nutrition – This is an approach that tailors nutritional interventions based on tumor genetics, microbiome composition, and individual metabolic patterns.

• Chrononutrition – Researchers are exploring how the timing of nutrient intake may influence the effectiveness of treatment and minimize side effects.
• Nutrient-Drug Interactions – Scientists are working to get a better understanding of how specific nutrients may enhance or interfere with individual cancer therapies.
• Microbiome Modulation – Investigating how diet affects gut bacteria composition and how it then impacts immune function and treatment response.
• Metabolic Approaches – Exploring how dietary patterns might influence cancer metabolism.

Mesothelioma patients face a long and difficult road, and targeted vitamin intake can’t replace conventional cancer treatments. Still, research suggests that complementing treatments with a thoughtfully implemented vitamin-rich diet may provide real benefits, including mitigating treatment side effects and possibly enhancing quality of life.