12 Best and Worst Foods for EGFR-Mutated NSCLC

Good nutrition is important when you’re getting treatment for EGFR-positive non-small-cell lung cancer (NSCLC). Experts recommend centering your diet on vegetables, fruit, lean protein, and whole grains to boost your overall health and help you tolerate treatment. While your doctor is your best source of advice, research shows there are certain foods that are especially helpful, some you should avoid, and others that get a mixed review.

This includes things like broccoli, cauliflower, cabbage, and kale. They contain a compound called sulforaphane, which may fight cancer by protecting your cells from damage, lowering inflammation, and blocking some processes cancer cells need to thrive and spread. The evidence has largely come from animal and lab studies, but sulforaphane was shown to weaken the activity of the EGFR protein in NSCLC specifically.

Beta-cryptoxanthin is one of the pigments that gives foods like squash, papaya, and tangerines their orange color. It’s in the same nutrient category as beta-carotene and lycopene, and helps your body make vitamin A. It may also fight lung cancer. Studies have found that people who eat higher amounts appear less likely to get lung cancer in the first place. And in lab tests, this substance lowered the ability of lung cancer cells to spread.

Many people don’t get enough vitamin D, found in fortified milk and also fatty fish like salmon and tuna. Researchers have found a connection between vitamin D deficiency, specifically vitamin D3, and progression of EGFR-positive NSCLC. It also appears that D3 could help EGFR inhibitors work better. You can get this nutrient from sunlight and supplements too, but ask your doctor before you take anything.

Blueberries, currants, and other berries get their color from a natural pigment called delphinidin. In lab tests, this substance blocked signals from the EGFR protein that help lung cancer cells spread. While the amount of delphinidin used in the research was far higher than you get from eating berries, they’re still a good choice. They’re loaded with antioxidants, which can lower the chronic inflammation that encourages cancer growth.

The right food choices can help you manage treatment side effects including nausea, diarrhea, and mouth sores. Things that are cold, soft, and bland are good options when you’re dealing with any of these, like yogurt, applesauce, and ice pops. With nausea and diarrhea, start with clear liquids like broth and gelatin until you can handle solid food. Avoid anything spicy, greasy, or acidic.

These are factory-made products that typically contain chemicals and additives, plus high amounts of fat, salt, and sugar. Think lunchmeat, chips, frozen dinners, canned soup, and packaged cookies. A study using health data from tens of thousands of people found those who ate the most ultra-processed foods were most likely to get lung cancer. It didn’t pinpoint the reason, but both added sugar and saturated fat contribute to chronic inflammation.

The char that forms when you grill a burger or pan-fry a steak over high heat contains compounds that may increase your cancer risk. Others come from smoking meat. To lower your exposure:

• Marinate meat first.
• Cook at low heat.
• Turn the meat often.
• Trim fat so the grill doesn’t smoke.
• Cut off the charred parts.

With diarrhea already a risk from EGFR-positive NSCLC treatment, you don’t want to eat anything that can cause or contribute to it. That includes:

• Foods with a lot of sugar, like candy, pastries, and soft drinks
• Sugar-free foods made with sorbitol, xylitol, and other sugar alcohols
• Foods with a lot of fat, like fried and fast foods
• Spicy foods
• Milk and dairy products (if you have a problem with lactose)
• Caffeine

You should avoid certain foods when you take some EGFR inhibitors, including osimertinib (Tagrisso) and erlotinib (Tarceva). Grapefruit and grapefruit juice, Seville oranges (used in marmalade), pomelos, and starfruit can cause too much of these drugs to reach your bloodstream, increasing your risk for side effects. The drugs afatinib (Gilotrif) and erlotinib (Tarceva) need to be taken on an empty stomach to make sure your body absorbs them correctly.

Red meat tends to have a lot of saturated fat. That contributes to chronic inflammation, which can drive cancer growth. But while some studies show that people who eat the most red meat are the most likely to develop lung cancer, other research has found no link. It could be that high-heat cooking methods cause the increased risk, or that people who eat a lot of meat eat less of other foods that protect against cancer.

Most experts recommend that you get plenty of protein when you’re going through cancer treatment. You need it to maintain muscle mass, help your body heal, and prevent infection. But researchers are studying whether eating less protein might be beneficial to cancer treatment. In animal tests, a protein-restricted diet was shown to slow or stop the growth of certain types of tumors and make chemotherapy and EGFR-inhibitors work better.

Compared to black tea, green tea contains more compounds called polyphenols, which protect your cells from damage. One in particular, ECGC, has been shown in lab and animal studies to slow the growth of lung cancer cells and make treatment work better. But that doesn’t mean it does anything for people with cancer. While some studies have found a link between drinking green tea and a lower risk of lung cancer, others have not.