The UK (and England specifically) has excellent research teams working both in nutrition and in cancer. Within cancer research, there are two broad thrusts: a focus on understanding the nutritional determinants of cancer risk through epidemiology; and improving cancer therapy by understanding the cellular and molecular processes in tumours as a means of identifying potential therapeutic targets.
Both cancer and nutrition represent complex systems in their own right, and the intersection between the two even more so. However while current research strategies certainly address issues of importance and recognise the complicated nature of biological pathways, they do not consistently attempt to engage with the complexity as a set of interacting systems. So while much is learned about the processes that occur in cancer and tumours, and the individual contribution of nutritional factors to risk, very little is known about the biological transition from the normal cell to cancer, or the critical set of influences that drives the process.
Preliminary work as part of the first phase of this Collaboration has identified a paucity of evidence on which health professionals can base their practice in offering nutritional support or advice to patients with cancer, who themselves report unsatisfactory experiences as part of their care in relation to their own needs around diet and physical activity advice and support. The possibility that nutritional factors might be one reason for differential response to therapy has not been a systematic target for study.
While much is known about the nutritional factors that influence cancer risk, little is known about the interactions between them or the individual “host” factors that might influence response to them. Even less research is directed to understanding how best to implement changes at either population or individual level to improve nutritional state to reduce risk of cancer and other chronic diseases.
The broad categories under which such a research agenda might be prosecuted can be seen to fall under the headings of basic science, clinical and service delivery, and population health. Within this framework it is possible to identify unanswered questions that might form the basis for a coherent national programme of research.