It was a real pleasure to present at the AUA meeting in Miami. I think it’s a wonderful consensus meeting in urinary cancers. The topic assigned to me was to uncover more about lifestyle measures, which our patients ask us about. And very briefly, we looked at this in three ways. The first was diet. Now, there’s no uniform, agreed diet beyond the usual kind of common sense healthy approach people should take...
It was a real pleasure to present at the AUA meeting in Miami. I think it’s a wonderful consensus meeting in urinary cancers. The topic assigned to me was to uncover more about lifestyle measures, which our patients ask us about. And very briefly, we looked at this in three ways. The first was diet. Now, there’s no uniform, agreed diet beyond the usual kind of common sense healthy approach people should take. I think protein intake has been felt to be important but certainly we are seeing more and more association or interesting associations with fiber and outcomes in patients treated with immunotherapy beyond kidney cancer. So in terms of diet that would be the general approach. We are not recommending supplements routinely. In terms of exercise, I think this is quite important. We have really good guidance now across many different tumor types, both for prevention and tolerating cancer treatment well, which is having a good aerobic and anaerobic activity. So what this means is 150 minutes per week of aerobic activity, which can be divided up as folks want, but also having the ability, if possible, to do resistance training, which is very important as well. And that would be kind of two sessions of anaerobic activity. So I think that’s in general the guidance we should be giving. And of course, with all the recent data and other cancer types in the adjuvant setting, one wonders if that can help in the adjuvant RCC setting as well. And then finally, the gut microbiome. This has been part of lots of investigation. We and others have tried to establish what does a collection program look like as standard of care? What would a baseline library of microbiome distribution given a patient’s own genetics and their diet? And then how can we manipulate that better? And all told, at this point, currently these are all really investigational parts of trials. It would not be advised to take routine prebiotics or probiotics as part of a patient’s general day-to-day diet, even though it might be attractive to think about it. And there’s more to come in terms of FMT, but also other ways to manipulate the microbiome that don’t require a full FMT and so these will be like live bacterial therapeutics so there’s a lot to come there but right now we would not be recommending our patients to take microbiome changing supplements as part of their day-to-day practice.
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