Treats, treatments, and the unseen impact of malnutrition in cancer mortality
By Dr John Brinsley and Dr Federica Amati

The ice cream van at my Grandma’s house always played ‘Greensleeves’ to announce its arrival – but it played it in a minor key.

As a child, hearing that joyous, melancholic tune, I’d fly out to the London streets, Grandma trailing behind, to claim our cherished treats.

My Grandma always loved an ice cream.

Last year, Grandma was diagnosed with cancer. Overnight our family became her carers, and we struggled as she grew thinner and frailer before our eyes. She’d always loved her food. Now, suddenly, she was unable to eat.

I knew from my medical training the shocking statistic: that one in two people will get cancer in their lifetime.¹ But what I didn’t know, and just as shocking to me now I was confronted by it, was the impact this can have on a person’s appetite.

Speaking to my friend and colleague, medical scientist, and public health nutritionist Dr Federica Amati, it’s clear that sadly this problem is common – but all too often, it’s hidden in plain sight.

“Up to 80% of patients with cancer suffer from malnutrition – in fact, one in five people who die from cancer die because of malnutrition associated with their disease.^2-4 I see this in my own family, in my clinic, and we see it at a population level all over the world. Cancer malnutrition is a significant problem that desperately needs more attention”.

Cancer is an insatiably hungry disease. Highly metabolically active, it steals calories and nutrients to fuel its own growth. And so, when demand can’t keep up with supply, the body – and our treatments – start to suffer.

As Dr Amati explained “without essential nutrients many cancer therapies are less effective, whilst recovery after surgery can become slower and incomplete. Hospital stays get longer, complications become more common and healthcare costs spiral”.

The idea that food is important to health feels intuitively true. But the role of diet in disease and its treatment was something I’d not considered. Because, despite training at a world-leading medical school, I’d never had a single class on nutrition.

“The fact that nutrition isn’t part of the standard medical curriculum” Dr Amati told me “reflects a broader culture of food being secondary in healthcare – at best a sideshow to medicines: the main event”.

But this is changing, slowly. “If you were training today, you would be taught nutrition. Since 2021, I have taught doctors-in-training at your old medical school the fundamentals of nutrition science and how, by optimising nutrition before, during, and after treatment, we can meaningfully and measurably increase the outcomes of those treatments”.

And other medical schools have started doing the same, too, meaning today there are doctors entering our health systems better armed to incorporate nutrition science into the holistic care of their patients. “It’s not enough yet, no, but it’s an important start”.

“The truth is, food isn’t medicine” Dr Amati said. “But nutrition is vital to our health and should be seen as an equal partner to medications if we’re to optimally (and affordably) treat disease and promote good health.”

 

Dr Federica Amati, Medical Scientist and Public Health Nutritionist

As a doctor, being armed with this knowledge is one thing, but being able to wield it effectively is another.

Because cruelly, at a time when optimal nutrition is needed the most, the symptoms of cancer and side effects of treating it – nausea and appetite loss; mouth sores and swallowing difficulties; changes in taste and smell – can all make eating unpleasant, if not impossible.

Solutions to this problem do exist, typically in the form of fortified milkshake supplements. On paper, these provide the nutrition our bodies need. But people don’t eat for nutrition – they don’t eat for their protein or their potassium: they eat for pleasure, for energy, and for connection. They eat for joy. And by focusing only on the ‘nuts-and-bolts’ of nutrition, these supplements can become unpalatable – with as few as 81% of patients taking them as needed.⁵

“And so”, Dr Amati said, “at this most challenging time of their lives, people will often turn to ice cream, because it can provide a large amount of calories in a small volume of food, and in a way that’s actually enjoyable to eat”.

Matthew Zachary, cancer survivor turned patient advocacy champion, told me how during his own cancer treatment he was unable to stomach food or supplements, and so practically survived off ice cream as the only thing he could eat to get him through.

Because the very features of an ice cream that makes it so joyful – cold temperature, creamy texture, and decadent flavour – are also precisely what makes them such a good salve to these symptoms.

But, as Dr Amati explained, whilst they might be a good stopgap, ice creams aren’t the answer: “high-street ice creams are delicious treats, but they’re not nutritious options, and shouldn’t be seen as a solution – because they only solve half the problem. There’s much more to nutrition than quantity alone: the quality of those calories counts, too”.

Maybe we can have our ice-cream cake and eat it too? Nutri-Ice is the first prescribable nutritional supplement that’s engineered by science but served like an ice cream. The brainchild of a devoted widower whose late wife faced this challenge, the dedicated Oncologist who treated her, and a passionate chef and food-industry expert, this innovative product combines cutting-edge medical knowledge with advanced microencapsulation technology, to provide patients the calories, protein, fibre, vitamins, and minerals needed to optimise their nutrition and better support their treatment, in a way they actually want to eat. Which, of course, makes it more likely that they will. Upon trying Nutri-Ice for the first time a patient told me “if this is medicine, I could eat this all day”.

And, really, that’s the point. As Dr Amati said, food is not medicine. But food is nourishment which – with the right education and training, paired with creativity and product innovation – could have the power to help transform those alarming statistics of cancer malnutrition, improve patient outcomes and quality of life, and even, to extend lives. It should be seen as a partner to a treatment, whilst still remaining a treat.

Food is joy. And whilst joy is not a drug a doctor can dispense, it is nonetheless indispensable to our quality of life, especially during treatment and recovery from serious illness – and, as in my Grandma’s case, in the face of death.

Because, ultimately, no medicine could make my Grandma better. No supplement, shake, or sorbet could change her destination. But even – especially – at the end of life, a greater appreciation of the role food and nutrition play – to health and to happiness – might just have made her journey to get there that little bit more joyful.

Greensleeves, but played in a minor key. My Grandma loved an ice cream.

Sources:

1. Cancer Research UK. Lifetime risk of cancer. Available at: https://www.cancerresearchuk.org/health-professional/cancer-statistics/risk/lifetime-risk. Accessed May 2025.
2. Arends J, et al. Crit Rev Oncol Hematol. 2023;185:103965.
3. Ravasco P. J Clin Med. 2019;8(8):1211.
4. Beirer A. Memo. 2021;14:168-173.
5. Galaniha LT, et al. Trends Food Sci Technol. 2020;102:254-260.

To learn more about the importance of nutrition within cancer care, visit https://www.creamotherapy.co.uk/