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Why is it important to consider inflammation if you have cancer?

Chronic inflammation can fuel cancer growth and reduce treatment effectiveness.  Understanding if you are affected by inflammation and developing a strategy to manage it is an important part of comprehensive cancer care.

Certain cancers have been associated with inflammation directly. These include cancers of the bladder, brain, breast, cervix, colon, esophagus, head and neck, liver, lung, lymphoma, mesothelium, ovary, pancreas, prostate, rectum, soft tissue, and stomach. 

On this page

What is inflammation? ›

Do you have inflammation? When to ask your doctor ›

Improving inflammation with evidence-based therapies ›

Top practices and therapies to lower inflammation ›

What is inflammation?

Inflammation is the body’s natural response to injury or infection, helping to heal and repair damage. It is marked by redness, heat, pain, swelling, and loss of function at the affected site. This process, known as acute inflammation, helps remove damaged tissues and restore balance. The discomfort typically fades as healing occurs.

However, factors such as the immune system, nervous system, environmental toxins, or hormonal imbalances can cause chronic inflammation. This ongoing inflammation contributes to the development and progression of many diseases, including cancer.

Over time, this persistent inflammation disrupts the body’s ability to heal and regenerate properly. Chronic inflammation drives cancer progression, increases recurrence risk, and suppresses anti-cancer immunity. Understanding and managing inflammation is crucial for prevention, during treatment, and throughout survivorship.

Symptoms of chronic inflammation

While symptoms of acute inflammation (swelling, redness, and pain) are familiar when experiencing an injury or an infection, symptoms of chronic inflammation are more vague. If you have had inflammation for a long time, it may be hard to sense symptoms in your body, but common signs include abdominal pain, digestive issues, fatigue, or mood symptoms. 

Do you have inflammation? What to ask your doctor 

Ask your doctor about how inflammation might be affecting your cancer treatment along with tests to measure inflammation levels. Markers such as elevated C-reactive protein (CRP),  interleukin-6 (IL-6), tumor necrosis factor α (TNF-α), and fibrinogen are associated with higher levels of inflammation, while lower levels of adiponectin are associated with lower systemic inflammation.  

Insulin resistance and inflammation are strongly linked, as the effects of higher blood sugar and insulin make chronic inflammation easier to develop. Signs of insulin resistance › include a hemoglobin a1c (HgA1c) of 5.4% or greater, or a diagnosis of prediabetes or diabetes.   

Since low methylation can contribute to inflammation, biomarkers that assess methylation can be checked, which include fasting homocysteine level along with B vitamin levels including B1 (thiamine), B6 (pyridoxine), B9 (folate), and B12 (cobalamin). Many of these tests can be covered by insurance if your doctor codes them as indicated for fatigue, cancer, nutritional deficiency, or neuropathy. Methylation is particularly important when you have inflammation because of its effects on gene expression, which can impact tumor promotion or suppression.

Open a discussion with your oncologist or primary care doctor about ways to identify and reduce inflammation as part of your comprehensive cancer treatment plan. Act on anti-inflammatory lifestyle practices and therapies, and monitor your response to these practices and therapies over time. If you are able to identify inflammation biomarkers that are personally relevant, you can get feedback through regular testing and check-ins with your care team that gives you confidence that you are on the right track.

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Improving inflammation with evidence-based therapies 

Managing inflammation through evidence-based therapies, including medications, lifestyle changes, and complementaryin cancer care, complementary care involves the use of therapies intended to enhance or add to standard conventional treatments; examples include supplements, mind-body approaches such as yoga or psychosocialtherapy, and acupuncture therapies, can help improve outcomes and overall well-being during and after cancer treatment.

One of the most well-researched lifestyle factors that contribute to inflammation is tobacco smoking. If you are a current smoker, connect with your care team about resources and support for quitting. Additional lifestyle practices directly impact inflammation, and with time can yield improvements in overall health that impact your daily quality of life.

7 Lifestyle Practices ›

High-quality research about inflammation links it to other body terrain factors. The most well-researched body terrain factor with links to inflammation is obesity ›, which is often closely linked to blood sugar balance ›. Additional terrain factors include the microbiome › and oxidative stressan imbalance between free radicals and antioxidants in your body in which antioxidant levels are lower than normal; this imbalance can cause harmful oxidation reactions in your body chemistry (when combined with inflammation, it’s called “inflammaging”). It may be hard to know where to start, but rest assured when you improve one area of terrain, the other terrain factors will improve as well, like a rising tide.   

Top practices and therapies to lower inflammation

1. Use movement as medicine. Moving your muscles allows for the increased production of anti-inflammatory cytokinescell signallng molecules that can promote or reduce inflammation, such as CRP, IL-6, TNFa, IL-4 and IL-10. Many of these molecules have both pro- and anti-inflammatory properties, which depend on other factors to determine whether the signal will play a pro-inflammatory role or an anti-inflammatory role., and helps to lower the amount of fat stored that contributes to inflammation. Try aiming for 150-300 minutes per week of movement, including things like “NEAT” or non-exercise active time in your daily routine, such as taking the stairs or parking at the far end of the parking lot. A recent study showed that in as little as 2 months, healthy changes in cytokine production occur, and that daily activity may be more helpful than any other change you can make to lower inflammation. See our Moving More › page for guidance.1Guo K, Zeng X et al. Lifestyle deterioration linked to elevated inflammatory cytokines over a two-month follow-up. Scientific Reports. 2024 14, 21381.

2. Use food as medicine. A diet rich in fiber as well as plants containing polyphenols, flavonoids, and antioxidants has been shown to reduce inflammation. A good general diet recommendation is a Mediterranean-type diet, but more information about specific diets and cancer can be found on our Eating Well › page. A fiber-rich, plant-forward diet can help to manage inflammation.2Margină D, Ungurianu A et al. Chronic inflammation in the context of everyday life: Dietary changes as mitigating factors. International Journal of Environmental Research and Public Health. 2020 Jun 10;17(11):4135.

3. Manage depression and anxiety. If you have depression ›, anxiety ›, or other mood symptoms, treatments such as psychotherapy, exercise, or antidepressant therapy can lower inflammatory cytokines from 18-48%.3Seaton N, Hudson J et al. Do interventions for mood improve inflammatory biomarkers in inflammatory bowel disease?: A systematic review and meta-analysis. EBioMedicine. 2024 Feb;100:104910.

4. Several supplements and specific nutrient-rich foods may help lower inflammation. 

5. Talk with your care team about including an anti-inflammatory medication to your regimen. Certain non-steroidal anti-inflammatory (NSAID ›) medications (such as celecoxib, sulindac, aspirin, and indomethacin) may be combined with other cancer therapies and improve the effectiveness of treatment. Examples of this include men with prostate cancer, particularly higher-grade, who took aspirin after diagnosis. Their prostate-cancer-specific mortality was reduced by about 40%. It’s very important to discuss this with your team, as some NSAID-treatment combinations did not improve outcomes or worsened them, and can also have serious side effects in certain circumstances.16Lai H, Liu Y et al. Targeting cancer-related inflammation with non-steroidal anti-inflammatory drugs: Perspectives in pharmacogenomics. Frontiers in Pharmacology. 2022 Dec 5;13:1078766; Elwood P, Morgan G et al. Aspirin and cancer treatment: systematic reviews and meta-analyses of evidence: for and against. British Journal of Cancer. 2024 Jan;130(1):3-8; Jacobs EJ, Newton CC, Stevens VL, Campbell PT, Freedland SJ, Gapstur SM. Daily aspirin use and prostate cancer-specific mortality in a large cohort of men with nonmetastatic prostate cancer. Journal of Clinical Oncology. 2014 Nov 20;32(33):3716-22.

6. Fasting: forms of fasting such as time-restricted eating (limiting your food intake to a window of 8 hours per day, for example) or longer fasts combined with fiber-rich diets have evidence to aid in decreasing body weight and lowering insulin resistance, which are both linked to inflammation. Note that fasting isn’t right for everyone. Discuss with your oncologist or primary care doctor before beginning a fasting program to make sure it is safe for you.17Cheng CW, Adams GB et al. Prolonged fasting reduces IGF-1/PKA to promote hematopoietic-stem-cell-based regeneration and reverse immunosuppression. Cell Stem Cell. 2014 Jun 5;14(6):810-23. Read the research in our review on fasting ›.

Explore other body terrain handbooks

Additional references 

Coussens LM, Werb Z. Inflammation and cancer. Nature. 2002 Dec 19-26;420(6917):860-7.

Vodovotz Y, Arciero J, Verschure PF, Katz DL. A multiscale inflammatory map: linking individual stress to societal dysfunction. Frontiers in Science. 2024:1:1239462.

Antonucci L, Karin M. The past and future of inflammation as a target to cancer prevention. Cancer Prevention Research (Philadelphia). 2024 Apr 2;17(4):141-155.

Liu T, Zhang L et al. NF-κB signaling in inflammation. Signal Transduction and Targeted Therapy. 2017:2:17023. 

Author

Amy Price Neff, MD

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Dr. Price Neff is a native Tennessean who grew up in Memphis. She was very fortunate to have a biologist for a father who worked in medical research and facilitated her early interests in immunology and cell biology. After attending UT Knoxville, where she did her undergraduate work in Neuroanatomy, she went to medical school at UT Memphis. Amy did her residency in Charlottesville, Virginia at the University of Virginia in the Department of Family Medicine where she also did a Fellowship in Faculty Development and focused on community mental health. At the time, the most interesting questions in healthcare for Amy were the lack of access to care for the uninsured and underinsured.

Moving to Nashville in 2015, Dr. Price Neff took time off to be a mom and worked very part-time at the University School of Nashville. She began a Fellowship in Integrative Medicine at the celebrated Andrew Weil Center for Integrative Medicine in Tucson, Arizona. In 2018, she started practicing again. In 2021, Dr. Price Neff began working with the Chopra Foundation as a medical provider of Ayurvedic Consults for their Perfect Health retreats held twice a month at Civana in Carefree, Arizona. She continues to study Ayurveda as well as deep inquiries into the microbiome, cancer metabolism, nutrition, mindfulness, medications and the mind, autoimmunity and the clinical questions that come up in daily practice. Additionally, Dr. Neff serves on the advisory board of the Southeast Coalition of Psychedelic Practitioners.

Amy Price Neff, MD

Reviewers

Laura Pole, MSN, RN, OCNS

Senior Clinical Consultant
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Laura Pole is senior clinical consultant for CancerChoices. Laura is an oncology clinical nurse specialist who has been providing integrative oncology clinical care, navigation, consultation, and education services for over 40 years. She is the co-creator and co-coordinator of the Integrative Oncology Navigation Training at Smith Center for Healing and the Arts in Washington, DC. Laura also manages the “Media Watch Cancer News That You Can Use” listserv for Smith Center/Commonweal. In her role as a palliative care educator and consultant, Laura has served as statewide Respecting Choices Faculty for the Virginia POST (Physician Orders for Scope of Treatment) Collaborative as well as provided statewide professional education on palliative and end-of-life care for the Virginia Association for Hospices and Palliative Care.

For CancerChoices, Laura curates content and research, networks with clinical and organizational partners, brings awareness and education of integrative oncology at professional and patient conferences and programs, and translates research into information relevant to the patient experience as well as clinical practice.

Laura sees her work with CancerChoices as a perfect alignment of all her passions, knowledge and skills in integrative oncology care. She is honored to serve you.

Laura Pole, MSN, RN, OCNS Senior Clinical Consultant

Christine Mineart, MPH

CancerChoices Program Director
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Christine has a dynamic background in the life sciences, public health, and program operations. Her career began at the lab bench with a Gates Foundation-funded HIV Vaccine research group, which led her to graduate studies in public health epidemiology at UC Berkeley. Her research experience spans clinical epidemiology research to evaluating the impacts of community nutrition programs in Los Angeles, the Central Valley, and Oakland. Most recently she has worked in executive operations for a seed-stage venture capital firm based in San Francisco. Personally, Christine is passionate about holistic health and wellness. She is a clinical herbalist and Reiki master, and she has been practicing yoga for 15+ years. She brings a breadth of experiences to her work leading the CancerChoices program.

Christine Mineart, MPH CancerChoices Program Director

Jen Green, ND, FABNO

Naturopathic oncologist and CancerChoices advisor
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Dr. Green is a naturopathic physician who is board-certified in naturopathic oncology (FABNO). Dr. Green is also a cofounder/research director for Knowledge in Integrative Oncology Website, a nonprofit website that harvests up-to-date research in integrative oncology to support evidence-informed decision making. Dr. Green has published scientific articles in journals such as the American Urology Association Update Series, Journal of Alternative & Complementary Medicine and Natural Medicine Journal.

Jen Green, ND, FABNO Naturopathic oncologist and CancerChoices advisor

Miki Scheidel

Co-Founder and Creative Director
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Miki Scheidel is Co-founder and creative director of CancerChoices. Miki and her family were deeply affected by her father’s transformative experience with integrative approaches to metastatic kidney cancer. That experience inspires her work as president of the Scheidel Foundation, which includes the integrative cancer care portfolio, and as volunteer staff at CancerChoices. She previously worked with the US Agency for International Development and Family Health International among other roles. She received her graduate degree in international development from Georgetown University and a graduate certificate in nonprofit management from George Mason University.

Miki Scheidel Co-Founder and Creative Director

Last update: March 4, 2025

CancerChoices provides information about integrative in cancer care, a patient-centered approach combining the best of conventional care, self care and evidence-informed complementary care in an integrated plan cancer care. We review complementaryin cancer care, complementary care involves the use of therapies intended to enhance or add to standard conventional treatments; examples include supplements, mind-body approaches such as yoga or psychosocial therapy, and acupuncture therapies and self-care lifestyle actions and behaviors that may impact cancer outcomes; examples include eating health-promoting foods, limiting alcohol, increasing physical activity, and managing stress practices to help patients and professionals explore and integrate the best combination of conventionalthe cancer care offered by conventionally trained physicians and most hospitals; examples are chemotherapy, surgery, and radiotherapy and complementary therapies and practices for each person.

Our staff have no financial conflicts of interest to declare. We receive no funds from any manufacturers or retailers gaining financial profit by promoting or discouraging therapies mentioned on this site.

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