Optimizing Your Body Terrain

Your body terrain is the state of your inner environment. It includes your nutritional status, metabolism, immune function, microbiome, environmental exposures, and more. Eight terrain factors have known links to cancer development, growth, and spread.

What is the tumor microenvironment, and why is it important?

Your tumor microenvironment is the non-cancerous cells, molecules, and blood vessels that surround and feed a tumor cell. A tumor can change its microenvironment, and the microenvironment can affect how a tumor grows and spreads.1National Cancer Institute. NCI Dictionary of Cancer Terms. Viewed April 30, 2018.

How does my tumor affect the microenvironment?

If cancer was simply a group of malignant cells or a disease of aberrant genes, we would have long ago succeeded in eliminating or curing cancer by removing or destroying cells or targeting genetic mutations. But it’s not. Cancers are “not just masses of malignant cells, but complex ‘rogue’ organs, to which many other cells are recruited and can be corrupted by the transformed cells.”2Balkwill FR, Capasso M, Hagemann T. The tumor microenvironment at a glance. Journal of Cell Science. 2012 Dec 1;125(Pt 23):5591-6.

Cancer cells and tumors actively participate in their microenvironments, similar to how a roommate would be an active participant in your home. Roommates bring in possessions and dirt, use water and electricity, and create waste. Some may be rude or even destructive, intruding on your space, making messes, eating your food, rearranging the furniture without asking you, making noise, causing damage—they change their environment. Cancer cells do the same thing on a cellular level, and usually to their advantage. “Tumor cells themselves alter the microenvironment to secrete things that help tumors grow.”3Joe Gray, PhD, quoted in Gibbs A. Area surrounding a tumor impacts how breast cancer cells grow. Oregon Health & Science University. March 14, 2018. Viewed April 30, 2018.

In addition to malignant cells, the tumor microenvironment contains these types of cells and structures:

  • Immune cells
  • Tumor blood vessels
  • Lymph cells, nodes, and channels
  • Fibroblasts, cells in connective tissue that produce collagen and other fibers, usually to help wounds heal
  • Pericytes, cells in linings of blood vessels that help with blood vessel formation
  • Adipocytes, fat storage cells

All the malignant and nonmalignant cells in the tumor microenvironment communicate with each other through a network of biochemicals—cytokines, chemokines and growth factors, as well as enzymes that promote inflammation and remodel your tissue structure.

All the cells in the tumor microenvironment play a role in cancer’s development, spread, and response to treatment. Altering the environment around tumor cells can impact their ability to grow and spread.

CancerChoices advisor Brian Bouch, MD, explains the importance of toxicity and genes in integrative cancer care, plus a functional medicine approach to diagnosis and care.

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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

Nancy Hepp, MS

Lead Researcher
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Ms. Hepp is a researcher and communicator who has been writing and editing educational content on varied health topics for more than 20 years. She serves as lead researcher and writer for CancerChoices and also served as the first program manager. Her graduate work in research and cognitive psychology, her master’s degree in instructional design, and her certificate in web design have all guided her in writing and presenting information for a wide variety of audiences and uses. Nancy’s service as faculty development coordinator in the Department of Family Medicine at Wright State University also provided experience in medical research, plus insights into medical education and medical care from the professional’s perspective.

Nancy Hepp, MS Lead Researcher

Last update: March 29, 2024

Last full literature review: July 2021

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.

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