The research, published in the journal Supportive Care in Cancer, was led by Barbara S. van der Meij of HAN University of Applied Sciences and Wageningen University & Research, together with colleagues at Radboud University Medical Center and Amsterdam UMC. The team conducted in-depth, semi-structured interviews with 24 patients receiving systemic therapy for metastatic cancer at a Dutch university medical center. The participants — 15 men and 9 women with a median age of 55, ranging from 25 to 78 years — represented a broad spectrum of tumor types and treatments, including chemotherapy, immunotherapy, hormone therapy and targeted therapy. Interviews averaged nearly 49 minutes and were transcribed verbatim and analyzed using reflexive thematic analysis, a method in which researchers systematically code interview data and iteratively refine themes while critically examining their own assumptions.

Three overarching themes emerged from the analysis. First, nutrition became a more prominent concern after diagnosis. Second, patients actively navigated nutritional information and advice from multiple sources, frequently encountering uncertainty and conflicting messages. Third, patients expressed a clear need for personalized, trustworthy and coordinated nutritional support. Together, these themes sketch a picture of patients who are not starving for information — they are drowning in it.

The first theme captures how a cancer diagnosis transforms a person’s relationship with food. Many participants described becoming newly aware of what they ate and reflecting on nutrition’s possible role in the disease itself. “Since I had cancer, I am more aware of what I eat,” one respondent explained. Views on whether diet influenced cancer development were divided: some believed healthy eating could reduce risk, with one participant musing, “Maybe I could have avoided getting cancer if I had known this about nutrition earlier.” Others held firm beliefs about diet’s effect on treatment — “Sugar makes tumors grow, so I don’t drink soft drinks anymore,” one said — even when those beliefs diverged from their oncologist’s assessment. One woman recalled her doctor telling her she “just had bad luck” and that the cancer had nothing to do with her diet, yet she remained convinced that nutrition played an important role and wanted to know more.

At the same time, treatment itself made eating genuinely difficult. Chemotherapy and other systemic therapies brought taste and smell alterations, nausea and reduced appetite that could strip food of its pleasure and even its social meaning. “I could no longer eat because my body refused to swallow anything that had a rotten taste in my mouth,” one patient recounted. Another described how a cherished Christmas dinner had to be downgraded to a lunch. Some described eating as “the necessary evil” — an exhausting obligation rather than a joy. Patients responded with practical adaptations: smaller and more frequent meals, milder foods, simple remedies like tea with honey, and a preference for eating at home, where familiar surroundings seemed to restore appetite. One man described how a sandwich made by his son flipped a switch and allowed him to eat and drink again after chemotherapy.

The second theme — the search for the “right” nutrition — proved to be the study’s most striking finding. Patients consulted an enormous range of sources: healthcare professionals, the Dutch Cancer Society website, dietetics resources, online forums, Facebook groups, fellow patients, family members and alternative practitioners. Confidence in evaluating what they found varied enormously. “I am highly educated and can think critically for myself: this is scientifically proven and this is nonsense,” one participant said. Others were overwhelmed: “There is so much on the internet. I don’t want to look at all that contradictory information.” The result, for many, was a burden of self-management. “So many different people say something and have their own opinions. Then I’m just left on my own again,” one patient said. Advice from acquaintances, general practitioners, dietitians and radiation oncologists simply did not match, and even complementary practitioners added to the confusion — one patient’s acupuncturist promoted intermittent fasting for cancer, leaving the patient unsure whether that was wise.

Notably, some patients became deliberately cautious once they understood the stakes. One participant on immunotherapy explained that he had once been open to trying alternative approaches but now avoided anything that might affect his immune system, fearing interference with a treatment that was working. This kind of risk calculation — weighing unproven supplements and diets against a therapy that is keeping the disease at bay — is precisely the territory where clear clinical guidance matters most, and where the study found it most often absent.

Interactions with healthcare professionals were, on the whole, appreciated. Most respondents praised the accessibility and warmth of their nurses and physicians, and regular follow-up from dietitians was especially valued — one patient highlighted weekly or biweekly calls with the option to phone back with questions. But gaps remained. Some felt that hospitals focused on treatment rather than prevention or broader wellbeing. Others doubted clinicians’ nutritional expertise: “Most doctors are sincere, I don’t doubt that, but they lack the knowledge about what nutrition can do,” one respondent said. And when clinicians asked about supplement use, concrete guidance did not always follow. “They also asked if I took supplements. Yes. But they didn’t say I couldn’t take them anymore. I had to find that out myself,” another patient recalled.

The social environment added another layer of complexity. Partners and family members shopped, cooked and adapted meals around taste alterations, and without that support patients said they would simply eat less. But household dynamics could also create friction — one woman lamented having “three men in the house who want a piece of meat on the table every day” — and well-meaning tips from friends and fellow patients, like probiotic drinks, added yet more voices to the chorus. Nutritional decision-making, the authors conclude, happens within a web of relationships both inside and outside the clinic.

The third theme points toward a solution. Patients did not simply ask for more information; they asked for information that was accurate, current, tailored to their situation, and consistent across everyone involved in their care. “It would be great if my GP, dietitian, and specialist worked together better so that I don’t get three different pieces of advice,” one respondent said. Others wanted automatic updates rather than having to hunt for answers, and clearer, less complicated materials, ideally with visual formats. The authors argue that nutritional support in metastatic cancer care should extend beyond information provision to include personalized, coordinated guidance that helps patients interpret, contextualize and apply what they hear. The findings echo a parallel study among healthcare professionals at the same hospital, which reported unclear role division and uncertainty about supplements, suggesting that the fix requires alignment across the whole care team — not just better patient education.

The study has limitations worth noting. It was conducted at a single university medical center, participation was voluntary and may have attracted patients with a particular interest in nutrition, and the diverse sample was not designed to compare tumor types or treatment modalities. Still, its focus on metastatic patients — a population living longer with advanced disease and facing nutritional challenges throughout prolonged treatment — fills an important gap. For a growing group of people whose cancer has spread but whose lives continue for years on systemic therapy, the message of this research is clear: the hardest part of eating well with cancer is not finding advice. It is knowing which advice to trust.

Subject of Research: Patient experiences and needs in navigating nutritional information during systemic therapy for metastatic cancer

Article Title: Navigating nutritional information while living with metastatic cancer: a qualitative study of patient experiences and needs

Article References: van der Meij, B. S., van den Berg, M. G., Nagtegaal, I. E., van Amstel, F. K. P., Ottevanger, P. B., & de Kruif, A. J. (2026). Navigating nutritional information while living with metastatic cancer: a qualitative study of patient experiences and needs. Supportive Care in Cancer, 34(9), Article 924. https://doi.org/10.1007/s00520-026-11148-1

Image Credits: AI Generated

DOI: 10.1007/s00520-026-11148-1

Keywords: metastatic cancer, nutrition, qualitative research, patient experiences, supportive care, dietary advice, systemic therapy, healthcare communication, dietitians, nutritional supplements, cancer misinformation, personalized nutrition