The Cancer Nutritionist

28/10/2026

Breast Cancer Awareness Month is about more than awareness. It’s about understanding your diagnosis and recognising why personalised care matters.

If you’ve experienced breast cancer, what’s one thing you wish someone had explained to you when you were diagnosed?

I’d love to hear your experiences.

17/10/2026

What happens when cancer treatment ends?

For many people, this is when a whole new set of challenges begins.

I’ve been reading some interesting research shared by the American Society of Clinical Oncology (ASCO), involving more than 34,000 people affected by cancer.

The study found that people who received a cancer survivorship care plan had better survival outcomes than those who didn’t.

Now, this doesn’t prove that the care plans themselves caused the improvement, but it certainly highlights the importance of looking at what happens beyond active cancer treatment, and this is something I feel particularly strongly about.

In my clinical practice, when I ask clients whether they’ve been given a survivorship care plan, the answer is so often NO.

Many describe feeling frustrated, anxious, angry and sometimes abandoned once their active treatment finishes.

For months, sometimes years, their lives have revolved around hospital appointments, investigations and treatments.

Then suddenly, they’re expected to get on with life, but life isn’t the same.

There’s often ongoing fatigue, disrupted sleep, changes in body composition, digestive problems, treatment related side effects, emotional challenges and, of course, the fear of recurrence.

Just because cancer treatment has finished doesn’t mean recovery is complete, and this is where I believe we need to do so much better.

As The Cancer Nutritionist, I’ve spent over 13 years in clinical practice, and since my postgraduate training in The Systems Approach to Cancer, I’ve been supporting people before, during and after cancer treatment.

My approach is rooted in integrative oncology and personalised nutritional and lifestyle medicine.

Through my RESPECT® model of health and wellbeing, we look beyond eating habits alone, addressing risk factors, sleep, physical movement, the internal and external environment, community, including the community of gut microbiome and social support, and appropriate therapeutics and testing.

It’s about understanding the individual, identifying where support is needed and developing a personalised approach to improving their health and wellbeing. Of course, this doesn’t replace the medical survivorship care plan provided by an oncology team. It complements it.

Cancer survivorship isn’t just about monitoring for recurrence. It’s also about supporting someone’s physical, nutritional and emotional wellbeing and helping them journey through life during and after treatment, and I’d really love to hear your experiences.

If you’ve completed active cancer treatment, were you given a survivorship care plan?

Did you feel supported and know what happened next, or were you left wondering how to manage your health and recovery?

Perhaps more importantly, what support do you wish you’d received?

Please share your thoughts in the comments, whether you’re someone who’s experienced cancer, a family member or a healthcare professional.

Your experiences matter, and these are conversations we need to be having.

Follow The Cancer Nutritionist for practical, evidence based information and personalised approaches to supporting health before, during and after cancer treatment.

I’m sharing the ASCO findings below for anyone interested in reading the research.

https://www.asco.org/abstracts-presentations/269504

This reflects what I hear so often in clinical practice. When I ask clients whether they’ve received a survivorship care plan, many tell me they haven’t. There’s often a real sense of frustration, anxiety and abandonment once active treatment ends. We absolutely need better continuity of care....

11/10/2026

BREAST CANCER AWARENESS MONTH:

Have you had your vitamin D levels checked? And what about your bone health?

October is Breast Cancer Awareness Month, and I wanted to share some interesting research, along with something I believe deserves far more attention when it comes to supporting people diagnosed with breast cancer.

Did you know that certain breast cancer treatments can affect your bone health?

If you’re taking letrozole, anastrozole or exemestane, you may recognise these medications.

They’re called aromatase inhibitors, and they’re commonly prescribed for hormone receptor positive breast cancer.

They work by reducing oestrogen production, which is important in helping reduce the risk of cancer recurrence. However, lower oestrogen levels can also accelerate bone loss, increasing the risk of osteoporosis and fractures.

Tamoxifen is another commonly prescribed medication, although its effects on bone health differ depending on whether a woman is premenopausal or postmenopausal.

So, here’s an important question. Have you had a DEXA scan?

A DEXA scan is a quick, painless, low dose X-ray that measures bone mineral density and helps identify weakened bones and osteoporosis.

In fact, NICE recommends a baseline DEXA scan for women starting aromatase inhibitors, experiencing treatment induced menopause or beginning ovarian suppression, unless they are already receiving certain bone protective treatments.

If this applies to you and you haven’t had one, it’s worth discussing with your oncology team.

Now, let’s talk about vitamin D.

Vitamin D plays an important role in helping our bodies absorb calcium and maintain healthy bones.

However, its potential relevance to cancer treatment outcomes is also an area of ongoing research.

In April 2025, a randomised clinical trial involving 227 women receiving treatment before breast cancer surgery reported some interesting findings.

Women receiving vitamin D supplementation alongside their conventional treatment had higher rates of pathological complete response.

In simple terms, this means that no residual invasive cancer was found in the breast tissue examined following treatment.

The researchers reported a pathological complete response rate of 39.5% in the vitamin D group compared with 16.8% in the control group.

That’s certainly an encouraging finding.

However, it’s important to understand that this was one study. It doesn’t establish that vitamin D supplementation improves long term survival or prevents recurrence, and further research is needed. Nor does it mean everyone diagnosed with breast cancer should start taking high doses of vitamin D.

This brings me to something I frequently encounter in my clinical practice.

When someone becomes a client, I review up to 12 months of their previous blood test results, alongside any relevant urine, stool and other investigations.

Sometimes someone has previously had their vitamin D tested and been told their result was normal, but what does normal actually mean?

There’s an important distinction between identifying a deficiency, establishing nutritional adequacy and considering what may be appropriate for an individual’s health circumstances.

As a practitioner trained in Nutritional Medicine, Functional Medicine and Lifestyle Medicine, I’m interested in the whole clinical picture.

A blood test result is one piece of information. It needs to be interpreted alongside someone’s medical history, medications, symptoms, dietary intake and other relevant findings. My philosophy is simple: TEST, DON’T GUESS.

Vitamin D is just one tiny part of what I assess. For example, when supporting someone with breast cancer, I may also consider:

• Their protein intake and whether they’re maintaining muscle mass and strength.

• Their calcium intake, vitamin D status and overall bone health.

• Whether their treatment is contributing to fatigue, sleep difficulties or joint discomfort.

• Their digestive health and nutritional intake.

• The importance of appropriate physical activity, particularly resistance and weight bearing exercise for bone health.

• Their nutritional needs before surgery, during chemotherapy or radiotherapy, and throughout recovery.

• Whether additional investigations or discussions with their medical team would be appropriate.

That’s before we begin exploring the many other areas covered by my RESPECT® approach, including risk factors, eating habits, sleep, physical movement, environment, community, therapeutics and testing.

This is because cancer care shouldn’t be solely about the tumour. We also need to consider the person living with cancer, and there’s so much that can be done to support someone’s nutritional status, physical wellbeing and quality of life before, during and after conventional treatment.

For those who don’t know me, I’m Helen Perks, a Registered Nutritional Practitioner specialising in cancer nutrition and integrative oncology support.

I have more than 13 years of clinical experience and work online with people throughout the UK and internationally.

My approach is personalised, evidence based and designed to work alongside conventional medical care.

If you or someone you love has recently received a cancer diagnosis, is undergoing treatment or is journeying through life after cancer, I offer a complimentary 20 minute telephone consultation.

It’s an opportunity to discuss your circumstances, explain how I work and explore whether my approach could be helpful.

Please feel free to send me a private message or visit:

helenperks.com.

With warmest wishes,
Helen

Helen Perks BSc
The Cancer Nutritionist

Registered Nutritional Practitioner | Functional & Lifestyle Medicine Practitioner
Specialising in Integrative Oncology
BSc Nutritional Medicine | mBANT | rCNHC
AFMCP Graduate | Postgraduate Systems Approach to Cancer (SATC)

📩 [email protected]
🌐 www.helenperks.com
🍲 Nourishing Soups by The Cancer Nutritionist

RESPECT® Your Future by Nourishing Today

05/10/2026

This is one of the best visual explanations I’ve seen of why vitamin D becomes so important at this time of year.

Watch what happens to the “vitamin D winter” as we move through the year.

The animation shows how the availability of UVB changes with latitude and season. Here in the UK, as we move through autumn and winter, the sun sits lower in the sky and eventually there simply isn’t enough UVB reaching us for us to rely on sunlight for meaningful vitamin D production through our skin.

There is an important bit of nuance though. That line isn’t a precise biological cut off.

Our ability to make vitamin D from sunlight varies considerably according to factors including our age, skin pigmentation, time of day, cloud cover, clothing and how much skin is exposed, and perhaps even more importantly, where somebody lives and how much sunshine they’ve had cannot tell me what their vitamin D status actually is.

That requires a blood test measuring 25 hydroxyvitamin D.

Vitamin D is something I pay particular attention to in my clinical practice, including with my cancer clients, which brings me to something particularly relevant during Breast Cancer Awareness Month.

There is some fascinating research looking at vitamin D status and outcomes following a breast cancer diagnosis.

A 2021 meta analysis involving 8,574 women with breast cancer found that those in the lowest vitamin D category had poorer overall survival, disease free survival and breast cancer specific survival compared with those in the highest category.

Another meta analysis involving almost 6,000 women with breast cancer also found that higher circulating vitamin D concentrations were associated with better overall survival.

However, here’s where we have to be careful with the science.

An association doesn’t prove that vitamin D itself produced those better outcomes.

It doesn’t mean that taking large doses of vitamin D will improve somebody’s cancer outcome, and it doesn’t establish one perfect vitamin D level that everybody with breast cancer should be trying to achieve.

There may be many reasons why somebody with a higher vitamin D status has better outcomes, and that’s precisely why observational evidence and evidence from an intervention are not the same thing.

What it does tell us is that vitamin D status is worth paying attention to.

Personally, I make the most of natural sunlight during the spring and summer months when UVB allows us to synthesise vitamin D naturally, but I don’t assume that having had plenty of summer sunshine means my vitamin D status will necessarily remain adequate throughout the winter.

Current UK guidance recommends that adults consider taking 10 micrograms, or 400 IU, of vitamin D each day during autumn and winter, with some people advised to supplement throughout the year.

In clinical practice, particularly when somebody is living with cancer, my approach is more individualised: I prefer Test, don’t guess.

What is their actual vitamin D status?

What is their medical history?

What treatment are they receiving?

What medications and supplements are they taking?

What does the wider clinical picture look like?

This is because vitamin D is biologically active. More isn’t automatically better, and supplementation should have a purpose.

This fits beautifully into the T in my RESPECT® prescriptions: Therapeutics and Testing.

Test where appropriate, interpret the result in context, and supplement with purpose.

If you’re currently going through cancer treatment, please don’t start taking high dose vitamin D because of something you’ve read on social media. Discuss supplementation with an appropriately qualified healthcare professional who understands your diagnosis, treatment and medications.

A really clever visual from William Wallace PhD and very timely as we head into our vitamin D winter.

I’ll put the breast cancer research papers in the comments for anyone who would like to read them.

Helen Perks BSc
The Cancer Nutritionist
Registered Nutritional Practitioner
Functional & Lifestyle Medicine Practitioner
Cancer Nutrition and Integrative Oncology Support

THE VITAMIN D LINE, DAY BY DAY Your skin makes vitamin D from the sun's UVB. In winter the sun sits low, its light crosses more atmosphere, and ozone absorbs most of the UVB. Watch the line move through a year. For each day, we computed where the clear-sky vitamin D dose drops below the research thr...

02/10/2026

What did a parasitic infection acquired years ago have to do with my client’s bladder cancer?

Before I ask someone with cancer what they are eating, I want to understand the person sitting in front of me.

I’m currently working with a man with bladder cancer who is preparing for treatment.

While taking his history, something caught my attention. He had previously lived in Africa, so I asked whether he had ever had schistosomiasis. “Yes”, and that answer mattered.

Schistosoma haematobium is a parasitic infection that affects the urinary tract. Its eggs can become embedded in the bladder wall, causing tissue injury and chronic inflammation.

Importantly, infection with S. haematobium is classified as carcinogenic to humans and has a well established association with bladder cancer, particularly squamous cell carcinoma.

Does that mean it caused his cancer? No. Cancer is multifactorial and I could never draw that conclusion about an individual. My role is not to determine the cause of his cancer, but understanding recognised risk factors is an important part of building a fuller clinical picture.

This is precisely why R in my RESPECT® framework stands for Risk Factors.

I have 2 very recent and comprehensive oncology reference books beside me. Neither highlighted this particular risk factor in the sections I consulted. So I went further into the research, and that’s where it became even more interesting.

Human studies discussed in the literature include differences in urinary microbiome profiles, urinary proteomics and elevated serum and urinary VEGF in people with bladder cancer and S. haematobium infection.

The mechanisms are still being investigated, so these findings shouldn’t be interpreted as proving what happened in one individual. However, they raise fascinating questions about the wider biological picture.

Suddenly, this wasn’t relevant only to R for Risk Factors.

E for Environment: His geographical history was part of his external environment and prompted me to investigate aspects of his internal environment too.

C for Community: Within RESPECT®, Community doesn’t only mean the people around us. It also includes our internal community of gut microbiome. Modern cancer biology increasingly recognises polymorphic microbiomes as an enabling characteristic that can influence hallmark capabilities.

This is where my training becomes important.

My BSc in Nutritional Medicine, subsequent training in Functional and Lifestyle Medicine, and postgraduate oncology training through Dr Nina Fuller Shavel, a world renowned integrative oncologist, have all shaped the way I practise: looking beyond the obvious, researching the individual and understanding the wider biological picture before personalising my evidence based recommendations.

This gentleman is also now within an incredibly valuable period before treatment: his prehabilitation window.

That means considering what we can appropriately do now to help optimise his nutritional status, preserve physical function and muscle, support psychological wellbeing and prepare him as well as possible for the treatment and surgery ahead, alongside the care of his medical team.

So I have developed his personalised RESPECT® Prescription around him, his medical treatment and the time we have available before treatment begins.

R Risk Factors
E Eating Habits
S Sleep Hygiene
P Physical Movement
E Environment
C Community
T Therapeutics and Testing

7 areas and 1 individual person.

Personalised cancer nutrition starts with understanding the person, not just what’s on their plate.

I’ll put the research papers behind some of what I’ve discussed here in the comments for anyone who would like to read further.

If you’d like to discuss how you can work with me, I lease do send a DM or book your 20-minute complimentary call with me via my website:

https://helenperks.com

With warmest wishes,
Helen

Helen Perks BSc
The Cancer Nutritionist

Registered Nutritional Practitioner | Functional & Lifestyle Medicine Practitioner
Specialising in Integrative Oncology
BSc Nutritional Medicine | mBANT | rCNHC
AFMCP Graduate | Postgraduate Systems Approach to Cancer (SATC)

📩 [email protected]
🌐 www.helenperks.com
🍲 Nourishing Soups by The Cancer Nutritionist

RESPECT® Your Future by Nourishing Today

29/09/2026

This is a conversation I had recently with a GP over dinner at the National Centre for Integrative Oncology conference in Oxford.

As a GP consultation may be just 10 minutes, and somebody living with cancer can arrive with fatigue, digestive symptoms, treatment side effects, loss of muscle, poor sleep, menopausal symptoms, anxiety, questions about supplements, changes in appetite and an overwhelming amount of information, no one healthcare professional can address all of that in 10 minutes, and nor should they be expected to.

For me, that is where multidisciplinary care becomes so important. I have worked in clinical nutrition for over 13 years and increasingly my role in oncology involves working alongside, not instead of, conventional medical care.

Just recently, a Professor I had written to regarding a client contacted me directly following their assessment, updated me on the investigation undertaken and discussed the next referral.

Within days, another client told me that their GP had asked which blood tests I would like requested, with the practice subsequently providing the appropriate route for those results to be shared.

Over the past 13 years, every appropriate request I have made to a GP or consultant for additional testing or referral has been accepted.

I think good integrative care depends upon knowing exactly where your own scope ends and somebody else’s begins. My oncology clients already have oncologists, surgeons, GPs and specialist nurses, and my role is different.

I have the time to explore the person behind the diagnosis: their nutrition, symptoms, sleep, movement, metabolic health, environment, support network, medications and supplements, and the questions that inevitably arise between medical appointments.

When something needs medical investigation, I communicate that appropriately. That conversation over dinner in Oxford reinforced something I feel increasingly strongly about:

Integrative oncology isn’t about replacing conventional medicine with something else, it’s about wrapping the right expertise around the same person.

Cancer care shouldn’t only treat the cancer, it should support the person living with it.

I’d love to see much more of that.

If you are living with cancer, preparing for treatment or surgery, going through treatment, or trying to find your way forward afterwards, I offer a complimentary 20 minute telephone call where we can talk about what is happening for you and whether the support I provide could help.

Feel free to send me a DM and we can arrange a time to speak, or book your call through my website:

https://helenperks.com

With warmest wishes,
Helen

Helen Perks BSc
The Cancer Nutritionist

Registered Nutritional Practitioner | Functional & Lifestyle Medicine Practitioner
Specialising in Integrative Oncology
BSc Nutritional Medicine | mBANT | rCNHC
AFMCP Graduate | Postgraduate Systems Approach to Cancer (SATC)

📩 [email protected]
🌐 www.helenperks.com
🍲 Nourishing Soups by The Cancer Nutritionist

RESPECT® Your Future by Nourishing Today

27/09/2026

A little bit about the person behind The Cancer Nutritionist…

I’m Helen. Registered Nutritional Practitioner, integrative oncology practitioner, creator of RESPECT®, lover of good food, travel, movement, family, dressing up, laughing and occasionally making a complete fool of myself!

I’ve worked in nutrition for over 13 years, and today much of my work is supporting people before, during and after cancer treatment.

I’m also a mum, wife, glamma, friend and a firm believer that looking after our health should help us LIVE our lives, not become our lives.

So, as I’ve welcomed quite a few new faces here recently, I thought I’d share a little more of the person behind the professional.

Tell me something about YOU that I wouldn’t know from looking at your Facebook profile.

27/09/2026

Movement is medicine. 💃

P stands for Physical Movement in my RESPECT® Prescriptions I write for my clients, but movement doesn’t always have to mean a workout.

Sometimes it can just be putting on a song you love, having a dance and doing something that makes your heart sing. ❤️

27/09/2026

Cancer pain and treatment related pain should not just be something you are expected to put up with.

Last weekend at the National Centre for Integrative Oncology conference in Oxford, I listened to an excellent presentation from Dr Deepak Ravindran on integrative approaches to cancer related pain.

It immediately made me think about a video I made on the joint and musculoskeletal pain women can experience while taking endocrine therapies such as letrozole and tamoxifen.

That video has now had more than 48,000 views and over 100 comments.

It wasn’t the numbers that were remarkable, it was the women saying:

“This is me”, and then asking:

“What can I actually DO about it?”

That is such an important question, because while side effects can sometimes be an unavoidable consequence of an effective cancer treatment, that does not mean we should stop asking whether there are safe, evidence based ways of helping someone manage them.

One example is acupuncture. Clinical guidelines recommend acupuncture for aromatase inhibitor related joint pain in breast cancer.

One of the largest randomised trials involved 226 women experiencing moderate to severe joint pain while taking aromatase inhibitors.

The acupuncture protocol used was twice weekly for 6 weeks, followed by once weekly for another 6 weeks.

Women receiving true acupuncture experienced significantly greater reductions in pain than those receiving sham acupuncture or no acupuncture, and follow up research found improvements in pain scores were still evident at 52 weeks.

Does that mean acupuncture will work for every woman, no, but it means there is an evidence based option worth knowing about and discussing with your healthcare team.

This is a perfect example of why T stands for Therapeutics, Testing and Targeted Supplementation in my RESPECT® Prescription.

When people hear “therapeutics”, they often immediately think supplements, but therapeutics can encompass so much more.

Depending on the individual and the evidence, it might include acupuncture, massage, hypnosis, guided imagery, relaxation or other mind body approaches, and crucially, T never sits in isolation.

If someone is experiencing pain, I also want to know:

How are they sleeping, moving, what is happening with their nutrition and nutritional status, is fatigue, anxiety or low mood contributing to how they are feeling, what is happening within their internal environment, and what support do they have around them?

That is why my RESPECT® Prescription considers all 7 areas:

R Risk Factors
E Eating Habits
S Sleep Hygiene
P Physical Movement
E Environment, internal and external
C Community, our microbiota and our human connections
T Therapeutics, Testing and Targeted Supplementation

One of my favourite messages from Dr Ravindran’s presentation was:

Assess. Match. Deliver. Review.

I love that.

It isn’t about throwing every complementary therapy at somebody because they have cancer, or about assuming that because something is “natural”, it must be safe, and it really isn’t about choosing inyegrative approaches instead of conventional cancer treatment. It’s about considering the whole person and asking:

What is appropriate for THIS person, at THIS point in their cancer journey, and what does the evidence tell us?

Then we assess whether it is actually making a difference to their pain, function and quality of life, and for me, that is responsible integrative oncology.

Thank you Dr Deepak Ravindran for such a fascinating presentation. It was also an absolute pleasure to meet you afterwards.

I’ll pop the acupuncture research I’ve mentioned into the comments for anyone who would like to read it.

RESPECT® Your Future By Nourishing Today.

27/09/2026

You might wonder why, as The Cancer Nutritionist, I’m talking about exercise.

It’s because supporting someone with cancer is about so much more than food.

Last weekend at the NCIO conference, I listened to a fascinating presentation on exercise before, during and after cancer treatment, and some of the research was incredibly powerful.

One of the studies discussed was the 2025 CHALLENGE trial involving 889 people who had been treated for stage III or high risk stage II colon cancer.

Those following a structured exercise programme had:

• a 28% lower risk of recurrence, a new primary cancer or death

• a 37% lower risk of mortality

• better disease free survival at 5 years

We also heard about the role physical activity can play in supporting fitness, muscle strength, fatigue, quality of life, cardiovascular health, sleep, anxiety and physical function during and after cancer treatment.

However, here’s the important bit. This does NOT mean telling somebody going through cancer treatment to just “exercise more”.

Cancer treatment can affect muscle mass, strength, energy, balance, cardiovascular function and metabolic health. Some treatments can cause peripheral neuropathy. Others can affect the heart.

So movement needs to be appropriate for the individual, their cancer, their treatment, their symptoms and where they are in their recovery.

That is exactly why P stands for Physical Movement in my RESPECT® Prescription.

When I work with someone affected by cancer, I don’t look at nutrition in isolation.

I look at:

R Risk Factors
E Eating Habits
S Sleep Hygiene
P Physical Movement
E Environment, internal and external
C Community, including the community of gut microbiota and our social connections
T Therapeutics, Testing and Targeted Supplementation

All 7 matter.

Food is enormously important, but we cannot nourish the body beautifully and then ignore sleep, muscle, movement, metabolic health, our internal environment and the other factors influencing health and recovery.

One statistic from the presentation was quite remarkable.

In one study of men receiving hormone therapy for prostate cancer, only 5% had a formal exercise prescription.

Just 5%!

We have increasingly compelling evidence for the importance of movement in cancer care. Now we need to get much better at putting that evidence into practice.

Also remember, movement doesn’t necessarily mean joining a gym. Sometimes it starts with asking:

“What can my body comfortably do today?”

Thank you to Darryl Edwards, founder of Movement Oncology, for such a thought provoking presentation and for the lovely chat afterwards.

RESPECT® Your Future By Nourishing Today.