Inflammation: The Terrain Factor Hiding Behind "I Just Feel Off"
Not every terrain factor announces itself clearly. Chronic, low-grade inflammation is one of the quieter ones — clients rarely walk in describing "inflammation." They describe persistent fatigue that rest doesn't fix, joint aches that came out of nowhere, brain fog, or a general sense of feeling unwell that doesn't map neatly onto any single symptom. Often, inflammation is underneath it.
Two kinds of inflammation, and why the distinction matters
Some inflammation during cancer treatment is expected and even necessary. It's part of how the body responds to surgery, processes damaged cells after chemo, or heals radiated tissue. That acute, purposeful inflammation which is a part of your body's natural healing process isn't the target here.
The concern is chronic, low-grade inflammation — the kind driven by diet, unstable blood sugar, poor sleep, unresolved stress, or gut dysbiosis, running quietly in the background regardless of what treatment is doing. This type of inflammation is well studied as a contributor to tumor progression and is linked to several other terrain factors: it worsens insulin resistance, disrupts the gut microbiome, and taxes an already burdened immune system.
Why chronic inflammation matters so much in cancer
This is worth spelling out plainly, because it's easy to underestimate.
When inflammatory cells stay active in the body long-term, they can actually help cancer grow and spread, through several different biological pathways at once.
Chronic inflammation is now understood to touch nearly every hallmark of how cancer develops and progresses. It can
contribute to DNA damage,
suppress normal immune surveillance,
block the natural process that clears out damaged cells (apoptosis),
support the growth of new blood vessels that feed a tumor (angiogenesis),and also
its ability to spread (metastasis).
Researchers estimate that chronic inflammation is a significant contributing factor in a substantial share of cancer cases worldwide, some estimates put it at roughly one in four. That's a sobering number, but it also points to something genuinely encouraging: because inflammation is one of the more modifiable terrain factors, bringing it down is one of the more concrete, evidence-supported things a person can actually do.
Inflammation and your immune system are directly linked
Here's a connection that surprises a lot of clients: when inflammation goes up, immune function tends to go down and not the other way around, which is often assumed.
Chronic inflammation keeps cortisol (your primary stress hormone) elevated. Sustained high cortisol has a direct, measurable effect on the thymus gland, causing it to shrink and reducing the production and activity of white blood cells. The thymus plays a central role in training and developing T-cells, the immune cells responsible for recognizing and responding to abnormal or cancerous cells. In other words: unchecked inflammation doesn't just cause discomfort, it can actively undermine the very immune surveillance your body relies on.
What actually causes chronic inflammation
Several everyday factors contribute, often stacking on top of each other:
Inadequate or poor-quality sleep
Too much or too little exercise (both extremes can be inflammatory)
Excess weight or obesity
Smoking
High-carbohydrate, high-refined-sugar diets
Bacterial or viral infections
Alcohol consumption
Environmental toxin exposure
An imbalanced ratio of dietary fatty acids
Sugar's role: inflammation and oxidative stress
This is a big enough piece that it deserves its own section. High insulin levels, caused by overconsuming sugar and refined carbohydrates, increase the body's production of C-reactive protein (CRP), a well-established marker of inflammation.
High blood sugar also generates free radicals (reactive oxygen species, or ROS), molecules that both sustain and actively promote ongoing inflammation. This is one more reason blood sugar stability (covered in its own terrain piece) and inflammation are so tightly linked, steadying one measurably helps the other.
The fat balance most people are missing
Humans evolved eating a diet with a ratio of omega-6 to omega-3 fatty acids of roughly 2:1. Today's typical Western diet has shifted dramatically, with ratios often between 15:1 and 40:1.
Heavy in omega-6 fats from corn, soy, canola, and other vegetable oils, and comparatively very low in omega-3s. This imbalance matters directly for inflammation.
Omega-6 fatty acids stimulate the body's production of pro-inflammatory markers, including prostaglandins. One omega-6 fat in particular, arachidonic acid, drives production of a highly inflammatory compound called prostaglandin E2 (PGE-2), formed by the COX-2 enzyme and released in response to infection or inflammation. PGE-2 has been shown to help support tumor growth and progression through several mechanisms.
Trans fats deserve special caution
Trans fats commonly listed as "partially hydrogenated vegetable oil" on food labels are found in salad dressings, non-dairy creamers, margarine, chips, cookies, and many packaged baked goods. They do double damage: they block your body's ability to use anti-inflammatory fats, and they lower your body's own production of anti-inflammatory molecules. Trans fats are linked to an increased risk of breast and colon cancer, and are worth actively avoiding whenever you see "hydrogenated" or "partially hydrogenated oil" on an ingredient label.
A note on cancer cachexia
This is an important, often misunderstood connection. Cancer-related cachexia (significant, unintended muscle and weight loss during illness) is itself an inflammatory condition, not simply a matter of "not eating enough." This means that just adding more calories or more protein to the diet won't rebuild lost muscle on its own if the underlying inflammation driving the cachexia isn't also being addressed. This is a nuanced, individualized situation that's worth discussing directly with your care team and a practitioner familiar with terrain-informed nutrition, rather than assuming more food alone will solve it.
Why this factor tends to respond quickly
Of the ten terrain factors, inflammation is often one of the more responsive to change — many clients notice a shift in energy and joint comfort within two to four weeks of consistent dietary and lifestyle adjustments, well before other terrain factors move.
What actually moves the needle
Prioritize omega-3-rich foods, and work on your omega-6:omega-3 ratio. Fatty fish, walnuts, and flaxseed provide anti-inflammatory fatty acids with reasonably strong research behind them; reducing processed vegetable oils alongside increasing omega-3 intake matters more than either change alone. For those not eating fish regularly, a quality fish oil or algae-based omega-3 supplement is worth discussing.
Reduce ultra-processed food and added sugar, not all carbohydrates. This distinction matters, whole-food carbohydrates aren't the driver of inflammatory load the way refined and ultra-processed foods and added sugars are.
Read ingredient labels for hydrogenated oils. Avoiding trans fats is one of the more clear-cut, low-effort changes available.
Address sleep before adding more supplements. Poor sleep is one of the strongest drivers of inflammatory markers, and no anti-inflammatory food list outperforms consistent, adequate sleep.
Consider curcumin and other botanicals thoughtfully. Turmeric/curcumin has real research behind its anti-inflammatory action, but it also has real interactions to consider with certain chemotherapy agents and blood thinners. This is a conversation to have with your care team before adding it, not a supplement to self-prescribe.
Look at the gut. Because inflammation and microbiome health are so closely linked, addressing one often improves the other. Worth reading alongside the gut-cancer connection piece if digestive symptoms are also present.
Inflammation isn't something to just push through
"I just feel off" is information, not something to dismiss as an unavoidable part of treatment. Persistent low-grade inflammation is measurable (via markers like CRP, when appropriate to test) and, more importantly, responsive to fairly specific changes — which makes it one of the more encouraging terrain factors to work on early.
If ongoing fatigue, joint discomfort, or a general "off" feeling has been part of your experience, it's worth mapping alongside the rest of your terrain. Book an Integrative Oncology Nutrition Consultation Today!
About the Author
Manjiri Nadkarni, BAMS, MD (Ayurveda), RHN, NNCP, ONC™, is an Ayurvedic practitioner offering oncology and survivorship nutrition support, seeing clients in person in Sarnia, Ontario and virtually across Canada and internationally. She is completing advanced integrative oncology certification (CAIMS).
This article is for general educational purposes only and does not constitute individual medical advice. It is not a substitute for care from your oncology team. Please consult your physician or oncologist before making changes to your diet, supplements, or treatment plan — particularly before starting any botanical or supplement, as some interact with chemotherapy and other medications. If you are experiencing unintended weight or muscle loss during treatment, discuss it with your oncology team, as cachexia requires coordinated medical management.
References
Coussens, L.M., & Werb, Z. "Inflammation and cancer." Nature, 2002.
Balkwill, F., & Mantovani, A. "Inflammation and cancer: back to Virchow?" The Lancet, 2001.
Hanahan, D., & Weinberg, R.A. "Hallmarks of cancer: the next generation." Cell, 2011.
Furman, D., et al. "Chronic inflammation in the etiology of disease across the life span." Nature Medicine, 2019.
Dhabhar, F.S. "Effects of stress on immune function: the good, the bad, and the beautiful." Immunologic Research, 2014.
Liu, S., et al. "Relation between a diet with a high glycemic load and plasma concentrations of high-sensitivity C-reactive protein in middle-aged women." American Journal of Clinical Nutrition, 2002.
Simopoulos, A.P. "The importance of the ratio of omega-6/omega-3 essential fatty acids." Biomedicine & Pharmacotherapy, 2002.
Wang, D., & DuBois, R.N. "Prostaglandins and cancer." Gut, 2006.
Vinikoor, L.C., et al. "Trans-fatty acid consumption and its association with distal colorectal cancer in the North Carolina Colon Cancer Study II." Cancer Causes & Control, 2008.
Fearon, K., et al. "Definition and classification of cancer cachexia: an international consensus." The Lancet Oncology, 2011.
Calder, P.C. "Omega-3 fatty acids and inflammatory processes." Nutrients, 2010.
Irwin, M.R., & Opp, M.R. "Sleep health: reciprocal regulation of sleep and innate immunity." Neuropsychopharmacology, 2017.
Gupta, S.C., et al. "Therapeutic roles of curcumin: lessons learned from clinical trials." The AAPS Journal, 2013.
