Research
Oncology studies
Leads: Dr. Julianna Caon, Jacob Lemire
Background: Patients with head and neck cancer are at high risk of malnutrition due to treatment-related side effects and metabolic changes, which can negatively impact treatment outcomes and quality of life. Registered Dietitians face challenges in accurately assessing body composition changes using standard methods, limiting their ability to tailor nutrition interventions. This study addresses this gap by exploring changes in body composition and the gut microbiome during active treatment, with the goal of enabling more precise, personalized nutrition care at BC Cancer Victoria.
Please send any questions to Jacob Lemire (Clinical Coordinator of Nutrition of BCC-Victoria) at jacob.lemire1@bccancer.bc.ca.
Leads: Eleah Stringer, Dr. Jonathan Livergant, Dr. Sally Smith
Background: Patients with head and neck cancer often have difficulty accessing clear, easy-to-understand information needed to make informed treatment decisions, especially across varying levels of health literacy. This gap can reduce patient engagement and negatively affect the quality of care. To address this, the HANC App is being developed and tested as an innovative, patient-informed digital tool to improve access to cancer information and support more informed, patient-centred care.
Please send any questions to Eleah Stringer (Research Lead) at eleah.stringer@bccancer.bc.ca.
Leads: Katie Tsoupakis, Eleah Stringer
Background: Patients with head and neck cancer often require enteral feeding during treatment, yet the timing, frequency, and communication around feeding tube use can vary, leaving patients feeling uncertain and overwhelmed. Understanding current practices and patient experiences is critical to improving nutrition care and supporting informed decision-making. This study addresses these gaps by examining feeding tube use at BC Cancer and exploring patient preferences for how information about feeding tubes is delivered.
Please send any questions to Eleah Stringer (Research Lead) at eleah.stringer@bccancer.bc.ca.
Leads: Dr. John Paul McGhie, Jacob Lemire
Background: Pancreatic cancer (PC) patients commonly experience pancreatic exocrine insufficiency (PEI), resulting in malabsorptive symptoms that increase nutritional risk and are associated with poorer survival, treatment response, and quality of life. Although pancreatic enzyme replacement therapy (PERT) can alleviate these symptoms, it remains under-prescribed and under-dosed, with evidence suggesting that involvement of a Registered Dietitian improves its use. This study aims to evaluate whether clinician-guided assessment using the BC Cancer PERT Tool correlates with pancreatic elastase-1 stool testing in identifying PEI among inoperable PC patients and those undergoing neoadjuvant chemotherapy at BC Cancer Victoria.
Intermittent fasting
Leads: Eleah Stringer, Dr. Nicol Macpherson, Dr. Julian Lum
Background: Over the past several decades, overconsumption of food has contributed to an increase in a number of diseases, including cancer. Investigators are undertaking new initiatives to study how nutrition and dietary behaviours affect people with cancer, exploring the potential of preventing/ managing cancer through changing one's eating patterns.
Background: This study tested intermittent fasting in patients with chronic lymphocytic leukemia and small lymphocytic lymphoma, who limited eating to an eight‑hour window six days a week for several months. Researchers monitored blood, stool, and survey data to assess whether fasting influenced tumour activity, metabolism, and autophagy, and also measured how long any biochemical changes persisted after fasting ended. The study leveraged the fact that CLL/SLL tumour burden can be easily tracked through blood lymphocyte counts.
Sponsorship: the Grewal Family and the BC Cancer Foundation.
Status: This study was completed in October 2022 (view pre-print of results). Please send any questions to Eleah Stringer (research lead) at eleah.stringer@bccancer.bc.ca.
Study 2 - Does Timing Matter? A case crossover study of intermittent fasting in patients with CLL/SLL at BC Cancer - Victoria
Background: Intermittent fasting is being studied as a potential way to slow cancer growth by triggering autophagy, with researchers testing 16‑hour fasting and 8‑hour eating windows in patients with CLL and SLL. The team is comparing two fasting routines to see how each affects tumour activity, inflammation, autophagy markers, and gut‑derived metabolites, while also assessing which approach patients prefer. Early findings are encouraging, but differences between fasting methods remain unknown.
Sponsorship: the BC Cancer Foundation.
Status: This study began Fall 2022. Please send any questions to Eleah Stringer (research lead) at eleah.stringer@bccancer.bc.ca.
Study 3 - Does Timing Matter? A trial of intermittent fasting in hematological malignancies
Background: Intermittent fasting shows potential health benefits, but rigorous trials in cancer patients and data on patient adherence remain limited, making it difficult to draw firm conclusions. This study will provide statistically robust evidence on how IF affects clinical outcomes, autophagy biomarkers, quality of life, and gut microbiome changes, while also documenting the patient experience and incorporating sex and gender considerations. Although early feasibility results are encouraging, they were not powered for statistical significance.
Sponsorship: the BC Cancer Foundation, the Lum Lab, Michael Smith Health Research BC Health Professional - Investigator Award, and the Lotte & John Hecht Memorial Foundation.
Status: This study is anticipated to begin in 2025. If you have been diagnosed with CLL/SLL, are not receiving anti-cancer treatment, live in British Columbia, and would like to receive an update when the study is open for recruitment, please email Eleah Stringer (principal investigator) at eleah.stringer@bccancer.bc.ca.
Others
Lead: Lindsay Van der Meer.
Background: The objectives of the BC Cancer Foundation-funded knowledge mobilization dietitian role centred on creating a leadership role to enhance capacity for BC Cancer to provide evidence-based nutritional care to patients and families. The three-year proof of concept role yielded significant outcomes in knowledge mobilization and innovation related to nutrition in cancer care.
Please send any questions to Lindsay Van der Meer (project lead) at Lindsay.VanderMeer@bccancer.bc.ca.
Leads: Evelyn Wu, Chrissie Ohlund, Andrea Holmes, Eleah Stringer
Background: Patients with head and neck cancer are at high nutritional risk due to treatment side effects and disease-related factors, often leading to unintended weight and muscle loss that can negatively affect treatment tolerance and recovery. Standard care relying on body weight alone does not adequately capture these changes, and some patients may misinterpret weight loss as beneficial. This study addresses this gap by evaluating whether providing detailed body composition feedback using bioimpedance analysis (BIA) can improve patient understanding and nutrition outcomes compared to weight measurement alone.
Please send any questions to Evelyn Wu (research lead) at evwu@bccancer.bc.ca.
Leads: Eleah Stringer, Lindsay Van der Meer
Background: People who live in rural and remote settings may be disproportionately impacted by the social determinants of health, in particular access to health services. The impact of geographical distance to a cancer treatment centre on malnutrition risk is not well understood. This research project characterized and analyzed malnutrition risk in relation to distance to the nearest BC Cancer centre among people receiving palliative radiation therapy (PRT) for gastrointestinal or breast cancer.
Publication: Van der Meer, L., RD, MHS, Cender, S., BSc, Sappal, S., BSc, & Stringer, E., RD, MSc (2026). Malnutrition Risk Among People Receiving Palliative Radiation Therapy at BC Cancer: A Geographical Analysis. Canadian journal of dietetic practice and research : a publication of Dietitians of Canada, 87(2), 53–58. https://doi.org/10.3148/cjdpr-2025-030
Lead: Eleah Stringer
Background: In collaboration with the Island Prostate Centre, this pilot project examined the feasibility of providing sustainable, evidence-based nutrition group education programs to prostate cancer patients living on Vancouver Island. The study was open to all men with a diagnosis of prostate cancer. The aim was to integrate nutrition education offered at time of diagnosis, through the treatment and post-treatment phase to help improve outcomes and survivorship.
Publication: Stringer, E. J., BSc, Sidhu, S., BSc, Austin, K., BSc, & Cosby, C., MSc (2021). Nutrition Education Seminars for Prostate Cancer-Diet and Prostate Program: Evaluation and Recommendations (DAPPER Study). Canadian journal of dietetic practice and research: a publication of Dietitians of Canada, 82(1), 27–31. https://doi.org/10.3148/cjdpr-2020-028
Chronic Lymphocytic Leukemia, Diet patterns, Autophagy, Metabolomics
Our early-stage research shows that intermittent fasting may slow cancer growth on a cellular level. Our team is recruiting both healthy controls and participants with hematological (blood) cancers who are willing to limit their eating to an 8 hour window per day for 3 or 6 months. We will investigate whether time-restricted eating slows tumour growth, affects cellular process, and improves quality of life.
You will follow 16/8 time-restricted (eating during an 8 hour window) for 6 days per week for a choice of either 3 or 6 months. At the start and end of the study you will complete a quality of life questionnaire and get monthly bloodwork at LifeLabs. You will track your eating times and receive check-ins from a study team member weekly for first month of study and bi-weekly check-ins thereafter to ensure your well-being as safety. There is an option to provide stool samples and completing an end of study interview.
Participants without cancer will not complete stool samples or questionnaires and will only complete check-ins for first month of the study.
- Age: 18 Years - 85 Years Old
- Accepting Healthy Volunteers: Yes
British Columbia
March 31, 2026
Principal investigator: Eleah Stringer
Health authority affiliation: Provincial Health Services Authority
Academic affiliations: University of British Columbia - Vancouver, University of Victoria
Collaborating organizations: Stefanska Lab, University of British Columbia, Deeley Research Centre, BC Cancer
Please see
Reach BC for more information of the study.
