Cancer Feedback

PREVENTIVE NUTRITIONAL INTERVENTION STRATEGY

We would like to ask you some questions that will hep us to suggest a Preventive Nutritional Intervention Strategy, and also to decide, if there is a nutritional product within the GC10-100 line of organic extracts, that will be effective to prevent the progression of the disease.

 

 

The patient’s primary cancer is:

 Glioblastoma
 Neuroblastoma
 Medulloblastoma
 Liver Cancer
 Lung Cancer
 Ovarian Cancer
 Pancreatic Cancer
 Other form of Cancer

Has the cancer metastasized 
to other organs?:

 Yes
 No
 

Approximate size of the main lesion: 

 Less than 1 cm
 More than 1 cm
 More than 4 cm
 

By which form of scan is the main tumor focus been monitored:

 MRI
 CT
 PET
 Ultra Sound
 Other (please specify)

Date of last scan:


Your diet is presently: 

 All food - no restrictions
 Vegetarian
 Organic
 Other (please specify)

Do you live in a...

 Rural area?
 Urban area?
 

Type of work, activity or profession:


 

items marked * are required

Name of patient (optional)

Address (optional)

 

 

Postcode / zip code*

Country*

Telephone*

E-mail*

Comments or questions:

 

 

 

 

 

Nutritional Medicine Research
26 Priestgate, Peterborough
PE1 1WG. United Kingdom

Telephone:
From the USA :
01144 7930 915 588 (8 am to 4 pm)
01144 7919 415 841 (24 hours)

From all other countries:
0044 7930 915 588
0044 7919 415 841 (24 hours)

From the UK:
07930 915 588
07919 415 841 (24 hours)

FAX
From the USA: 01144 7939 010 379
From all other countries: 0044 7939 010 379
From the UK: 07939 010 379