The neutrophil-to-lymphocyte ratio (NLR) provides critical insights into cancer prognosis, treatment response, and immune resilience.

What is NLR?  
The NLR is a simple, cost-effective biomarker derived from routine blood tests that reflects systemic inflammation and immune status. NLR measures the balance between neutrophils (pro-inflammatory white blood cells) and lymphocytes (immune cells involved in adaptive immunity). It’s calculated by dividing the absolute neutrophil count by the absolute lymphocyte count from a complete blood count (CBC) with differential[1][2][19].  

 Why NLR Matters in Integrative Oncology  

1. Prognostic Value  

• Elevated NLR (>3–5, depending on cancer type) correlates with poorer survival outcomes across a wide range of cancers[1][6][12]. High NLR reflects tumour-promoting inflammation and impaired immune surveillance, accelerating cancer progression[3][8].  
  
  
• Pre-treatment NLR predicts response to therapies, including immunotherapy and tyrosine kinase inhibitors[5][13]. For example, NLR combined with tumour mutational burden (TMB) identifies patients more likely to benefit from immune checkpoint inhibitors[5].  

2. Inflammation and Immune Dysregulation  

•  Neutrophils secrete pro-inflammatory cytokines (e.g., VEGF, IL-6) that fuel angiogenesis and metastasis, while lymphocytes mediate antitumor responses[6][8]. A high NLR signals a dominance of pro-tumor inflammation over adaptive immunity[14].  
  
  
•  Chronic inflammation, a driver of cancer, is linked to NLR elevation[1][8]. Integrative approaches often target inflammation through diet, stress reduction, and supplements, making NLR a practical low cost effective monitoring tool.  

3. Accessibility and Cost-Effectiveness

•  NLR requires no specialised testing—it uses routine pathology known as the Complete Blood Count (CBC) data [2][19]. Your oncologist asks you to get blood drawn for this test regularly. You jist need to be sure to always get a personal copy. This is makes monitoring the NLR so accessible as we are leveraging existing diagnostics for personalised integrative knowledge and care.   

How to Calculate NLR
Obtain a copy of your CBC results with differential . Identify Absolute neutrophil count (ANC)  and Absolute lymphocyte count (ALC) . Divide the number of neutrophils by the number of Lymphocytes.
e.g: If neutrophils = 7.0 ×10³/µL and lymphocytes = 1.4 ×10³/µL, NLR = 5  

Interpretation of the NLR Range 

• 1–3  Normal (balanced inflammation/immunity)[7][22]

• >3–5 Mild elevation (monitor closely)[12][20]

• >5 High risk (poor prognosis, aggressive disease)

  [4][12]
  Note these Factors Impact NLR Interpretation
• Chemotherapy: Can alter blood cell counts, affecting the ratio
• Infection: May cause temporary spikes in neutrophils
• Other medical conditions Can impact the balance of neutrophils and lymphocytes

Therefore, while a declining NLR trend generally suggests positive progress in controlling cancer, it's essential to consider these potential confounding factors when evaluating results.

Integrative Applications

• Monitoring: Track NLR during treatment to assess inflammation control and immune recovery[5][20].  
• Lifestyle Modifications: Diet (anti-inflammatory), exercise, and stress management may help lower NLR by reducing chronic inflammation[22].  
• Complementary Therapies: Curcumin and Molecular Hydrogen are studied for their anti-inflammatory effects, potentially improving NLR. Discount codes for both are here.

NLR monitoring clearly builds a bridge between conventional and integrative oncology by offering a cheap measurable, actionable marker of systemic health—empowering patients and practitioners to tailor holistic strategies alongside standard care[1][6][14].