This is the second article in a MyDietExercise.com series on how to beat cancer through diet and exercise from our Expert, Doctor Amy Thomas. You can read her first post here.
It is crucial to eat well and get an adequate amount of calories during cancer treatment. Unfortunately, this is not an easy undertaking.
Cancer patients require a higher proportion of nutrients in their diet just to maintain standard body functions. Still more nutrients are required to repair damage caused by cancer treatment. As a result, weight loss is a common problem for people with cancer, even before treatment. Cancer patients have an increased metabolic rate so they are using energy faster than normal and require more calories to maintain lean body mass. Also, in certain types of cancer, tumors induce both anorexia (loss of appetite) and weight loss through proteins called cytokines.
Confounding the problem, many cancer treatments contribute to malnutrition by direct appetite suppression and unpleasant side effects associated with eating. These include taste and smell changes, nausea, dysphagia (pain with swallowing), mucositis (mouth sores and swelling), diarrhea, bloating, and constipation. Appetite loss can also result from anxiety and stress related to the diagnosis of cancer and fear of the unknown.
The combination of anorexia and increased energy requirements can lead to unhealthy weight loss and protein-calorie malnutrition. Anorexia is present in up to 25% of cancer patients at the time of diagnosis, and up to 50% of all cancer patients experience a severe protein-calorie malnutrition known as "cachexia". Cachexia can be very dangerous for cancer patients. It may diminish a tumor's responsiveness to treatment, and it is associated with more complications and an increased likelihood of dying from cancer. A healthy diet is critical for patients to maintain energy stores in order to fight cancer and avoid the risks associated with malnutrition. A healthy diet can help cancer patients prevent the breakdown of body tissue, decrease their chances of infection, withstand the negative effects of treatment, and heal more easily once treatment is complete.
Nutritional recommendations for people with cancer can be quite different from those for the general public. Rather than eating the traditional low-fat, high-fiber diet, cancer patients may be told to increase their intake of high calorie, high-protein foods. Examples of high-calorie, high-protein foods include whole milk, cream, cheese, and cooked eggs. Other options include milk shakes, puddings, and ice cream. Another seemingly contradictory recommendation is to increase intake of high-fat foods in order to maintain a healthy weight. This can be done by increasing your use of butter, margarine, oil, sauces, and gravies. Sometimes cancer patients may need to avoid high fiber foods since they can be difficult to tolerate when experiencing diarrhea or a sore mouth.
Drinking fluids is especially important for cancer patients, particularly when dealing with a sore mouth and inability to eat. Water, juice, soup broth, ice cream, popsicles, tea, milk, and gelatin are all suitable fluids. For patients without fluid restriction, the fluid intake goal should be 48 ounces, or six 8-ounce glasses, per day. Small sips throughout the day can be easier to tolerate than large volumes all at once.
- To improve taste, rinse your mouth before eating and use plastic utensils if experiencing metallic tastes. Lemon-flavored drinks may stimulate taste and help with dry mouth.
- If you're experiencing mucositis, you might try avoiding acidic or spicy foods, avoid foods that stick to the roof of your mouth, and chew small bites of food thoroughly. You may also find protein-rich nutritional supplements, such as Boost or Ensure, helpful when swallowing solid foods is difficult.
- For dry mouth, eat softened or moist foods. Adding creams, gravies, and oils, or poaching in a broth may help.
- If your appetite is poor, try to determine the time of day when eating is most tolerable. For most people this is morning, when steroid hormones stimulate appetite.
- Keep your favorite foods readily available, especially those which require minimal or no preparation.
- Ask friends and family to help with shopping, cooking, or picking up your favorite take-out.
Remember, nutritional recommendations will vary depending on cancer type, body weight, and the specific side-effects related to treatment, but a healthy diet is a vital component of cancer survival in all patients. And be sure to review your diet with your oncologist or dietitian on a regular basis.
- Amy E. Thomas, MD.
Published On: December 10, 2007