Be Proactive

Nutritional issues are common among people with cancer.  It has been estimated that 50-80% of all cancer cases result in poor nutritional status [i].  In fact, 30% of all deaths from cancer are a result of severe malnutrition [ii].  Many cancer treatments can cause side effects such as changes in appetite and taste, mouth sores, gastrointestinal symptoms such as nausea, vomiting, and constipation as well as unintended weight loss.  Addressing these issues often helps patients maintain or strengthen their body’s nutrition stores, minimize nutrition-related side effects and complications such as infection, strengthen immune function, preserve lean body mass, enhance response to treatment, improve the ability to tolerate side effects, extend survival time, and improve quality of life [iii][iv][v].  As a result, a comprehensive, proactive nutritional program including access to healthy nutritious meals, early and ongoing nutritional counseling and education on nutrition and cancer is often recommended.

 

The Research

Research has shown that identification of nutrition problems and treatment of nutrition-related symptoms stabilized or reversed weight loss in 50% to 88% of cancer patients [vi]. Additional research demonstrated that when nutritional side effects and deficiencies were identified early, 75% of patients maintained or increased their weight [vii].  Early and intensive nutritional intervention has helped to minimize weight loss and effects on nutritional status, quality of life and physical function [viii][ix]. Nutrition counseling during cancer treatment not only improves nutritional status but also lessens the impact of treatment-related side effects which improves the quality of life [x][xi][xii]. Nutrition counseling has also been shown to be help symptoms and side effects even more than nutritional supplementation [xiii].

 

Take Control

When many things seem out of control during a cancer diagnosis, nutrition is something that you can control.  Taking the initiative to optimize your nutritional intake and to seek nutritional counseling will empower you and your loved ones to make a difference in response to treatment and overall quality of life.  Here are some easy and helpful ways to start making that difference:

  •  Consume regularly scheduled meals that are healthy and well- balanced including nutrient-dense foods such as poultry, meats, eggs, beans, nuts, dairy, whole grains, fruits, and vegetables.
  •  Seek input from a Registered Dietitian (RD) who is a Certified Specialist in Oncology Nutrition (CSO is a credentialed nutrition professional who specializes in nutrition for cancer patients) on how to improve nutrition before, during, and after cancer treatment and provide appropriate nutritional guidelines specific to your disease and individual nutritional needs.
  • Obtain information from a credible source that provides information and guidelines based on sound, scientific evidence.
  •  Avoid “miracle cures” and unknown dietary supplements, most of which do not have evidence to support their use or benefit during or after cancer treatment.  If something sounds “too good to be true,” chances are it is.

 Stay tuned for future blog posts that will discuss more specific recommendations for managing side effects of cancer treatment and discuss nutrition strategies and solutions to common nutritional issues and questions!

 

References
[i] Karthaus, M., Frieler, F. (2004). Eating and drinking at the end of life. Nutritional support for cancer patients in palliative care. Wien Med Wochenschr, 154(9-10): 192-8. PMID: 15244044.

[ii] Palesty, J.A., Dudrick, S.J. (2004). What we have we learned about cachexia in gastrointestinal cancer.  Dig Dis, (21)3: 198-213. PMID: 14571093.

[iii] Rivadeneira, D.E., Evoy, D., Fahey, T.J. 3rd, Lieberman, M.D., Daly, J.M. (1998).  Nutritional support of the cancer patient. CA: A Cancer Journal for Clinicians, 48(2): 69-80. PMID: 9522822.

[iv] Shils, M.E. (1979). Principles of nutritional therapy. Cancer, 43(5 Suppl): 2093-102. PMID: 109185.

[v] American Cancer Society. (2010). Nutrition for the Person with Cancer During Treatment: A Guide for Patients and Families. Atlanta, GA: American Cancer Society, Inc.

[vi] Ottery, F.D., Kasenic, S., DeBolt, S., et al. (1998). Volunteer network accrues >1900 patients in 6 months to validate standardized nutritional triage. Proceedings of the American Society of Clinical Oncology, 17: A-282, 73a.

[vii] Marin, C.M., Gomez, C.C., Castillo, R.R., Lourenco, N.T., et al. (2008). Nutritional risk evaluation and establishment of nutritional support in oncology patients according to the protocol of the Spanish Nutrition and Cancer Group. Nutr Hosp, 23(5): 458-68. PMID: 19160896.

[viii] Isenring, E.A., Capra, S., Bauer, J.D. (2004). Nutrition intervention is beneficial in oncology outpatients receiving radiotherapy to the gastrointestinal or head and neck area. British Journal of Cancer, 91(3): 447-52. PMID: 15226773.

[ix] Boleo-Tome, C., Chaves, M., Monteiro-Grillo, I., Camilo, M., Ravasco, P. (2011). Teaching nutrition integration: MUST screening in cancer. Oncologist, 16(2): 239-45.  PMID: 21273515.

[x] Isenring, E.A., Bauer, J.D., Capra, S. (2007). Nutrition support using the American Dietetic Association medical nutrition therapy protocol for radiation oncology patients improves dietary intake compared with standard practice. Journal of the American Dietetic Association, 107(3): 404-12. PMID: 17324657.

[xi] Ravasco, P., Monteiro-Grillo, I., Marques, V.P., Camilo, M.E. (2005). Impact of nutrition on outcome: a prospective randomized controlled trial in patients with head and neck cancer undergoing radiotherapy. Head Neck, 27(8): 659-68. PMID: 15920748.

[xii] Ravasco P., Monteiro-Grillo I, Vidal PM, et al. (2005). Dietary counseling improves patient outcomes: a prospective, randomized, controlled trial in colorectal cancer patients undergoing radiotherapy. Journal of Clinical Oncology, 23(7): 1431-8.  PMID: 15684319.

[xiii] Jager-Wittenaar, H., Djikstra, P.U., van Oort, R.P. et al. (2010). Malnutrition in patients treated for oral or oropharyngeal cancer-prevalence and relationship with oral symptoms: an explorative study. Support Care in Cancer, (Epub ahead of print). PMID: 20844902.
Jessica Iannotta, MS, RD, CSO, CDN

Jessica is a registered dietitian and certified specialist in oncology nutrition (CSO). She studied nutrition at Cornell University and completed her dietetic internship at New York Presbyterian Weill Cornell Medical Center. She obtained her Master's degree through the University of Medicine and Dentistry of New Jersey. Jessica has worked in inpatient and outpatient oncology settings since 2001 in the North Shore-LIJ Health System. Jessica is in charge of all operations including clinical and culinary operations ranging from menu development to evidence-based website content, relationships with registered dietitians and social workers and developing processes and protocols for intake, management and outcomes analysis of patients.

2 Comments
  1. Had my tubes tied in 2007 through lsparoacopy. Thinking nothing else major could happen. 2008 till now cysts balding,pain daily I was diagnosed with PCOS and Adenomyosis a few weeks ago. I am also high risk for cancer because my mom died at 51 from breast cancer and brain cancer she had 10 brain tumors, and bone cancer as well. I just got my BRCA gene Test done just waiting for the results .I have to see an endocrinologist in a few days I am now 29 years old.

    1. Thank you for sharing. You have a lot going on. Please let us know if there is a specific subject that you would like more information on regarding your condition and we will try to cover it in a blog topic. Best regards.

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