by Jenna Koroly, MS, RD, CSOWM, CDN
With gastric cancer awareness month coming up, we are featuring a study on nutritional intervention in gastric cancer patients. The normal course of treatment for gastric cancer patients includes surgery and adjuvant chemotherapy to reduce relapse rate. Chemotherapy can lead to serious side effects in the gastrointestinal tract, including nausea, vomiting, diarrhea, constipation, and mouth sores. These side effects may cause decreased appetite and nutritional intake, which in turn can result in malnutrition. The following study highlights the important benefits of specialized nutritional and educational interventions on nutritional status and treatment compliance of the gastric cancer patient.
Beneficial Effect of Educational and Nutritional Intervention on the Nutritional Status and Compliance of Gastric Cancer Patients Undergoing Chemotherapy: A Randomized Trial
Journal: Nutrition and Cancer
This randomized controlled trial included 144 gastric cancer patients at the First Affiliated Hospital of Sun Yat-sen University in China. The authors studied how nutritional and educational interventions influenced nutritional status and compliance of gastric cancer patients undergoing postoperative chemotherapy.
The control group received standard nutrition care and education including information on the purpose and side effects of chemotherapy, guidance on nutritious and easily digestible foods, telephone follow-up to obtain 24-hour food recalls, encouragement to eat, and advice on how to manage side effects. The intervention group received specialized nutrition care and education including nutritional prescription with an individualized meal plan, guidance on meal preparation for the caregiver, and dedicated helplines to contact. Follow-up via telephone consisted of suitable recipes depending on side effects and mental health counseling.
The authors found:
1. Significantly higher caloric and iron intake in the intervention group compared to the control group after 24 hours
2. Significantly higher hemoglobin levels in the intervention group compared to the control from 3rd to 7th chemotherapy sessions (hemoglobin is a marker of anemia)
3. Significantly higher total serum protein levels at 2nd and 4th chemotherapy sessions, and significantly higher albumin levels at 3rd and 4th chemotherapy sessions in the intervention group (markers of nutritional status)
4. A significantly decreasing weight trend in the control group, but not in the intervention group
5. A significantly higher chemotherapy compliance rate, and significantly lower overall rate of chemotherapy withdrawal due to adverse side effects in the intervention group
For the Patient and Caregiver
Ensure you have a specialized health care team that can provide individualized nutrition recommendations, focused on guidance and recipes for your specific side effects. In order to maintain optimal nutrition, seek out the proper nutritional guidance and counseling during and after gastric cancer treatment to address any nutrition concerns that may come up. This will also help you to stay on track with your treatment and nutrition plan.
For the Healthcare Team
Individualized nutrition prescription and plans, guidance on meal preparation, recipes geared towards specific side effects, and follow-up via a helpline all set the intervention group apart from the control group. These are all nutrition solutions that are easy to implement in healthcare settings, and can help improve patient care and outcomes. Involving an oncology registered dietitian in the healthcare team available to gastric cancer patients can benefit the patient at all points in their treatment journey.
[i] Feng-lan, X, Yong-qian, W, Li-fen, P, Fang-yu, L, Yu-long, H, Zhuo-qin, J. (2017). Beneficial effect of educational and nutritional intervention on the nutritional status and compliance of gastric cancer patients undergoing chemotherapy: a randomized trial. Nutrition and Cancer, 69(5), 762-771. DOI: 10.1080/01635581.2017.1321131