BY chioma Nwankwor
Miss Chioma Nwankwor is a Registered Nutritionist Dietitian at Marigold Hospital, Lagos. She is also a volunteer Dietitian at Lakeshore Cancer Center, Lagos.
Nutrition is essential for good health and a vital component of the healing process. Eating the appropriate class of foods before, during, and after cancer treatment can help the patient feel better and stay stronger. A healthy diet includes eating the foods and taking liquids that have the nutrients which the body needs. Examples of these nutrients are vitamins, minerals, protein, carbohydrates, fat, and water.
Medical Nutrition therapy assists cancer patients in getting the nutrients needed to maintain their body weight and strength, keep their body tissue healthy, and help to fight infection before, during, and after cancer treatment.
Eating habits that are good for cancer patients can be very different from the usual healthy eating guidelines, and optimal nutrition can help patients deal with the effects of cancer and its treatment.
Studies show that most cancer treatments work better when the patient is well nourished and gets enough calories and protein in the diet. Well-nourished cancer patients can have a better chance of recovery and overall better quality of life.
A Registered Dietitian can help the patient improve side effects of cancer treatment such as:
- loss of appetite
- mouth sores/dry mouth
- taste changes, and weight loss/weight gain.
Dry mouth is an exceptionally parched mouth, often caused when salivary glands become irritated or damaged, leading them to make less saliva or saliva that is thick or sticky. A cancer patient may experience this side effect, also known as xerostomia by taking prescription or over-the-counter medications when undergoing chemotherapy, or after radiation treatments that target the head or neck area. Because saliva serves many functions, dry mouth may lead to a range of other symptoms, including increased thirst and hoarseness and an increased risk of oral infection and tooth decay. Other potential complications include altered speech, changes to taste or smell, difficulty swallowing, and indigestion. Any of these side effects may impact patients’ overall eating and drinking habits and nourishment.
A dry mouth may cause chewing and swallowing difficulties. Dietitians may educate patients on how to modify food textures to make the foods easier to eat. Recommendations may include eating soft, moist foods, incorporating liquids, and avoiding dry coarse foods, avoiding alcohol, and smoking. Dietitians may also offer recipes for homemade shakes, smoothies, or other forms of liquid nutrition, suck on ice chips or frozen fruits, drink about 8 cups of water daily that is tailored to the patients’ specific nutrient needs to ease dry mouth symptoms and complications.
Loss of Appetite
Loss of appetite is a reduced or lack of desire for food. Appetite loss is common among cancer patients and is caused by cancer, particularly cancers of the gastrointestinal tract like the stomach and pancreatic cancers, ovarian and lung cancer. Loss of appetite is a condition called “cachexia,” or a metabolic change caused by cancer and treatments. Many anti-cancer drugs and treatments, such as chemotherapy, immunotherapy, and radiation therapy treatments that focused on the stomach and intestines, are also linked to a loss of appetite. Side effects that disrupt the gastrointestinal tract may prompt a loss of appetite too. These include dry mouth, mouth sores, issues with chewing, and constipation. Pain, fatigue, and depression may also lead to loss of appetite. If left unchecked, appetite loss may lead to weight loss and wasting of muscle marked by loss of strength, as well as compromised immune function. Weight and muscle loss may also lead to increased treatment toxicity, as well as treatment interruptions or delays.
Consuming enough nutrients to maintain good nutritional status may be difficult for cancer patients if they don’t feel like eating. Dietitians may recommend scheduled eating times, instead of relying on hunger-based cues, which are blunted or absent. Dietitians also work with patients’ medical oncologists to recommend appetite stimulants, if appropriate. Loss of appetite can be caused by nausea, altered taste, mouth sores, or pain. Nutritional recommendations may include consistency of foods and liquid nutrition that are well tolerated and easy to ingest. Dietitians may also recommend vitamin and mineral supplementation to make up for deficits in the diet. Additional supplements that contain fish oil or eicosapentaenoic acid, or EPA, may help correct underlying changes in metabolism. A feeding tube or intravenous feeding can provide additional nutritional support. Dietitians regularly reassess patients’ responses to other interventions and communicate with the care team if this type of nutritional support is needed. They will also provide education and monitoring to help patients manage these feedings.