My previous experience as Bayhealth Medical Center’s out-patient dietitian for both the cancer centers at Milford Memorial Hospital and Kent General Hospital in Delaware gave me the amazing privilege of assisting individuals in their fight against cancer with good nutrition. Nutrition is a critical component within the treatment protocol, and patients should be followed by a dietitian as part of their complete plan of care.
Different therapies require different approaches. Often the patients I saw in the Radiation Oncology center had issues swallowing (particularly head and neck, as well as lung cancer patients) due to the size of a tumor or in preparation for the swelling that can occur from the radiation itself. These patients may require a feeding tube. Many times these tubes are just a temporary means to administer the nutrition the individual needs during treatment but cannot get by normal eating. A dietitian writes a script for the patient for a specific amount of mineral and vitamin-fortified formula that will meet their individual nutritional needs, taking into account total calories, protein, fats, carbs, fiber, and water, which their doctor will then approve. These patients are usually well enough to administer their own formula, which is easily “bloused” or injected into the tube via a large bore syringe.
For those patients not receiving their nutrition via tube-feeding, increased calories and protein is critical regardless of treatment type (chemotherapy or radiation). Individuals with cancer should take in about 30-35 calories per kilogram* of body weight, and 1.4-1.5 grams of protein per kilogram of body weight due to the increased stress the cancer and treatment can put on their systems. Loss of lean body mass is of particular concern, so I encouraged my patients to increase their intake of high-protein foods, such as lean meat and dairy, whole soy foods, beans, certain grains such as quinoa, eggs and nuts. Supplement drinks such as Boost or Ensure can provide necessary nutrition when one has lost their appetite or solid foods make them nauseous. I also provided to my patients a variety of smoothie recipes they can make at home with protein powder, peanut butter, fruit, flax seed, even ice cream.
Fruits and vegetables are strongly encouraged for the antioxidant power and fiber they provide. I stressed to my patients to wash fresh produce thoroughly since any bacterial or pesticide residue may compromise their weakened immune systems. Patients on “neutropenic” precautions are told to avoid all fresh produce as much as possible, or to at least consume cooked, canned or frozen items (including pasteurized juices) only during their course of treatment. Individuals may want to purchase only certified organic items, taking care to wash these items thoroughly as well.
Supplements or any alternative treatments may be beneficial but a patient should always talk with their doctor or dietitian about any supplements/therapies they may be taking/receiving concurrently with their conventional treatment, as they may be contraindicated. An example of this is mega-dosing of anti-oxidant vitamins like A, C or E, which may interfere with the chemotherapy agent, rendering it virtually ineffective. Many times patients and their families are lured by the promises of unproven alternative therapies, which can be very costly and even potentially harmful to the individual, so caution and common-sense is advised.
*Find your weight in kilograms by dividing your weight in pounds by 2.2.