HealthCert Blog

Nutrition is an important aspect of everyone’s health, but for those who have been diagnosed with cancer, it is especially crucial for treatment. Cancer and cancer treatments such as chemotherapy, radiation therapy, and immunotherapy can have varying side effects that make maintaining a healthy diet challenging.

Side effects can include nausea and vomiting, low blood cell counts, decreased appetite, constipation and or diarrhea, mouth sores, and taste change. Malnutrition is common in cancer patients and can lead to several negative consequences, including cachexia (1), poor prognosis, reduced survival, and impaired immune function (2).

Appropriate medical nutrition therapy as part of comprehensive cancer management in primary care can help improve clinical outcomes and support patients’ quality of life.

For further information on this topic, you may be interested to learn more about the HealthCert Professional Diploma program in Medical Nutrition Management.

Common symptoms and how to manage them

It is important that cancer symptoms and side effects that affect eating and cause weight loss are treated early. Besides medicine, medical nutrition therapy can help lessen the effects that cancer and its treatment have on patients. Below are the most common symptoms and strategies to manage them.

1. Appetite loss

Anorexia, the loss of appetite or desire to eat, is typically present in 15% to 25% of all patients with cancer at diagnosis and may also occur as a side effect of treatments or related to the tumour itself (3). Depression, loss of personal interests or hope, and anxious thoughts may be enough to bring about anorexia and result in malnutrition (4). Tips for managing appetite loss include:

• Eat well when appetite is best, choosing nutrient-dense, high-protein foods.
• Try liquid meal replacements (e.g., Ensure, Fortisip) if regular food is not tolerated.
• Making food as appealing and attractive as possible and eating in a relaxing environment. Eat with family or friends.
• Doing a bit of physical activity each day, which can help increase appetite.

2. Nausea and vomiting

Nausea and vomiting can have a significant impact on nutrition intake (5). Physicians should work with the medical team to use anti-nausea medications as appropriate, with special attention to timing prior to meals. Strategies to assist with nausea and vomiting include:

• Eating small, frequent meals throughout the day.
• Eating cool foods with little odour.
• Taking nausea medicine as prescribed, focusing on 30 minutes before meals or timing meals when medications are working at their best.

3. Fatigue

Fatigue is a common side effect of cancer. It can be caused by the cancer itself, radiation therapy or chemotherapy, not eating, low blood counts, poor sleep or depression (6). Mitigating strategies include:

• Cook in large quantities and freeze meals in advance
• Keep easy to prepare meals and snacks handy
• Consider nutritional shakes
• Asking friends or family to help with grocery shopping or preparing foods

4. Diarrhoea

Diarrhoea has many causes including chemotherapy, radiation therapy to the pelvis, stomach and abdomen, infections, and food sensitivities (7). To help patients control these symptoms as best as possible, recommend:

• Consuming a low fat, low fibre diet.
• Drinking fluids to replace what is lost, such as water, diluted juice, and sports drinks with electrolytes.
• Eating small amounts of food and drinking small amounts of liquid throughout the day rather than three large meals
• Patients to take a multivitamin and mineral supplement to make up for potential losses and malabsorption.

Learn more about how nutrition therapy can play a role in cancer management with the online HealthCert Professional Diploma program in Medical Nutrition Management.

– Lynette Law, Accredited Practising Dietitian

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References

1. van der Meij BS, Teleni L, McCarthy AL, Isenring EA. Cancer cachexia: an overview of diagnostic criteria and therapeutic approaches for the accredited practicing dietitian. J Hum Nutr Diet. 2021;34(1):243-54.
2. Van Cutsem E, Arends J. The causes and consequences of cancer-associated malnutrition. Eur J Oncol Nurs. 2005;9 Suppl 2:S51-63.
3. Tong H, Isenring E, Yates P. The prevalence of nutrition impact symptoms and their relationship to quality of life and clinical outcomes in medical oncology patients. Support Care Cancer. 2009;17(1):83-90.
4. Bruera E. ABC of palliative care. Anorexia, cachexia, and nutrition. BMJ. 1997;315(7117):1219-22.
5. Salihah N, Mazlan N, Lua PL. Chemotherapy-induced nausea and vomiting: exploring patients’ subjective experience. Journal of multidisciplinary healthcare. 2016;9:145-51.
6. Bower JE. Cancer-related fatigue–mechanisms, risk factors, and treatments. Nat Rev Clin Oncol. 2014;11(10):597-609.
7. Stein A, Voigt W, Jordan K. Chemotherapy-induced diarrhea: pathophysiology, frequency and guideline-based management. Ther Adv Med Oncol. 2010;2(1):51-63.