May 19, 2009

Hospitals Focus On Better Nutrition For Cancer Patients

Experts say severe malnutrition and weight loss play a role in at least one in five cancer deaths and now American institutions are making changes to combat this, The Associated Press reported.

Hospitals are now hiring highly trained gourmet chefs, while the American Cancer Society's dietitians-on-call phone service is working toward providing better food with better nutrition for cancer patients.

Certified Master Chef Jack Shoop, who is in charge of the kitchen at the Cancer Treatment Centers of America in Philadelphia, said he is learning that with cancer, you've got to "bring a lot more nutrients to each spoonful of food."

"The visual heartiness, and the actual heartiness, of these foods has to be understood for [patients] to embrace it," he said.

Newly diagnosed cancer patients often begin exhibiting lower appetites immediately, and most treatments can bring side effects like nausea, vomiting and diarrhea that worsen the problem.

Some cancers inhibit absorption of the nutrients patients need and often leave those fighting their ailments with strangely altered taste, mouth sores, dry mouth, difficulty swallowing and constipation.

A wasting syndrome called cachexia, where patients lose excess fat and vital muscle, affects about half of all cancer patients, causing severe weight loss and malnutrition.

Cachexia is the immediate cause of death for at least 20 percent of cancer patients, according to estimates from The National Cancer Institute.

Patients are considered "at-risk" when they've lost more than 10 percent of their usual weight; meanwhile, other research suggests that patients who lose more than 5 percent of their pre-cancer weight have a worse prognosis than those who better maintain their nutrition.

The American Cancer Society urges newly diagnosed cancer patients to be assessed by a registered dietitian immediately, as surveys suggest just a third of patients have access to cancer nutritionists where they're being treated.

Colleen Doyle, nutrition chief at the society, which offers nutrition advice through its hot line at 1-800-ACS-2345, said patients who are well-nourished as they're going through treatment have shorter hospital stays, are better able to tolerate treatment and often have a better quality of life.

However, there are common nutrition myths all over the Internet, according to Maureen Huhmann, who chairs the American Dietetic Association's oncology nutrition group.

She said the No. 1 Web-perpetuated myth is that sugar feeds tumor cells, which is not true. In fact, protein-packed milkshakes and smoothies can literally be lifesaving for some patients, Huhmann said.

Many cancer patients don't realize that they're not just losing fat but muscle, too.

Carolyn Lammersfeld, the Cancer Treatment Centers' nutrition director who works with Shoop, the chef, to help patients find palatable options, said patients can be even be overweight and obese yet still be malnourished.

Cancer patients usually require twice the protein of a healthy person and about 10 percent more calories. But experts say some tumors bring bigger nutritional threats than others. For instance, gastrointestinal and lung cancers tend to cause more weight loss than breast cancer.

Although they're not always covered by insurance, anti-nausea medications often bring relief to many patients. Some of these include a synthetic version of an ingredient from marijuana, and while cancer experts don't promote smoking marijuana, some advocates claim it helps.

Appetite stimulants work for some and, for worst cases, doctors can prescribe feeding tubes.

Dieticians still advise patients to eat through the mouth for the best results, and many suggest snacking throughout the day instead of trying to force down large meals.

Shoop delights in giving patients taste tests in his Philadelphia hospital cafeteria to introduce them to healthful foods they may never have tried, such as Quinoa, a grain with the same amino acids of meat, or Arctic char, a salmon-like fish but less fatty.

Additionally, he instructs caregivers on how to add 400 extra calories and 20 grams of protein to a simple smoothie, milkshake or oatmeal - using whole milk or yogurt, some protein powder, and grinding up fruits, nuts and flax seed.

"People need to know that weight loss and not being able to eat is not a good thing during cancer treatment," said Lammersfeld.


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