The CNC Nutrition & Cancer Series

Most people with cancer experience some type of complication, either from the treatment or the cancer itself. This often affects ones’ ability to eat normally. Not eating normally can lead to changes in muscle mass and malnutrition. It’s important to monitor both eating habits and weight as malnutrition is a serious condition for cancer patients.

Factors Contributing to Malnutrition

Many factors can contribute to malnutrition. Often, people don’t realize they’ve begun to eat less, lose weight and are trending down the road towards malnutrition. Most causes of malnutrition are from one of the following:

  • Inability to consume the needed calories because of side effects like loss of appetite, fatigue, loss of taste, or nausea.
  • Increased calorie needs due to the body needing to repair and heal more.
  • An inability to absorb food because of diarrhea, vomiting, or lack of digestive enzymes.
  • Tumors causing obstructions within the mouth and/or digestive tract or surgical removal of different parts of the mouth, jaw or digestive system.

How Do I know If I’m Malnourished?

You can start by taking the CNC Critical Nutrition Screening which is based on a validated malnutrition screening tool. A malnutrition diagnosis is based on a few different criteria:

  • The amount of food you are eating compared to your normal amount.
  • The amount of weight loss experienced over a period of time.
  • Loss of muscle mass and body fat.

Not everyone that is malnourished is “skinny” or “thin” either. Malnutrition can develop in people who are overweight. Lack of nutrition is ultimately the cause and nutrient depletion can happen before body weight is lost. You can’t assume weight loss is a good thing for any cancer patient, including those that are overweight.

Your physician, a nurse or registered dietitian can determine your risk or level of malnutrition and track your status over time. A simple malnutrition screening, as mentioned above, can be helpful in determining your status. If you’re concerned about your current condition, have been eating less, or have unintentional weight loss please schedule a consultation with someone on your healthcare team or a CNC oncology dietitians.

Can Malnutrition Be Cured?

Malnutrition may be reversed, especially if detected early. Work with your healthcare team or an oncology dietitian to correct any side effects that might be interfering with your ability to eat normally or absorb nutrients. Seek recipe modification tips like pureeing foods to make them easier to chew, swallow and digest. In advanced stages of cancer a phenomenon called “cancer cachexia” can develop. This is a progressive syndrome characterized by loss of appetite and loss of skeletal muscle mass. This condition impacts functional status and causes metabolic alterations including inflammation and insulin resistance. Cancer cachexia can’t be fully reversed at this time but there is active research in this area.1

Avoiding Malnutrition During Cancer Treatment

The best strategy to reduce your risk of malnutrition is to work with an oncology dietitian from the start of your diagnosis. Together a plan can be created to help optimize your nutritional status. Steps can be taken to help reduce or eliminate significant side effects. It’s important to continue to eat a healthy diet throughout treatment. Some specific advice includes:

  • If you are experiencing difficulty chewing or swallowing, alter recipes or choose recipes that are already soft.
  • If you are dealing with fluid retention, plant-based foods are naturally lower in sodium and can help. Fluid retention can appear as weight gain and make malnutrition seem less apparent.
  • If you are experiencing weight loss, add healthy high-calorie foods to your diet (e.g. avocado, peanut butter, other nut seed butters).
  • Finally, don’t forget about exercise. Engage in physical activity on a daily basis, to the extent you can. Exercise will help maintain muscle mass, moderate appetite, and reduce fatigue.

1Management of Cancer Cachexia: ASCO Guideline
Journal of Clinical Oncology 2020 38:21, 2438
https://ascopubs.org/doi/10.1200/JCO.20.00611

This blog article was produced by
The Cancer Nutrition Care Editorial Board

Author
Angela Hummel, MS, RDN, CSO
Consulting Oncology Dietitian

Editor
Lori Bumbaco, MS, RDN, CSO, LDN
Co-Founder, Cancer Nutrition Care

Executive Editor & Producer
Bob Simek
Founder & President, Cancer Nutrition Care