Treating malnutrition starts by identifying its cause, and taking it seriously

Because malnourished patients may become too sick to continue treatment or may experience slower recovery rates, getting the nutrients you need should be a top priority. A number of tools are available to help.

For many cancer patients, malnutrition is the guest they didn’t expect, or want. It may show up shortly after you’ve been diagnosed with cancer, if nausea or vomiting prevents you from eating well, or if the disease disrupts how you digest or metabolize food. Or it may creep in during treatment. It may affect you even if you appear to be eating plenty of calories and protein but, because of your cancer, are unable to maintain enough fat stores and muscle mass. Because malnourished patients may become too sick to continue treatment or may experience slower recovery rates, getting the nutrients you need should be a top priority. A number of tools are available to help.

If you have battled malnutrition after a cancer diagnosis, you’re not alone. The majority of cancer patients suffer from nutritional deficiencies. Up to 90 percent of patients with cancers of the gastrointestinal tract and 60 percent of those with lung cancer experience some degree of malnutrition. In fact, protein-calorie malnutrition, which is caused by the body’s inability to take in sufficient amounts of carbohydrates, proteins and fat, is the most common secondary diagnosis in cancer patients. Malnutrition may be caused by the disease itself, such as when a tumor in the gastrointestinal tract blocks the digestive process, hampering nutrient absorption. Or it may be caused by treatments like surgery, which may drain the body of energy and nutrients, or chemotherapy, which may make you nauseous or dampen your appetite.

Serious consequences

Whatever the cause, malnutrition may have serious consequences, including longer hospital stays, a higher risk of cancer recurrence and, sometimes, even death. “Patients who are experiencing any degree of malnourishment don’t seem to tolerate treatment nearly as well as others,” says Matt Rinehart, Clinical Oncology Dietitian Team Lead at our hospital in Tulsa. “It’s extremely important to know that if you allow malnutrition to remain unchecked, it may delay or suspend your treatment indefinitely, and it may end up taking someone’s life well before the cancer could have.”

That may sound severe, but it makes sense if you think about it. If you’re having trouble keeping food down because you’re nauseous and or vomiting, for example, you may not be considered strong enough to undergo tumor removal surgery, or you may have to suspend chemotherapy treatments until you regain your strength. You may also be too weak to participate in the physical or occupational therapies designed to help you recover from surgery, delaying the time it takes to get back on your feet. Some patients, especially those with gastrointestinal cancers, develop a “wasting condition” called cachexia, which prevents the body from storing muscle and fat and causes death in 20 percent to 40 percent of cancer patients, according to the National Cancer Institute.

Identifying the causes

To treat malnutrition, it’s important to identify its cause so the members of your care team are better prepared to help you address it at its source. They may also help you prevent malnutrition before it starts. Rinehart offers these tips for treating malnutrition’s most common origins:

  • If you are anorexic:
    • Drink more water.
    • Eat small, frequent meals to help boost metabolism and increase appetite.
    • Add ginger to your diet. It may work as an appetite stimulant because it aids in healthy digestion, soothes the stomach lining, reduces nausea if taken regularly and decreases inflammation.
    • Talk to your doctor about whether an appetite stimulant is appropriate.
    • Work with your care team to address other side effects that may be affecting your appetite.
    • Consider oral supplements that are high in calories or protein.
  • If you are constipated:
    • Drink more water.
    • Eat more fiber-rich foods.
    • Take probiotic supplements or get them through yogurt.
    • Eat stone fruits such as apricots, peaches, cherries, prunes, plums and nectarines, which may have a natural laxative effect.
    • Drink prune or black cherry juice, after warming it up some on a stove or in a microwave.
    • Stay active and talk to your physician about exercise that is medically appropriate.
    • Speak with your physician about stool softener or laxative recommendations as needed.
  • If you are nauseous or vomiting:
    • Drink more water.
    • Eat small, frequent, protein-rich meals.
    • Add ginger and peppermint to your diet.
    • Avoid foods that are spicy, greasy, heavy or pungent.
    • Focus more on bland foods.
    • Take anti-nausea medications as prescribed.

A doctor's advice is key

Before changing your diet or trying to manage malnutrition on your own, talk to your doctor to make sure you are taking the appropriate steps for your needs, and to see if other remedies may help. If you’re a head and neck cancer patient, for example, malnutrition may cause you to lose muscle mass throughout your body, including in your throat. So your doctor may recommend that you work with a speech therapist to help you strengthen those muscles and improve your ability to swallow.

Your risk for malnutrition, and the complications it may cause, doesn’t end once you finish treatment. Many survivors work with a registered dietitian to help them get the nutrients they need to stay healthy. Head and neck cancer patients, for instance, may continue to struggle with dry mouth, taste changes and swallowing difficulties for months or even years after treatment. “These cancer survivors are more likely to slip through the cracks after treatment, but their nutritional side effects may last for a long time, and we need to stay ahead of them as much as we can,” Rinehart says.