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Why does malnutrition affect GI cancer patients more than others?

March 15, 2018 | by CTCA

A plate of healthy food including salmon, broccoli, and wild rice
In patients with cancer of the gastrointestinal system, malnutrition is a constant threat because of the digestive tract's role in processing food and waste. Still, patients can take certain precautions in keeping their body nourished, and getting educated about the issue is a good first step.

Malnutrition often goes hand in hand with cancer, affecting between 30 percent and 85 percent of patients, most often because treatments make them feel too sick to eat or digest food properly. But in patients with cancer of the gastrointestinal system, malnutrition is an even more constant threat because of the digestive tract’s role in processing food and waste. Still, patients can take certain precautions in keeping their body nourished, and getting educated about the issue is a good first step.

It's important to know the risk, and what you can do to prevent malnutrition from occurring, or to reverse the trend if you already have it.” - Pankaj Vashi, MD, AGAF, FASPEN - Chair of the Department of Medicine at Cancer Treatment Centers of America® (CTCA)

What gets malnourished?

The vast majority of GI cancer patients—up to 90 percent—experience malnutrition at some point in their cancer journey. The condition occurs when patients don’t get enough calories, proteins or other nutrients, either because they don’t feel like eating, or can’t, or because their body isn’t processing food and waste normally. This may happen for a number of reasons. When cancer develops, for example, it produces chemicals that change the way the body absorbs nutrients, making it difficult to maintain muscle mass and often leading to weight loss. As it grows and spreads, the disease also causes the body to use up much of its energy, and patients often experience weakness and fatigue. Gastrointestinal cancer patients have additional concerns: Their tumors may block areas of the gastrointestinal tract and interrupt nutrient absorption.

Treatments like chemotherapy and surgery often compound the issue by causing nausea, vomiting and diarrhea, as well as appetite loss. “All of this makes you more susceptible to malnutrition during cancer,” Dr. Vashi says. He cautioned patients not to let body types or excess weight fool them into believing malnutrition isn’t a concern for them. “It’s not only a danger for people who are thin,” he says. “Even people who are obese can be malnourished. It’s caused by a deficiency in necessary nutrients.”

How can nutritional assessments help?

A nutritional assessment may help determine your risk for malnutrition, and help you prevent the condition from worsening if you’ve already developed it. “Early detection and intervention are vital to treating malnutrition and reversing its effects,” Dr. Vashi says. A dietitian may help diagnose the cause of your nutrient deficiency and develop a meal plan tailored to getting you back on track. If you are unable to swallow, chew or otherwise eat normally, you may require a feeding tube that can deliver nutrients directly to the stomach.

Malnutrition may cause far-reaching and often severe impacts, such as weakness, fatigue and an inability to fight off infection or continue treatment. That’s why it’s critical to educate patients on the importance of proper nutrition, says Mary Parker Davis, MS, RD, LD, and Andrea Laney, RD, both registered dietitians at our hospital near Atlanta. It’s also important to understand that overcoming the condition won’t happen overnight, and that there are right ways and wrong ways to gain weight. Just eating junk food, for example, won’t give you the healthy fats, complex carbohydrates and proteins your body needs. But drinking high-protein nutritional supplements may help add some of those necessary nutrients back into your diet. “We tell people to think of food as medicine,” Parker Davis says. “We schedule time to take medicine each day. So we need to schedule time to eat healthy foods each day, too.”