The dieticians at Mediclinic City Hospital offer nutrition counselling for individuals concerned about maintaining proper nutrition before, during, and after cancer treatment. This includes:
- General guidelines for balanced nutrition and nutrition guidelines for specific cancers
- Treatment concerns with regards to nutrition during chemotherapy or radiation
- Side effects like nausea, vomiting, difficulty swallowing or eating etc.
- Weight management
Why is nutrition important?
Eating the right kinds of foods and meeting the nutritional requirements in terms of macro and micronutrients before, during, and after treatment can help you feel better and stay stronger.
Good nutrition is especially important if you have cancer because both the illness and the side effects of the treatments can be modified by the way you eat. Cancer and cancer treatments can also affect the way your body tolerates certain foods and uses nutrients.
How and when can a dietician help you?
The nutritional goals of people with cancer vary from individual to individual. A dietician can help you identify your nutrition goals and plan ways to help you to meet them, in order to overcome any possible difficulties during the treatment. Eating well while you’re being treated for cancer might help you:
- Feel better
- Keep up your strength and energy levels
- Maintain your weight and your body’s store of nutrients
- Better tolerate treatment-related side effects
- Lower your risk of infection
- Heal and recover faster
Your dietician can help you when you have:
- Loss of appetite
- Significant weight loss or loss of lean body mass >5% in 30 days; >10% in six months
- Significant difficulty with swallowing or chewing
- Uncontrolled diarrhoea
- Abdominal pain/discomfort, indigestion, gas, constipation
- Ongoing issues with constipation
- Planned or recently post-op from major surgeries to the head/neck, esophagus, stomach, small bowel, colon, abdomen
- Other nutrition interventions like enteral nutrition/feeding tubes or parenteral nutrition/TPN
What is your nutrition journey during treatment?
Your care team: dieticians
As dieticians at Mediclinic City Hospital’s Comprehensive Cancer Centre, we provide medical nutrition therapy to patients which includes:
- Screening and assessment
- Identification of treatment complications with nutritional implications
- Nutrition intervention and nutrition prescription
- Continuous nutrition monitoring and reassessment with education
Providing optimal nutrition care during treatment requires a complete understanding of the disease, the treatment, the nutritional consequences, and appropriate interventions and practices.
The decision on any nutrition intervention is made taking in consideration the type of the cancer and if the patient is at high nutritional risk.
I. Oral nutrition – Recommended nutritional intervention to increase oral intake in cancer patients who are able to eat but are malnourished or at risk of malnutrition, adding strategies to increase caloric intake and using ONS (oral nutritional supplements)
II. Enteral Nutrition – If oral nutrition remains inadequate despite nutritional interventions, counselling and ONS (oral nutritional supplements)
1. Nasogastric (NG) tube
A small flexible tube goes down your nose to the back of your throat, down your food pipe (oesophagus) and into your stomach. Nutrition is given by the tube with ONS (oral nutritional supplements).
2. Nasojejunal (NJ) tube
A small flexible tube goes down your nose, to the back of your throat, down your food pipe (oesophagus), through your stomach and into your small intestine (jejunum). A NJ tube is used when you can’t use your stomach. An x-ray or camera is used to guide the placement.
Both NGT and NJT are temporary solutions.
For longer term use of a PEG (percutaneous endoscopic gastrostomy) or PEJ (percutaneous endoscopic jejunostomy is recommended.
3. PEG (percutaneous endoscopic gastrostomy)
PEG is a feeding tube that is placed directly into your stomach and nutrition is given directly by the tube.
4. PEJ (percutaneous endoscopic jejunostomy)
PEJ is a tube placed in your jejunum, which is the second part of the small intestine, when is not feasible to place the tube directly into the stomach.
III. Parenteral nutrition
Parenteral nutrition (PN) is intravenous administration of nutrition, which may include protein, carbohydrate, fat, minerals and electrolytes, vitamins and other trace elements for patients who cannot eat or absorb enough food through tube feeding formula or by mouth to maintain good nutrition status.
General concepts for Cancer prevention
Recommendations by American Institute of Cancer and Research (AICR)
Make whole grains, vegetables, fruits and pulses (legumes) such as beans and lentils a major part of your normal diet.
Scientific evidence shows that eating mostly plant-based foods — whole grains, vegetables, fruits, and beans — plays a big role in preventing cancer and contributing to a healthier life. That’s because plant-based foods are high in the types of fibre, nutrients, and phytochemicals (natural substances) that may help to prevent cancer. Plus, plant-foods can help you manage your weight, and give you the energy you need to enjoy physical activity.
Follow the New American Plate 2/3—1/3 model.
AICR’s New American Plate emphasises foods that can reduce your risk for cancer and other chronic diseases. Get started by covering at least two-thirds (2/3) of your plate with plant foods such as whole grains, vegetables, fruit and beans. The remaining third (1/3) of your plate may be filled with animal-based protein rich foods such as seafood, poultry and dairy foods and occasionally with lean red meat.
Being active and managing your weight can play a huge role in minimising your risk for cancer. Get educated about weight management, and learn how to make the small changes that can make big differences in your health.
Maintaining a healthy weight is one of the most important things you can do to protect yourself from cancer.
When you have excess weight, you increase your risk for a number of health conditions, including heart disease, high blood pressure, and diabetes. You also increase your risk for cancer.
Even though awareness is relatively limited on the link between excess weight and cancer risk, the fact is, aside from not smoking, staying at a healthy weight throughout life is the single most important thing you can do to protect yourself from cancer.
www.aicr.org/new-american-plate for cancer-fighting
www://elsevier.com: “ESPEN practical guideline: Clinical Nutrition in Cancer”