Nutrition therapy: An overlooked aspect of cancer treatment?

Nutrition therapy: An overlooked aspect of cancer treatment?
PHOTO: Nutrition therapy: An overlooked aspect of cancer treatment?

SINGAPORE - Every day, 28 people in Singapore are diagnosed with cancer. And according to statistics provided by the Singapore Cancer Registry, 12 people here die of cancer every day.

For most cancer patients fighting to survive, doctors will recommend traditional treatment methods such as radiation therapy and chemotherapy.

But in the many discussions on how best to treat the disease, how many doctors will stress on the importance of nutrition?

While nutrition therapy is not commonly mentioned in doctor-patient discussions, the lack of proper nutrition can result in cancer cachexia - the loss of lean body mass that can dramatically increase one's risk of death from cancer.

According to a pilot study published in Support Care Cancer, about 20 per cent of all cancer deaths are caused directly by cancer cachexia, and 50 per cent of all cancer patients suffer from some degree of cancer cachexia.

As cancer and its treatments take a heavy toll on a patient's body and health, a high percentage of cancer patients succumb quietly to the effects of malnutrition.

What's cancer cachexia?

"It is a syndrome in which the patient loses skeletal muscle mass and body weight as a result of poor appetite (anorexia) and abnormal metabolism," said Professor Maria Isabel Correia, MD, Ph.D..

The chief of the Nutrition Service at the University Hospital and Mário Penna Foundation, Belo Horizonte, Brazil, was in Singapore recently to speak to local healthcare professionals on the importance of nutritional therapy in cancer treatment at the invitation of Abbott Nutrition.

She explained that cancer cachexia occurs because of the lack of proper nutrition through diets, especially if the patient experiences very poor appetite.

Cancer patients also often have problems digesting and absorbing nutrients, and added on to the drop in appetite due to the psychological impact of cancer, results in malnutrition.

Simply put, the patient wastes away and suffers a significant drop in his or her quality of life.

"The body breaks down skeletal muscle mass for energy, thereby sparing organs with critical functions. This tactic ultimately leads to loss of physical function," she told YourHealth.

In addition, cancer-induced weight loss has been scientifically associated with other poor outcomes for patients, such as reduced response to therapy, more complications and infections, and generally a lower rate of survival.

The good news is that this can be reversed if the patient undergoes targeted cancer nutritional therapy before cancer cachexia actually sets in, Prof Correia said.

The role of nutrition

The role of nutrition

According to Prof Correia, it is being increasingly recognised that cancer cachexia can be prevented and treated by cancer-specific nutritional therapy individualised for each patient based on their personal tastes, tolerance and aversions.

"Drugs may also help, but essentially, nutrition is fundamental, as it is for any human being," she said.

"In fact, treatment should be seen as multimodal, which includes aspects such as: pain control, exercise, psychological support, anti-nausea drugs and nutrition among many others."

One way nutrition can combat cancer cachexia is by the consumption of 2.2 grams of EPA daily by cancer patients.

EPA, which stands for eicosapentanoic acid, is derived from deep sea fish oils. Prof Correia explained that EPA helps in the fight against inflammation caused by cancer tumours.

"Inflammation leads to loss of muscle mass, which in turn leads to loss of body mass and is directly related to functionality and immunological response among others," she said.

Other than EPA, taking hypercaloric and hyperproteic foods can be helpful too.

These energy and protein-rich ingredients help counter the physiological abnormalities that underlie weight loss due to cancer cachexia.

However, these nutrients are sometimes not easily obtained by patients having difficulties eating normally.

Hence, supplements have been scientifically formulated to contain a combination of the crucial nutrients: EPA, protein, calories, vitamins and minerals - all of which work towards helping to prevent weight loss and loss of lean body mass.

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