Food For Thought: Nutrition In Lung Cancer

Maintenance of adequate nutrition is an integral component of the cancer treatment process. Counseling in nutrition has been shown to improve quality of life, strengthen response to therapy, and increase survival. Eating the right kinds of foods will help patients to stay strong and fight infections.

A leading cancer specialist, Dr. Shirish Alurkar, Director - Medical Oncology at Apollo CBCC Cancer Care (Ahmedabad), says "At the outset, it is important to notify that there is no evidence to support that eating any one food or taking any supplement will help cure lung cancer. People should be wary of any claims that a certain food or supplement will cure your cancer. However, a diet rich in fruits, vegetables, lean protein and whole grains could help patient feel their best during treatment. At the time of discussing the management plan with the patient, diet sheets with high calorie and high protein sources should be distributed for quick reference. Foods with high calories like cheese, eggs, lentils, fish and nuts should be given if well tolerated by the patients. When you are feeling good, you can tolerate treatment better and increase the chances that you will be able to stay on a treatment that is fighting your cancer."

The first law of thermodynamics postulates that increased energy expenditure is equal to the amount of energy added to the system minus the energy expended. In the cancer process, fat metabolism is altered. This results in decreased energy in the system along with higher levels of energy expended out. This leads to decreased body weight and loss of muscles. It is also called cancer cachexia.

When asked about the significance of weight loss and nutrition, Dr. K M Parthasarathy, Senior Consultant & Head of Department - Medical Oncology at Dharamshila Narayana Superspeciality Hospital (Delhi), said "Patients with more than 10% weight loss at the initial visit to the doctor are at a greater risk for hospitalization and poor prognosis. More than one-third of patients have 5% weight loss at the time of diagnosis. Alarmingly, if proper diet is not followed and if nutritional advice is disregarded, the weight loss gradually becomes more as treatment progresses. Thus, it is important to recognize those patients who are at risk for malnutrition or who are already malnourished at diagnosis, and for patients it is crucial to maintain a healthy nutritional diet. Protein is an essential nutrient for healing, tissue maintenance and growth and high protein sources should be included in the diet as much as possible."

During the chemotherapy cycle itself, it is recommended that patients eat lightly. Eating small portions slowly and every few hours seem to work best. Avoid skipping meals on these days and eating fatty, greasy or spicy foods. Drinking small amounts of water every 1/2 hour if tolerated serves as an energy boost.

Chemotherapy, by itself, can be physically nauseous for the patient. Dr R Rajkumar, Consultant - Medical Oncology at Velammal Medical College Hospital and Research Institute (Madurai), says" Chemotherapy can also lead to mouth sores and blisters on the tongue. This leads to decrease in consumption of food, thereby compounding the weight loss. To help with mouth sores, using a straw and avoiding food that is too hot or spicy or crunchy is advisable. To help with digestive side effects, a balanced diet is advised. Eating smaller proportion of meals and adding healthy fats to pack more nutrients reduces the risk of loose motion or constipation. Nutritionists and dieticians are integral in the screening, ongoing assessment and counseling of patients with cancer. Targeting specific patients who are prone to weight loss or those have undergone rapid fall in weight for counseling may provide a significant benefit to their nutrition status and improve their quality of life."

A multidisciplinary approach involving the treating physician, radiologist, pathologist and a nutritionist can help in providing exemplary care to the patient that will lead to a better living. Remember though, the best dietary advice is to stop smoking cigarettes!