Whether a patient makes the decision to be treated aggressively for mesothelioma, or chooses only symptom control, nutrition plays a vital role in his or her well-being. By consuming enough essential nutrients, including vitamins, minerals, protein, carbohydrates, fat and water, the patient will benefit by feeling better and remaining stronger. Unfortunately, the side effects of various treatments, or simply the progression of the disease, sometimes makes it difficult to eat well, resulting in malnutrition. Cancer also can cause changes in how the body metabolizes protein, carbohydrates and fat, and may lead to weight loss.
Doctors who specialize in the treatment of mesothelioma feel that a high percentage of their patients have lost 10% or more of their normal body weight even prior to making treatment decisions, and it is statistically at this stage that overall health begins to decline. Too few calories and too little protein in the diet are the most common nutritional problems facing most cancer patients, and because these nutrients are important for healing, fighting infection and providing energy, it is important that they be supplied in the diet. For those looking into surgical, chemotherapeutic or other treatment options, aggressive nutritional support may be necessary to ready them for treatment, and for those choosing palliative care, enhanced nutrition will offer better quality of life and better overall health.
Initial Assessment of Nutritional Needs
Early assessment of a patient’s nutritional status can help identify any potential problems that could lead to delay in treatment or affect quality of life, and could also indicate whether nutritional therapy is in order. Evaluation may include:
- Weight changes over a period of months
- Changes in the quantity or types of food eaten
- Symptoms such as nausea, vomiting, diarrhea or constipation that have affected appetite
- Inability to conduct normal daily living
Goals of Nutritional Therapy
The primary goal of nutritional therapy is to help patients get the nutrients necessary to maintain a healthy weight and adjust to changes brought on by aggressive treatment or mesothelioma progression. It is important to remember that guidelines for normal eating may differ substantially for someone fighting cancer. A nutritionist can help:
- Prevent or correct malnutrition
- Prevent wasting of muscle, bone and other lean body mass
- Enable the patient to better tolerate aggressive treatments such as surgery, chemotherapy or radiation
- Maintain the ability to fight infection
- Maintain strength and energy
- Maintain or improve quality of life
Nutrition for Cancer Patients May Be Different
What would normally be considered sound nutrition practice for a healthy person may not be the same for someone who has cancer. This can be confusing, since foods now encouraged by a nutritionist are contrary to everything you have previously been told. Whereas recommendations normally stress a diet that includes large portions of fruits, vegetables and whole-grain breads and cereals, moderate amounts of meats and dairy products, and reduced intake of fat, sugar and salt, recommendations for cancer patients focus on higher calorie and protein content. Adding more eggs, cheese and whole milk to the diet, and using additional sauces, gravies and salad dressings are encouraged. Other suggestions might include changing cooking methods to include more butter, margarine or oil. Foods containing high amounts of fiber that can aggravate treatment-related side effects such as diarrhea or sore mouth may be more limited.
The reason for these dietary modifications is to help the body build strength and better tolerate the effects of the cancer and/or its treatments. When you are healthy, eating enough to get the proper nutrients is not usually an issue, but it can be a challenge when you have cancer.
Effects of Mesothelioma Treatment on Nutrition
After a mesothelioma diagnosis, treatment plans are formulated. The purpose of these treatments are all the same – to kill cancer cells, however, healthy cells may also be damaged in the process causing side effects which can ultimately affect nutrition.
When someone has surgery, the body’s needs for nutrients and energy increase because it must heal, fight infection and recover, however, because many patients experience pain, fatigue or loss of appetite, they may not be able to eat as they normally would. The purpose of chemotherapy is to stop the growth of cancer cells and prevent them from dividing. Unfortunately, because there are also healthy cells in the body which grow rapidly, such as those in the mouth and digestive tract, eating may become difficult at times. Side effects such as nausea, vomiting, diarrhea, constipation, sores in the mouth or changes in the way foods taste can easily affect nutrition. Radiation therapy may also affect healthy cells near the cancer site and cause side effects such as fatigue and decreased appetite.
In short, any patient who chooses to be treated aggressively can benefit from working with a nutritionist. Some patients may have concurrent health problems such as diabetes, high cholesterol, etc., and therefore, a program can be tailor-made taking into consideration the patient’s total health picture. More on nutrition and the side effects of cancer treatment.
Preparing for Treatment
Eating a healthy diet is one of the most important things a patient can do to prepare themselves for mesothelioma treatment. Those who are well-nourished before treatment begins often have more reserves to maintain their strength, rebuild tissue and fight infection than those who are not. It is also easier for the body to cope with side effects caused by treatment, should they occur.
Being well-informed about mesothelioma, keeping a positive attitude and talking about your feelings regarding treatment choices with family and friends, can also be helpful in reducing anxiety which can lead to decreased appetite. If eating-related problems do become an issue, your doctor may be able to prescribe medication that can help.
Not all patients experience side effects from treatment that will affect their nutrition, but it is safe to say that most patients will have good days and bad days. While you are in the hospital or are undergoing treatment on an outpatient basis, speak with your doctor, nurse or a nutrition therapist about meals, snacks, beverages or supplements that are applicable for your particular needs. In general, the following hints may help:
- When you are able to eat, try to eat foods that have high calorie and protein content.
- When you don’t feel like eating, try to find one or two things that are tolerable and continue eating those until you can add other foods to your diet; add a liquid meal supplement to make up for nutrients you are not getting in your meals.
- Drink plenty of fluids, especially when you aren’t eating well. Six to eight cups of liquid per day are a good goal for most adults.
Nutrition for Advanced Mesothelioma
It is common in advanced cancer, that the desire for food decreases. Patients may feel very little hunger, and may be satisfied with smaller portions. At this time, food should be looked on as a source of enjoyment, and dietary restrictions are not usually necessary since the quantity of food taken is limited. Nevertheless, it is always a good rule of thumb to check with a medical professional before making any drastic dietary adjustments.