Cancer is the uncontrolled growth of cells due to DNA damage (mutations) and occasionally, due to an inherited propensity to develop certain tumors. Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. Because chemotherapy targets rapidly dividing cells, healthy cells that normally grow and divide rapidly may also be affected by the cancer treatments. These include cells in the mouth and digestive tract and scalp causing nausea and hair loss, which are usually temporary and reversible.
Nutrition can be affected by symptoms experienced due to cancer and cancer treatments, as well as psychological involvement such as depression or anxiety. Side effects that interfere with eating and digestion may occur during chemotherapy. The following side effects are common: poor appetite, fatigue, nausea, vomiting, diarrhea or constipation, inflammation and sores in the mouth, changes in the way food tastes, and infections. [Wojtaszek et al, 2002]
Patients undergoing chemotherapy require 1.5 grams of protein per kilogram of ideal body weight per day, in contrast to normal adults who require 0.8 grams of protein per kilogram of actual body weight. [Gelinas et al, 1990, Bell et al, 1996] Hence for cancer patients, nutrition during chemotherapy is important. The main goal before, during, and after treatments is to maintain adequate calories for weight maintenance and adequate protein to optimize your immune system, strength, and tolerance to treatments. The side effects of chemotherapy may make it difficult for a patient to obtain the nutrients needed to regain healthy blood counts between chemotherapy treatments. Nutrition therapy can treat these side effects and help chemotherapy patients get the nutrients they need to tolerate and recover from treatment, prevent weight loss, and maintain general health. Nutrition therapy includes supplements high in calories and protein, as well as tube feedings.
For cancer patients, diet and nutrition during chemotherapy must be based on what is tolerated by managing the different symptoms. It is important to manage these symptoms while maintaining the goals for adequate calories and protein.
Protein-calorie malnutrition (PCM) is the most common secondary diagnosis in individuals diagnosed with cancer, stemming from the inadequate intake of carbohydrate, protein, and fat to meet metabolic requirements and/or the reduced absorption of macronutrients. [McMahon et al, 1998, Colasanto et al 2005] The loss of appetite or desire to eat is typically present in 15% to 25% of all cancer patients at diagnosis and may also occur as a side effect of treatments. Anorexia is an almost universal side effect in individuals with advanced cancer. [Langstein et al, 1991, Tisdale et al, 1993]
Good nutrition practices can help cancer patients maintain weight and the body’s nutrition stores, offering relief from nutritional impact symptoms and improving quality of life. [American Cancer Society, 2002] Poor nutrition practices, which can lead to malnutrition, can contribute to the incidence and severity of treatment, side effects, and increase the risk of infection, thereby reducing chances for survival. [Vigano et al, 1994]
People with cancer frequently require a high calorie diet to prevent weight loss. They may also need a diet that is high in protein content to prevent muscle wasting. During and after chemotherapy, your body will need to repair. Foods that are rich in protein supply the body with amino acids, which help to build, repair, and maintain cells and muscle tissue, to heal wounds, and to support the immune system.
Proteins are used by the body to help tissues grow and for repair. During chemotherapy there is an increased protein loss. This causes malnutrition if untreated. Protein supplements like casein and whey help the body in supplying the increased demand for proteins. The side effect of chemotherapy may interfere with the digesting abilities. Hence it is recommended that small, frequent meals of easy to digest foods may be given. Casein meets this criterion. It is a simple protein to digest and the clot forming ability of casein provides a sustained slow release of amino acids into the blood stream. This will surely help in meeting the demand of the body for an increased supply of amino acids, for providing energy and promoting protein synthesis. Chemotherapy treatments decrease one’s immunity levels. Whey protein has a role in boosting immunity. In a normal person, GSH is present in the body, which prevents the formation of cancerous cells. Whey contains an ample supply of the amino acid cysteine, which is a precursor of GSH. Whey protein contains all the essential amino acids in higher concentration than all vegetable proteins. The amino acids found in whey are efficiently absorbed and utilized. Hence, it is recommended that casein and whey proteins are used to support chemotherapy nutrition.
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