The Tribune

By Dr Felicia Adderley

Physiotherapist

It seems as though the world is becoming more health conscious than ever before. We have so many choices when it comes to what we eat. But which choices are the right ones? Add a cancer diagnosis on top of that and things can get even more confusing. Many people wonder if they should change what they eat, take dietary supplements or eat organic food. Sometimes it seems as though we end up with more questions than answers.

The cancer survivor goes through several phases after being diagnosed, including treatment, recovery and either life after recovery or living with advanced cancer. Nutritional counselling plays an important role in all these phases. Studies do confirm the health benefits of dietary counselling during cancer treatment. This helps to improve outcomes, such as fewer treatment-related symptoms, improved quality of life and improved dietary intake.

During cancer treatment some overall goals of care should include preventing or resolving nutrient deficiencies, achieving or maintaining a healthy weight, preserving lean body mass, minimising nutrition-related side effects and maximizing quality of life.

When making decisions regarding nutrition for the cancer survivor first we must consider whether they fall into the over nourished or undernourished category. Malnutrition and anorexia can be negative effects of cancer treatment. In fact, considerable weight loss and malnutrition affect about 50 per cent of cancer survivors at the time of diagnosis. Nausea, change in taste and/or smell and loss of appetite can be the culprits in this case, causing the cancer survivor to have a decrease in body mass.

Possible solutions for cancer survivors at risk for becoming underweight may include consuming smaller more frequent meals with little liquids during those meals. Liquids should then be ingested between meals to avoid dehydration. If it is determined that nutritional needs cannot be met by food alone, fortified nutrient-dense beverages (whether prepared commercially or at home) can be utilised to improve intake of nutrients. In extreme cases where the appetite is low, medication in the form of appetite stimulants can be prescribed at the discretion of the patient’s primary care physician.

Using vitamins, minerals and other dietary supplements during cancer treatment remains controversial. For example, it may be counterproductive to take folate supplements or eat fortified food products that contain high levels of folate if receiving antifolate therapies (such as methotrexate) as cancer treatment.

Also, supplements with high antioxidant activity should be avoided, because they can interfere with the cellular oxidative damage that chemotherapy and radiation inflict on cancer cells as a part of their mechanism of action. Because of emerging evidence about the negative effects of even modest use of dietary supplements in the oncology population, it is usually not advised to take supplements during and after treatment, or to only take supplements needed to treat a deficiency or promote another aspect of health. At this time, it is advised to avoid exceeding 100% of the daily value of vitamins C and E while undergoing active treatment.

Nutritional counselling by a registered dietician, nutritionist, or well-informed health care professional remains important for cancer survivors in the recovery phase. They may emerge from the treatment phase underweight and malnourished or overweight as a result of the treatment itself.

Deciding on the best options for your diet can be overwhelming. But remember that help is available.

• For further information or queries contact Dr Felicia Adderley at 361-5435, via e-mail at feliciaadderley@gmail.com, or visit Felicia Adderley PT, DPT, CKTP on Facebook for more information.

Stay tuned for the next article in this series which will discuss cancer rehabilitation.