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Information provided by Denise Luk, registered dietician
In the previous article, we discussed six myths about eating that commonly mislead breast cancer patients. Many patients are still confused about cancer diets. For example, do breast cancer patients have different dietary needs from the general population? Should I eat more to get stronger? If I lose weight, should I try to gain it back quickly? Denise, a registered dietician, answers the most commonly asked nutrition questions below:
1. My weight has risen and fallen sharply. Do I need to work hard to gain back the weight?
Reactions to cancer treatment vary from patient to patient. Some gain weight while others lose. If your weight drops significantly after you develop cancer, it may mean you have malnutrition. Studies have found that malnutrition can make cancer treatment less effective and detract from the patient’s quality of life.
I suggest that cancer patients consult their healthcare providers and registered dieticians, because they may need to consume more calories and protein in their daily diet. Minimize the consumption of lower-calorie but filling food items such as soup, water, tea, and thin porridge. Nuts, meat, fish, dairy products, and their substitute products can be added to the diet in appropriate amounts. These help increase the body’s absorption of calories and protein.
However, some patients, for various reasons, gain rather than lose weight during treatment. In these cases, I suggest that patients consult their healthcare providers and registered dieticians about controlling their weight because obesity may increase the risk of cancer, relapse, and other chronic diseases. They should reduce their oil, salt, and sugar intake. In addition, try to be more active and adjust the amount of consumed food and drink.
2. Does protein help fight cancer?
Some factors, including treatment side effects and negative emotions, can cause patients to lose their appetite and not eat normally. When the body doesn’t take in enough energy, it breaks down the protein present in the body to obtain sufficient energy. This results in loss of muscle and a drop in weight and works against controlling the disease. Patients with cancer typically need more calories and proteins than the general population. The recommended protein intake for the average person is 0.8 grams per kilogram of body weight, whereas according to the European Society for Clinical Nutrition and Metabolism (ESPEN), the recommended protein intake for cancer patients is 1 to 1.5 grams per kilogram of body weight. Assuming a bodyweight of 60 kilograms, the required protein intake would be about 60 to 90 grams, which is about 25 to 100% more than for the average person. Therefore, I suggest that patients routinely choose more protein-rich foods such as meat, eggs, fish, dairy products, bean products, and quinoa.
3. I have no appetite, I never feel like eating. What can I do?
Poor appetite, nausea, and vomiting are common clinical problems. Some patients even experience taste changes, mouth sores, difficulty swallowing, and similar problems during treatment. I recommend that patients adjust their diet according to their individual situations. For example, to deal with problems like loss of appetite, patients can try to eat smaller amounts but eat more often, make foods more concentrated to improve their nutritional value, choose foods that they like, or try making some new dishes to stimulate their appetite. If the situation doesn’t improve, I suggest consulting healthcare providers and dieticians. If necessary, consult with your physician regarding the use of appropriate nutritional supplements that boost the body’s absorption of calories and protein to help maintain weight and cope with anti-cancer treatment.
4. Is there any difference between a breast cancer diet and the average diet?
Apart from possibly requiring more calories and protein or needing to make adjustments according to weight, both cancer patients and the general public should maintain a balanced and healthy diet, and eat more fruits, vegetables, and plant-based foods and less refined and processed foods. It’s also important to get regular and appropriate amounts of exercise, avoid alcohol, and drink more water.
5. An additional tip about your diet if you have breast cancer: food safety is paramount.
Your immunity may be affected when you have cancer. Especially during chemotherapy, your immunity may drop, making you more susceptible to bacterial and viral infections. So it’s important to always follow food safety rules. Remember to wash your hands before you handle food. Meat should be thawed in a refrigerator instead of at room temperature. Food should be cooked thoroughly before it’s eaten. Never eat raw eggs, raw fish, or any uncooked or mouldy food. Wash fruits and vegetables thoroughly with running water before eating them, and scrub the skin of melons vigorously before you cut them. Finally, remember to handle raw and cooked foods separately to avoid cross-contamination.
Perhaps we could also include the use of Alternative / Herbal Medicines?
Consult with your physician before taking any form of alternative or herbal medication or supplement. Studies show that intake of alternative medicine leads to poorer treatment outcomes in patients with cancer.
References:
- Argilés, JM. Cancer-associated malnutrition European Journal of Oncology Nursing, 9:Suppl 2, S39–S50;2005
- Arends J, et al. ESPEN guidelines on nutrition in cancer patients. Clinical nutrition (Edinburgh, Scotland), 36:1, 11-48;2017.
- World Cancer Research Fund. https://www.wcrf.org/dietandcancer/resources-and-toolkit. NPM-HK-0328-05-2020. Accessed 2021 May.
- Johnson SB, et al. Use of Alternative Medicine for Cancer and Its Impact on Survival. JNCI: Journal of the National Cancer Institute, 110:1, 121-124;2018