Nutrition in Cancer

Nutrition is a fundamental pillar of human life, health, and development across the entire lifespan. From the earliest stages of fetal development, at birth, through infancy, childhood, adolescence, and on into adulthood and old age, proper food and good nutrition are essential for survival, physical growth, mental development, performance and productivity, health, and wellbeing. It is an essential foundation of human and national development.

The projected incidence of patients with cancer in India among males was 679,421 and among females 712,758 for the year 2020. The burden of cancer in India is intimately linked to the country’s major socioeconomic inequalities in access to health care and other areas. In the current situation, nutrition plays a major role in cancer patients.

As Dr. Johanna Budwig said that ‘’The food we eat is not mankind’s only determining factor. The body, soul, and spirit all have their functions and roles to play, their areas of influence. But the harm done by eating the wrong kind of food fats has repercussions in all realms of life, including healthy mental and spiritual functioning’’.

Patients with cancer are at particularly high risk for malnutrition, Cancer cachexia because of both the disease and its treatments threaten their nutritional status.it is estimated that the deaths of 10-20% of patients with cancer can be attributed to malnutrition rather than to the malignancy itself.

Therefore, nutrition is a valid and important aspect of multimodal cancer care. The prevalence of malnutrition and cancer cachexia in patients with cancer has been reported to range from about 20% to more than 70% in worldwide studies, with the differences related to patient age, cancer type, and cancer stage. In cancer cachexia, patients experience involuntary weight loss with ongoing loss of skeletal muscle mass with or without loss of fat mass; such as wasting cannot be reversed by conventional nutrition care and may lead to functional impairment.

Screening for nutritional risk as early as possible allows for the identification of patients at risk of becoming malnourished. Screening should be done as soon as possible rather it should be done at diagnosis or hospital admission by using different assessment tools like SGA (subjective Global assessment), PG-SGA(Patient Generated-Subjective Global Assessment), MUST(Malnutrition Universal Screening Tool), NRS-2002(Nutritional Risk Screening -2002), MNA(Mini Nutritional Assessment), Nutritional intake, BMI(Body Mass Index), DEXA scan, BIA(Bioimpedance analysis), and screening should be repeated in the course of treatment for evaluation.

The nutritional needs of people with cancer vary from person to person. After all assessment and screening dietician or nutritionist helps to identify the proper nutritional goals and plan ways to meet them. They plan individual diet as per patient’s estimated Resting Energy Expenditure, lifestyle, disease state, current intake, food preferences, food allergies, present symptoms, blood parameters, ongoing or previous medications, current body weight, duration of weight loss, etc. Proper and good nutrition for cancer treatment always supports to feel better by increasing body strength and energy. Good and balanced nutrition helps to maintain the patient’s ideal weight and helps to store all the required nutrients followed by reduces treatment-related side effects, risk of primary or secondary infections thereby provide faster recovery and short duration of hospital stay. Therefore, Nutrition Counselling and patient dietary compliances are equally important in cancer treatment.

Key Nutrients Needs to Fight Cancer

1.Proteins
We need protein for our growth, to repair body tissue, and to keep our immune systems healthy. when our body doesn’t get enough protein, it might break down muscle for the fuel it needs. This makes it no longer to recover from illness, and gradually reduces resistance to infection.in cancer, people need more protein than usual. During treatment
like after surgery, chemotherapy, or radiation therapy extra protein needed to heal tissues and help to fight infection.
Sources: Egg, Fish, Chicken, Milk, paneer, low-fat dairy products, nuts, peas, lentils, soy foods, dried beans.

2.Carbohydrates
It is a major source of energy. carbohydrate gives the body fuel for physical activity and proper organ function.
Best Sources: Fresh Fruits, vegetables, and whole grains.
Other Sources: bread, potatoes, rice, spaghetti, pasta, cereals, corn, peas, sweets & sugar.
In cancer, any form of sugar or sweetened products is harmful to a person. consumption of sugar rapidly feed the tumor cells to grow very faster and spread out all over the body.

3.Fats
It plays a vital role in nutrition. Fats & oils are a rich source of energy for the body. The body breaks down fats and uses them to store energy, insulate body tissue, and transport fat-soluble vitamins through the blood.
Fats are like Monounsaturated Fatty Acids (MUFA- Olive oil, canola oil, peanut oil) and Poly Unsaturated Fatty Acids (PUFA-sunflower oil, palm oil, flaxseed oil, safflower oil) are good for health.
Whereas Saturated fats like red meat, whole milk, butter, lard, coconut oil& Trans fats like-hydrogenated vegetable oil, fried oils, vegetable shortening, animal products can raise bad cholesterol & lower good cholesterol.

4.Vitamins & Minerals
Vitamins and minerals try to boost the immune system of people with cancer and even destroy cancer cells. When we eat a balanced diet with enough calories and proteins usually, we get plenty of vitamins & minerals.
Sources: Dietary supplements, protein foods, nuts & seeds, cereals.

5.Fiber
Fiber also has an important role in our body. Incorporation of fiber into a daily diet helps to prevent piles, constipation, maintain proper bowel movement, maintain a proper glucose level in the body as well as helps to maintain ideal body weight. In cancer also fiber reduces the occurrence of colon cancer.
Sources: Soluble Fiber- Sprouts, oats, quinoa, barley, apple.
Insoluble Fiber- Green leafy vegetables, drumstick, etc.

6.Water
Water and liquids or fluids are vital to health. All body cells need water to function. If you don’t take in enough fluids or if you lose fluids through vomiting or diarrhea, you can become dehydrated, thereby the fluids and minerals that help to keep the body working can become dangerously out of balance. A person should drink about2-3 lit water each day to be sure that all the body cells get the fluid they need.

7.Antioxidants & Phytonutrients
Antioxidants include vitamins A, C, and E; selenium and zinc; and some enzymes that absorb and attach to free radicals (destructive molecules), preventing them from attacking normal cells. Eating a variety of fruits and vegetables, which are good sources of antioxidants.
Phytonutrients or phytochemicals are plant compounds like carotenoids, lycopene, resveratrol, and phytosterols that have health-protecting qualities. Fruits and vegetables, foods made from plants, like tofu or tea.