Stories of Interest

Keeping the Body Fueled During Cancer Treatment
March 26, 2009

Six months ago Nancy G. was diagnosed with cancer. Since then she’s undergone surgery, six weeks of radiation therapy and two rounds of intensive chemotherapy. Everything is looking up . . . except that she weighed in at 20 pounds under her ideal weight at her last doctor’s appointment. For many of us, losing 20 pounds would be a good thing. For Nancy, it could be deadly – seriously compromising her ability to beat the disease.

 

According to Heather Borsa, Oncology Dietitian at Elkhart General, the experience described here is not uncommon. “Our doctors have some amazing weapons in their arsenal when it comes to knocking out cancer” she states. “But, as effective as these treatments can be, they can sometimes play havoc with good nutrition. If you’re a cancer patient, maintaining a healthy diet is more than a ‘good idea.’ It’s critical – ensuring that you get the fuel you need to put up the best fight.”

Borsa is uniquely qualified to discuss the nutritional challenges facing cancer patients. She is a Board Certified Specialist in Oncology Nutrition – one of only three dietitians in Indiana to have earned this credential. Additionally, she served as one of only eight dietitians selected from a nationwide pool of candidates to create the national standards for certification in oncology nutrition.

“The role of the Oncology Dietitian goes far beyond the age-old council we should all follow to eat your fruits and vegetables,” she remarks. “Our goal with a cancer patient is to identify barriers to good nutrition and find creative ways to overcome them.

"For some cancer patients, nausea is a big factor. As in Nancy G.’s case, radiation and chemo can often cause nausea, and although the treatment plan may integrate pre-medication to minimize the impact, it can still be a real problem for many patients. We often find that foods that were favorites before treatment can now make you sick. So we search for ‘workarounds’ – nutritious meals that the patient will enjoy and will be more forgiving.”

Cancer treatment can also affect taste and smell, again adversely influencing appetite and nutritional intake. Many patients report that some foods they used to like now have a metallic taste. For others, what used to be considered the pleasant aroma of cooking is now an objectionable odor that can trigger nausea. “When the taste of certain foods is a problem, we again look for alternatives” says Borsa. “As for smell, we’ll recommend that, when possible, favorite foods with a high odor be prepared outdoors on the grill. And we’ll recommend avoiding restaurants where the cooking aromas are strong or where they do tableside preparation. That may be a nice touch of ambiance for many people, but for a cancer patient, it can be a real problem.”

The oncology dietitian plays a major role with patients who are dealing with a condition that actually obstructs the normal digestive process. Cancers of the throat or neck can make swallowing difficult or impossible. And if the disease is in the gastrointestinal system, normal processing of food can be impaired. In these cases, it’s often necessary for the patient to have a feeding tube or get intravenous (IV) nutrition, and the oncology dietitian plays a vital role. “For every cancer patient, the goal is proper nutrition – getting the fuel needed to heal the body,” Borsa emphasizes. “These patients are no different. We just need to use an alternate route.”

Borsa’s involvement with a cancer patient starts shortly after admission to the hospital. “I see every patient within the first 72 hours of admission,” she says. “And I’ll continue working with the patient and the family throughout their course of treatment. After discharge, many of my patients will continue treatment on an outpatient basis, in chemotherapy or radiation therapy, and I’m able to monitor their progress throughout.” In some cases, her involvement starts well before hospital admission. For instance, newly diagnosed breast cancer patients will often participate in the Hospital’s Breast Cancer Clinic program, allowing the patient and family to meet with the entire team of cancer care specialists in one setting. Borsa is part of this team that includes the surgeon, radiation oncologist, medical oncologist and oncology nurse. “The patient and family need to understand the role that nutrition will play in the treatment plan, and it’s important that we establish this right at the beginning. The medical staff here is great in making sure we’re involved up front.”

Another important part of the oncology dietitian’s job comes into play with patients who wish to explore the use of complementary or alternative homeopathic remedies. “Certainly there are cases where these remedies have shown some benefit,” Borsa explains. “But we emphasize that it can be dangerous to take alternative remedies without letting the medical team know. That way we can evaluate whether there might be harmful interactions because of a conflict with the medical treatment.”

Obesity, a big contributor to so many poor health conditions, is an even nastier villain when it comes to cancer. “Study after study supports the position that obesity significantly increases one’s potential to get cancer,” states Borsa. “Conversely, maintaining a healthy weight can play a big role in protecting you from the disease.”

For people who are already battling cancer, obesity is a major handicap. “When I see a cancer patient who is seriously overweight, we’ll work hard to get the weight under control as part of the nutrition plan. But it can be extra difficult, because the patient is already dealing with the disease and the treatment. That’s why it’s so important for everyone to think of healthy weight management as proactive protection against cancer.”

Eat Smart & Stay Healthy!

Make an appointment for Individual Nutrition Counseling with one of Elkhart General's Registered Dietitians. Call 574-523-3444. To learn more about our Nutrition Services Programs, call 574-523-3303.