Public confused about nutrition for cancer patients

Weight loss during cancer treatment shouldn’t be ignored, even if overweight

Many cancer patients not getting the nutritional care they need, experts claim

Half of adults are unclear about whether nutrition makes a difference during cancer care, and 60% don’t know that losing weight during treatment carries risk, including for patients who are overweight or obese.

 A RED C survey commissioned by the Irish Society for Clinical Nutrition and Metabolism (IrSPEN), on a representative sample of 1,000 adults, found concerning levels of misinformation and misunderstanding around nutritional status during cancer care.

Despite the fact that half of us will develop cancer the research found:

• More than half of people (56%) are not clear on the importance of nutritional care during cancer treatment, with one in four thinking that good nutritional intake was not crucial
• 28% of people incorrectly believed that if a person is overweight or obese, losing weight is a positive side effect of cancer with a further 32% unsure
• A majority (53%) were not clear that maintaining muscle mass and strength is important for patients undergoing treatment for cancer
• 36% incorrectly believed or were unsure that overweight cancer patients would be ‘unlikely’ to require nutritional care (screening, advice, monitoring and access to dietitians).

IrSPEN spokesperson and Obesity Specialist at St Vincent’s University Hospital Professor Carel Le Roux said current medical research shows that maintaining nutritional health, body weight and muscle mass during cancer care significantly improves medical outcomes – including for people with overweight or obesity.

“Losing weight without trying and losing muscle mass are common problems in cancer – affecting at least a third of patients. Contrary to what people seem to think weight and muscle loss are harmful during treatment – whether people are under or overweight. It makes treatment less effective and increases risks of complications.

“From the time of diagnosis and during active treatment, the goal is to minimise weight change, to preserve muscle mass and maintain body strength.”

“It is of concern that the RED C survey shows that patients with obesity may be particularly at risk of not receiving the care they need, due to a misconception that losing body mass is a positive side-effect of cancer.”

Professor Le Roux said that this is an important message, as 40-60% of cancer patients are overweight or obese at the time of diagnosis.

“There is a time for achieving weight loss in patients with obesity, but it is not while undergoing cancer treatment, as it may negatively impact the patient’s response to treatments, which can affect overall survival.

“As clinicians we need to pay greater attention to relatively modest changes in body weight and muscle mass, since the earlier we can catch it, the more effective we can be in preventing cancer related malnutrition.”

IrSPEN President and Consultant Gastrointestinal Surgeon Professor John Reynolds said there is a need to dispel the myth that weight loss and deterioration in nutritional status are an inevitable consequence of cancer and treatments.

“High quality cancer care would benefit from a greater focus on the patient’s nutritional status, which is why IrSPEN continues to push for more specialised dietitians in cancer care and mandatory routine nutrition screening for outpatients receiving cancer treatments, not just inpatients.

“This follows the findings of a national survey we conducted with UCC of over a thousand cancer patients in 2018 which highlighted major gaps in access to services and support for patients with nutritional issues.

“Weight loss and malnutrition are not inevitable, or something that can be dealt with after treatment. An important pillar of cancer care is to keep the patient in the best possible condition to benefit from treatments.”

Specialist Oncology Dietitian, Veronica McSharry, said that by the time many cancer patients are referred to her for help, they are severely malnourished.

“Failure to address nutritional deterioration in cancer, including in those who are overweight, puts the patient at risk of poor tolerance to chemotherapy, increased complications in surgery and increased need for hospital inpatient care.

“We would like all patients to be screened for signs of developing malnutrition at every hospital outpatient visit and treatment setting, so that we can intervene early with patients who are unable to eat enough to maintain their weight and muscle mass.”

Ms. McSharry said that once cancer patients’ nutritional needs have been identified they can be addressed effectively, but catching them early is vital.

“We can advise on changes to diet, provide treatments for digestive issues, incorporate extra protein into foods or recipes, or prescribe protein and energy supplements for those who cannot manage to eat enough. Tube feeding or even intravenous feeding options are available for more complicated issues. Nutritional challenges can be addressed.

“We need greater awareness among people suffering from cancer and their families, and also professionals involved in providing cancer care, that addressing nutrition problems benefits the patient.”

See also www.irspen.ie

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