Nutrition in tumor diseases was the topic of a recent conference of the Cancer Center at the Augsburg hospital. A conversation with keynote speaker Professor Markus Masin.
Why is nutrition therapy an important topic for cancer patients??
When a patient with a tumor disease goes to an oncologist, he or she either wants to be cured or, if that is not possible, to gain life time. An oncologist with modern therapy can certainly give it to him. But it can come to the point that the patient can no longer eat. About one-third of cancer patients do so because of loss of appetite, changes in taste, aversion to certain foods and the like. And if you don’t eat, you starve – it’s always been that way and will always be that way.
Prof. Masin: 25 percent of cancer patients die from malnutrition
Weight loss and emaciation are unavoidable in cancer patients because they are caused by the disease itself?
One third of oncological patients survive the disease excellently, another third – patients suffering from tumors of the upper gastrointestinal tract – have swallowing difficulties and can be fed very well via liquid nutrition. The last third suffers from food aversions due to high cytokine activity; patients no longer like meat, or sweets seem bitter to them. They simply can’t eat anymore, and weight loss occurs.
What are the consequences?
It is not the fat mass that disappears, but first the muscles. Legs and arms become thinner. This leads to weakness and fatigue, the dreaded chronic exhaustion. It is a vicious circle from which the patient can no longer escape. Sometimes state-of-the-art therapies have to be discontinued because the patient can no longer make it to the office. When it comes to that, everybody has lost. Just imagine: 25 percent of all oncological patients do not die from their tumor disease, but from pathological malnutrition! That’s 50 in this country.000 patients per year. These are people who could possibly still be alive if they had received nutritional therapy.
Nutritional therapy would help – but is neglected
What can be achieved with nutritional therapy?
That patients will regain weight and strength. This means that after weeks of lying on the couch, for example, they can do something around the house again – or anything else they like to do. As a result, they gain significantly in quality of life.
What is the situation of cancer patients with regard to nutrition therapy in Germany??
At the moment, it is the case that industry employees often do consultations on the wards, which is quite problematic. Only in a few exceptions there are own experts in the houses. Nutrition therapy is a stepchild in medicine and is hardly recognized. It would have to be obligatory, both with established physicians and in hospitals, that the quality standards/guidelines are implemented and that there are basically own employees who take care of nutritional therapeutic measures. If we could do that, we’d be a big step forward, but we’re still miles away from that.
What would have to be done in the case of each individual tumor patient?
Every patient needs to have nutritional care – that should be standard. Screening for malnutrition should become mandatory. If a patient notices, nutritional therapy measures must begin. Whereas nutritional medicine is sometimes confused with dietetics. But the patient does not need a diet, there are no prohibitions. He can eat anything he wants.
What patients can do
Is there anything a patient can do themselves if they notice they are losing weight?
Yes. If he loses five percent of his body weight in four weeks or ten percent in three months, he should bring it up with his doctor. The consequence should be that the doctor sits down with him and looks at what the problem is. Possibly the patient can be helped with nutritional counseling. But if he suffers from loss of appetite, changes in taste, vomiting or food aversions, he needs targeted nutritional therapy.
Many patients also seek help through special cancer diets ..
Yes, the patients want to do something good for themselves. But from a nutritional standpoint, cancer diets don’t make sense.