Historically, cancer patients have been counseled on the importance of maintaining their body weight in the face of treatment associated with reduced appetite. Today, the focus is more nuanced, says Zhaoping Li, MD, PhD, director of the UCLA Center for Human Nutrition. “Weight was always the primary goal during cancer treatment, because of the concern that patients would become malnourished,” Dr. Li says. “Now, we are not as concerned with weight loss as we are with whether or not the patient is losing stamina or experiencing reduced function. In addition, rather than patients passively taking in calories, we want them to stay as active as possible and use activity as a driver to better use nutrition.”
In the past, Dr. Li says, cancer patients were encouraged to consume high-calorie foods in order to maintain their weight during treatment, in many cases without regard to nutritional value. Now, the advice is more specific. Of particular importance is protein intake. “Protein is very important both to support the vital organs during treatment and to bolster the immune system,” Dr. Li explains. The U.S. recommended daily allowance is 0.8 grams per kilogram of body weight (0.36 grams per pound) for average healthy individuals, but cancer patients should strive to consume as much as 1.2 g/kg, she says. For patients having trouble getting enough protein from food, Dr. Li recommends nutritional supplements in the form of protein shakes. Dr. Li also advises patients to avoid high intake of simple sugars because they can interfere with the response to chemotherapy. Instead, she recommends complex carbohydrates — ideally from whole grains, vegetables and fruits, which have the added benefit of providing the body with essential nutrients and feed and regulate the gut micriobiome, which is essential to a patient’s ability to respond to cancer treatments. The variety of fruits and vegetables is more important than picking one or two “super foods.” Patients should get answers to any questions regarding foods from dietitians and physicians who specialize in cancer nutrition.
At the Simms/Mann-UCLA Center for Integrative Oncology, part of UCLA’s Jonsson Comprehensive Cancer Center, patients are counseled on ways to improve quality of life and reduce anxiety associated with cancer. Carolyn Katzin, MS, CNS, a wellness specialist with the center and author of The Cancer Nutrition Center Handbook, says nutrition often is a major source of anxiety for cancer patients. “It can be overwhelming when your friends and family are constantly sending you information they find on the Internet about what you should or shouldn’t be eating,” Katzin says.
She tells patients that the foundation of health and recovery is built on sleep and relaxation, and she discusses tools such as mindfulness meditation that help to reduce anxiety. Also central to the process, Katzin notes, is consuming sufficient protein and remaining hydrated. She also offers more specific advice, such as how to incorporate cabbage, garlic, berries and other helpful foods into the diet; ways to work with tastes and textures when treatment is affecting the taste buds; and the benefits of foods such as papaya for patients who are experiencing treatment-related digestive difficulties. But these are less important than the larger lifestyle factors. “People tend to come in worried about the ‘cherry on top,’ whether it’s a specific food or an exotic supplement, but the most important thing is to have that foundation,” Katzin says.
By offering practical guidelines and recipes, Katzin seeks to reduce some of the stress associated with a cancer diagnosis. “Patients worry quite a bit about whether they’re eating the right or wrong foods,” she says. “My goal is to inform them with science-based information, help them gain a feeling of mastery, and have them leave feeling inspired and uplifted.”