Why does malnutrition affect patients with gastrointestinal cancer more?

m Malnutrition often goes hand in hand with cancer, affecting 30 to 85 percent of patients, often because treatments make them feel too sick to eat or digest food properly. But in patients with gastrointestinal cancer, malnutrition is a more persistent threat due to the digestive system’s role in processing food and waste. However, patients can take some precautions to keep their bodies nourished, and a good first step is to educate yourself.

“It’s important to know the risks and what you can do to prevent or reverse malnutrition if you already have it.” – Pankaj Vashi, MD, AGAF, FASPEN – Chief of Medicine, Cancer Treatment Centers of ^America® (CTCA)

What is malnutrition?

The vast majority of gastrointestinal cancer patients, up to 90 percent, are malnourished at some point in their cancer journey. The condition occurs when patients do not get enough calories, protein or other nutrients, either because they do not feel like eating or cannot eat, or because their bodies do not process food and waste normally. This can happen for a number of reasons. When cancer develops, for example, it produces chemicals that alter the way the body absorbs nutrients, making it difficult to maintain muscle mass and often resulting in weight loss. As it grows and spreads, the disease also causes the body to use up a lot of its energy, and patients often experience weakness and fatigue. Gastrointestinal cancer patients have additional concerns: Their tumors can block areas of the digestive system and disrupt nutrient absorption.

Treatments such as chemotherapy and surgery often exacerbate the problem by causing nausea, vomiting, and diarrhea, as well as a loss of appetite. “All of this makes you more likely to become malnourished during cancer,” says Dr. Fashi. He warned patients not to let their body type or excess weight fool them into believing that poor nutrition did not concern them. “It’s not just dangerous for skinny people,” he says. “Even obese people can suffer from malnutrition. It is caused by a lack of essential nutrients.”

How can nutritional assessments help?

A nutritional evaluation can help determine your risk of malnutrition and help prevent the condition from getting worse if you’ve already developed it. “Early detection and intervention are essential to treat and reverse malnutrition,” says Dr. Fashi. A dietitian can help you diagnose the cause of your nutrient deficiencies and develop an eating plan designed to get you back to normal. If you are unable to swallow, chew, or eat normally, you may need a feeding tube that can deliver nutrients directly to your stomach.

Malnutrition can cause long-term and often serious effects, such as weakness, fatigue, and an inability to resist infection or continue treatment. That’s why educating patients about the importance of proper nutrition is critical, says Mary Parker Davis, MS, RD, LD and Andrea Laney, RD, both registered dietitians at our hospital near Atlanta. It is also important to understand that overcoming this condition will not happen overnight and that there are right and wrong ways to gain weight. Just eating junk food, for example, won’t provide you with the healthy fats, complex carbs, and protein your body needs. But drinking protein-rich supplements can help add some of those essential nutrients to your diet. “We tell people to think of food as medicine,” Parker Davis says. “We set a schedule for taking medications every day.