Wednesday, July 7, 2010

Keeping nourished during treatment

If you have cancer, one of the best things you can do for yourself is to maintain your nutritional health. It is well established that patients who are well-nourished have an improved quality of life, are better able to tolerate treatment and have shorter hospital stays. Malnourished patients do far worse: suffering with more severe and frequent treatment-related side effects, have a poorer quality of life, are more susceptible to infection and illness, and have decreased survival times.

According to the National Cancer Institute in the U.S., for every hundred people that die of cancer, twenty to forty of them literally starve to death.

Before a patient is even diagnosed, appetite may be affected, weight loss may occur and nutritional deficiencies may be present. Unfortunately, significant weight loss at the time of diagnosis is associated with decreased survival and reduced response to surgery, radiation therapy, and chemotherapy.

Then to make matters worse, treatment-related side effects can sap vital nutrients from the body and/or leave the patient with little appetite or desire to eat. These side effects include: nausea, vomiting, diarrhea, altered taste and smell, mouth sores, dry mouth, difficulty swallowing, constipation, pain and depression.

Eventually many malnourished patients advance to a condition known as cachexia. This is a progressive wasting syndrome where the patient loses significant body weight, fat and muscle, and becomes weaker and weaker. Successful treatment of cachexia is difficult, so preventing it in the first place through nutritional monitoring and intervention is critical.

Since nutritional well-being is so critical to treatment, early screening of nutritional issues and implementation of nutritional therapies are essential to the health of the individual with cancer.

Unfortunately, nutritional therapies are often initiated as part of palliative care, rather than as supportive care during treatment. In patients with advanced cancer, nutritional therapy is modest, with a focus on reducing the risk of infection, improving quality of life, and providing symptom relief.

In patients who have been recently diagnosed, are undergoing active treatment or are recovering from cancer treatment, the goals of nutritional therapy include: to maintain or improve nutritional status, to restore deficient nutrients, to fight the inflammation in the body, to maintain or increase weight, to boost the immune system, to help fight fatigue, to reduce nutrition-related side effects and complications, and to maximize quality of life.

It is imperative that people understand the importance of nutritional health and its impact on cancer.

• Eat as healthy as you can during treatment. If you can’t eat or are having trouble with certain foods, find substitutes to ensure your protein and caloric needs are being met. Eggs are an easy source of protein and are easy to digest. Protein shakes are also an excellent choice for those with cancer. A high quality whey protein, mixed with some yogurt or antioxidant-rich fruit, will provide a good nutrition boost.

• Monitor your weight and energy levels. If you are losing weight during cancer, it is not a good thing.

• Get professional help if necessary– don’t accept your fatigue and weight loss as just part of the disease. Find out if everything is being done to maintain and support your nutritional needs. The earlier that problems are identified and nutritional therapies implemented, the greater the chance of improving outcomes.

Monday, July 5, 2010

Vitamin D and Cancer Prevention

Most people are aware that Vitamin D is the ‘sunshine vitamin’, and we make this critical vitamin after exposure to the sun.  However, even in the summer, 66-68% of Canadians do not have sufficient levels of Vitamin D.

Common sense would tell us that our levels drop in the fall, when our exposure to the sun is limited.  And drop they do, quite dramatically.  Several studies suggest that approximately 95% of Canadians lack adequate vitamin D in the fall.  That’s an astounding number and should make everyone realize how important it is to be taking their daily vitamin D supplement, particularly when several forms of cancer, including breast, ovarian and colon, are linked to vitamin D deficiency, as well as cardiovascular disease, osteoporosis, and stroke.

So how much vitamin D should you be taking to maximize the health benefits from this key nutrient?  Currently, most organizations, including the Canadian Cancer Society, recommend only 1000 IU. 

However, a charitable organization called GrassrootsHealth (http://www.grassrootshealth.net/) has gathered the opinions of sixteen prominent vitamin D researchers and physicians in the United States and Canada – and they recommend an intake of 2000 IU of vitamin D3 per day (Vitamin D3, also called ‘cholecalciferol’, is the type of vitamin D you should be looking for in a supplement).  These scientists firmly believe, as do I, that this amount is safe, and is absolutely necessary to achieve ‘sufficient’ levels for the majority of the population.  Two thousand IU is also the upper limit that the United States’ National Academy of Sciences, Institute of Medicine regards as having no adverse health effects.

A review article published last year in Annals of Epidemiology, suggests that by raising oral intake of vitamin D3 to 2000 IU per day that approximately 58,000 new cases of breast cancer and 49,000 new cases of colorectal cancer would be prevented in Canada and the United States each year.

The importance of adequate levels of vitamin D is further demonstrated by a study of five hundred and twelve women living in Toronto, who had been diagnosed with breast cancer. These women had their vitamin D levels measured and then were followed up to determine outcomes.  The results, published in 2009 in the Journal of Clinical Oncology, showed that women with deficient vitamin D levels were more likely to experience a distant recurrence or die compared to those with sufficient levels of the vitamin.

Did you take your vitamin D today?