Malnutrition in cancer patients

The effects of cancer are debilitating.

Whether it is the disease itself or a side effect of the treatment, cancer patients lose their appetite and do not get enough nourishment into their bodies – leading to the risk of malnutrition and putting added stress onto a system that is already battling to cope.

People with cancer are at increased risk of malnutrition

Malnutrition starts early in the course of the disease and gets worse as time progresses. (1) Causes of malnutrition in cancer include:

• Anorexia (loss of appetite) – this may be due to treatment as well as the cancer itself (1)

• Side effects of cancer treatment – nausea and vomiting can affect 30-70% of patients undergoing chemotherapy and decreases the ability to maintain adequate nutrition intake (1)

• People with cancer often need extra calories and protein to support their immune system cells, to heal tissues and to help fight infections (2,3)

• Cancer cells utilise nutrients, which leaves less nutrients available to meet the needs of normal healthy body cells (3)

• Cancer may make it harder to eat or digest food – especially when cancer affects the mouth, throat or digestive tract (3)

Malnutrition in cancer can adversely affect health and survival

Malnutrition in cancer can affect the efficacy of cancer therapies such as chemotherapy and radiotherapy and can decrease the chance of survival. (1) Studies have shown that a weight loss of more than 10% prior to chemotherapy decreased survival in patients with lung cancer and that male patients who lost more than 3% muscle tissue after chemotherapy had poorer survival than those who lost less than 3%, (1) Malnutrition can also affect a person’s tolerance to cancer treatments and can lead to a poorer quality of life. (1)

It is well recognised that cancer itself and certain types of cancer treatment can suppress or weaken the immune system and increase a person’s risk of getting a serious infection. (3) This risk is worsened if a person becomes malnourished as a lack of vitamins, minerals, calories and protein can also weaken the immune system. (3)

Nutrition is an important part of cancer treatment

Eating the right kinds of food before, during and after cancer treatment can help a person feel better, stay stronger and can also improve your response to cancer treatment. (1,2) Nutritional support, in the form of high-protein, oral nutritional supplements is essential as part of cancer care. (1) Good nutrition can prevent body tissue from breaking down, maintain defences against infection, help a person cope better with side effects of treatment and support the process of rebuilding healthy body tissue. (2) It can also improve your response to cancer treatment (1) Probiotics (healthy bacteria in food products), such as Lactobacillus paracasei, have been shown to colonise the digestive tract and enhance immune responses. (4,5)

Tips to increase calories and protein intake

1.    Eat smaller snacks throughout the day (2,6)
2.    Eat your biggest meal when you feel hungriest (2,6)
3.    Limit fluids during meals as these may make you feel too full (2,6)
4.    Exercise lightly or take a walk before meals to increase your appetite (2,6)
5.    Schedule mealtimes rather than waiting until you feel hungry (6)
6.    Avoid smells that make you feel sick (6)
7.    Try cold foods as they may be more appealing e.g. smoothie or pasta salad (6)
8.    Drink high-calorie, high-protein beverages like liquid supplements (2,6)

Caring for someone suffering from cancer means giving strength as well as support. It means supporting their nutritional intake to give them the energy and nutrition their bodies need. Nestlé Nutren Optimum is a meal in a glass with all the vitamins, nutrients and strength-building protein.

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1. Data on File. Nestlé, South Africa. Management of Gastrointestinal Cancer: The Role of Nutritional Intervention. Posters presented at the 10th World Congress in Gastrointestinal Cancer, 2008, June 25-28, Barcelona, Spain.
2. American Cancer Society. Nutrition for the Person With Cancer During Treatment: A Guide for Patients and Families. [Internet] [cited 2013 Apr 17]. Available from: URL:
3. American Cancer Society. Infections in People With Cancer. [Internet] [cited 2013 Apr 17]. Available from: URL:
4. Tsai Y-T, Cheng P-C, Fan C-K, Pan T-M. Time-dependent persistence of enhanced immune response by a potential probiotic strain Lactobacillus paracasei subsp. Paracasei NTU 101. Int J Food Microbiol 2008;128:219-225.
5. Crittenden R, Saarela M, Mättö J, Ouwehand AC, Salminen S, Pelto L, et al. Lactobacillus paracasei  subsp. paracasei F19: Survival, Ecology and Safety in the Human Intestinal Tract – A survey of Feeding Studies within the PROBDEMO project. Microb Ecol Health Dis 2002;(Suppl 3):22-26.
6. Mayo Clinic. No appetite? How to get nutrition during cancer treatment. [internet] 2012 Aug 10 [cited 2013 Apr 17]. Available from: URL:

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