Strength through nutrition: support for GI cancer patients

4 days ago | Angie Murad, Patient Educator | @muradangie

Written by Madelyn Strong, M.S. R.D.N., L.D.

Nutrition is an important aspect of care for all patients with cancer. It plays a crucial role in supporting overall health and well-being while undergoing treatment, as well as in enhancing recovery and quality of life. However, individuals with cancer of the gastrointestinal tract are often faced with unique challenges that can impact eating and digestion. These challenges may result from various factors, including tumor location, treatment and side effects.

Difficulty chewing or swallowing

Cancers located near the head and neck or esophagus can affect chewing or swallowing. This can occur because of the tumor or the treatment, such as radiation. If this occurs, strive to eat smaller, more frequent meals consisting of soft textured and moist foods. Choose foods such as yogurt, eggs, pasta, stews or soups. You may find foods with added moisture to be easier to eat, such as adding gravy to mashed potatoes. If eating solid foods is difficult, consider using higher calorie smoothies, milkshakes or protein drinks to help get the nutrition that your body needs. In some cases, other forms of nutrition such as a feeding tube, may be used to help meet your nutrition needs during treatment.

Pancreatic insufficiency

Pancreatic insufficiency is most often associated with pancreatic cancer either from the tumor itself or from surgery or treatment. Individuals with pancreatic insufficiency may have symptoms such as weight loss, gas, bloating and changes in stools, such as increased foul odor, lighter color, or even an oily or greasy appearance to stools. Pancreatic insufficiency is managed using pancreatic enzymes.

Pancreatic enzymes help break down consumed fats, proteins and carbohydrates. If your oncology care team has recommended pancreatic enzymes, it is important to take them as directed. For most individuals this means taking them with every meal and snack, especially those containing fat or protein. The goal is for pancreatic enzymes to travel through your digestive system with your food, so take the first capsule right before or with your first bite of food. If you take more than one capsule at a meal, you may consider spreading the dose out throughout the meal.

If you continue to experience symptoms of weight loss, gas, bloating or changes in your stools, consider reaching out to your team to ensure that your pancreatic enzymes are the correct dose for you.

Dumping syndrome

Dumping syndrome is a condition in which food, especially food high in simple sugars, moves from your stomach into your small bowel too quickly after you eat. Sometimes called rapid gastric emptying, dumping syndrome most often occurs because of surgery to your stomach or esophagus. Symptoms can include nausea, stomach cramps, diarrhea, dizziness/lightheadedness or a rapid heart rate. Most people with dumping syndrome develop symptoms within 30 minutes after eating, but others may may develop symptoms 1 to 3 hours after eating.

Managing dumping syndrome involves eating small, frequent meals and snacks and minimizing simple sugars, such as jams or jellies, juices, regular soda, or candy. Additionally, limiting fluid consumption for 30-60 minutes before and after eating can help reduce symptoms. Finally, including proteins (such as meats, eggs, dairy products, beans or legumes or nuts) and healthy fats (avocado, olive oil, nuts or seeds) can help slow down digestion.

Bowel resections

Some cancers of the small intestine or colon may require surgical removal of the tumor. As part of this removal, a portion of healthy tissue is also removed. At times, the surgeon may also need to perform a colostomy or ileostomy, in which stool is rerouted out of the body via a stoma, a surgically created opening, in the abdomen. If you have a colostomy or ileostomy, you'll find that various foods affect your digestive tract differently. Initially after surgery you may be instructed to follow a low fiber diet as your body recovers from surgery. Additionally, you may find that if you have difficulty eating many foods, this generally improves over time. Many individuals find that they feel better when consuming smaller, more frequent meals with larger meals consumed earlier in the day to reduce stooling overnight. Eating slowly and chewing your food well can help improve digestion. Having an ostomy, particularly an ileostomy can make dehydration more likely, be sure to drink plenty of fluids each day. If you are having difficulty staying hydrated, talk to your team about strategies to improve your hydration.

Summary

Patients with GI tract cancers often face challenges with eating, nutrient absorption, and treatment side effects. These issues vary by diagnosis, treatment, and surgery; it's important to work with your oncology team and dietitian to support your nutrition.