Public unaware of importance of nutrition during cancer care

A new survey has revealed a high level of confusion among adults when it comes to the issue of nutrition for cancer patients.

According to the findings, six in 10 of adults are unaware that losing weight during cancer treatment is risky for patients even if they are overweight or obese.

Research shows that maintaining body weight and muscle mass during cancer care significantly improves medical outcomes, including for people who are overweight or obese. However, the survey found that over half of adults did not understand that maintaining muscle mass and strength is important when undergoing cancer treatment.

“Contrary to what people seem to think, weight and muscle loss are harmful during treatment whether people are under or overweight. It makes treatment less effective and increases risks of complications. From the time of diagnosis and during active treatment, the goal is to minimise weight change, to preserve muscle mass and maintain body strength,” explained IrSPEN spokesperson and obesity specialist at St Vincent’s University Hospital, Prof Carel Le Roux.

IrSPEN noted that at least one-third of patients lose weight without trying and lose muscle mass during cancer care. However, despite the risks associated with this, at least one in four adults incorrectly believe that if a person is overweight or obese, losing weight is a positive side-effect of cancer, while a further one in three are unsure about this.

Meanwhile, one-third of adults surveyed incorrectly believe that overweight cancer patients are ‘unlikely’ to require nutritional care.

An estimated 40-60% of cancer patients are overweight or obese at the time of their diagnosis.

“It is of concern that the survey shows that patients with obesity may be particularly at risk of not receiving the care they need, due to a misconception that losing body mass is a positive side-effect of cancer.

“There is a time for achieving weight loss in patients with obesity, but it is not while undergoing cancer treatment as it may negatively impact the patient’s response to treatments, which can affect overall survival,” Prof Le Roux said.

He insisted that clinicians need to pay more attention to even relatively modest changes in body weight and muscle mass, as the earlier this is picked up, “the more effective we can be in preventing cancer-related malnutrition”.

Also speaking about this issue, IrSPEN president and consultant gastrointestinal surgeon, Prof John Reynolds, said there is a need to dispel the myth that weight loss and deterioration in nutritional status are an inevitable consequence of cancer and its treatments.

“Weight loss and malnutrition are not inevitable or something that can be dealt with after treatment. An important pillar of cancer care is to keep the patient in the best possible condition to benefit from treatments,” he noted.

He insisted that there should be a bigger focus on the nutritional status of cancer patients, “which is why IrSPEN continues to push for more specialised dietitians in cancer care and mandatory routine nutrition screening for outpatients receiving cancer treatments, not just inpatients”.

According to specialist oncology dietitian, Veronica McSharry, by the time many cancer patients are referred to her for help, they are already severely malnourished.  

“Failure to address nutritional deterioration in cancer, including in those who are overweight, puts the patient at risk of poor tolerance to chemotherapy, increased complications in surgery and increased need for hospital inpatient care.

“We would like all patients to be screened for signs of developing malnutrition at every hospital outpatient visit and treatment setting, so that we can intervene early with patients who are unable to eat enough to maintain their weight and muscle mass,” she explained.

Ms McSharry emphasised that once cancer patients’ nutritional needs have been identified, they can be addressed effectively, however catching them early is vital.

“We can advise on changes to diet, provide treatments for digestive issues, incorporate extra protein into foods or recipes, or prescribe protein and energy supplements for those who cannot manage to eat enough. Tube feeding or even intravenous feeding options are available for more complicated issues. Nutritional challenges can be addressed,” she said.

However, she added that more awareness is needed about this issue among people suffering from cancer and their families, as well as professionals involved in providing cancer care.

The RED C survey was commissioned by IrSPEN and involved a representative sample of 1,000 adults.