Nutritional Strategies and Energy Requirements in Cancer Treatment: Addressing Cachexia and Understanding Cancer Staging

khadyapathya2024
Feb 4
4 min read

Cancer is a disease when cell grows abnormally inside body and destroy the body tissues.

Stages of Cancer: Understanding Tumor Progression

Cancer is classified into different stages to determine its severity, spread, and treatment approach.

1. General Stages of Cancer

Stage 0 – Carcinoma in Situ (CIS)

Cancer is localized and has not spread.
Cells are abnormal but have not invaded surrounding tissues.
Highly treatable if removed early.

Stage I – Early-Stage Cancer

Small tumor, confined to the organ where it started.
No lymph node involvement and no metastasis.
Often curable with surgery or radiation.

Stage II – Localized Cancer

Tumor is larger than in Stage I.
May have spread to nearby tissues or lymph nodes but not to distant organs.
Treatment options: Surgery, chemotherapy, radiation, or a combination.

Stage III – Regional Spread

Cancer has spread further into nearby lymph nodes and tissues.
More aggressive treatment needed, including chemotherapy, radiation, or targeted therapy.

Stage IV – Metastatic or Advanced Cancer

Cancer has spread to distant organs (e.g., lungs, liver, brain, bones).
Treatment is usually palliative (focused on managing symptoms and prolonging life).

**cancer.gov/about-cancer/understanding/what-is-cancer**

Other Cancer Staging Systems

Blood Cancers (e.g., Leukemia): Use different systems based on white blood cell count and organ involvement.
Brain Cancers: Typically staged based on tumor grade rather than TNM [Tumor size (T), Node involvement (N), and Metastasis (M)].

Nutritional Management for Cancer

Nutrition plays a vital role in cancer treatment and recovery. A well-balanced diet can help strengthen the immune system, maintain energy levels, and support overall well-being. Here are some key aspects of cancer nutrition:

1. Nutrients during Cancer treatment phase

· Protein-Rich Foods: Helps repair tissues and maintain muscle mass. Sources: lean meats, poultry, fish, eggs, dairy, beans, nuts, and soy products.

Healthy Fats: Reduces inflammation. Sources: olive oil, avocado, nuts, seeds, and fatty fish.
Complex Carbohydrates: Provides steady energy. Sources: whole grains, fruits, vegetables, and legumes.
Hydration: Drink plenty of water, herbal teas, or clear broths to prevent dehydration.
Small, Frequent Meals: Helps manage nausea, loss of appetite, and digestive issues.
Avoid Processed Foods: Limit red and processed meats, sugary drinks, and heavily processed snacks.

source: cancercenter.com/community/blog/2021/02/nutrition-for-cancer-patients
2. Nutrition for Cancer recovery phase
- Include Plant-Based Food: Focus on whole foods, vegetables, fruits, nuts, seeds, and whole grains.
- Increased Needs Due to Cancer Cachexia (Weight & Muscle Loss): Requires higher calorie and protein intake. Sources: lean meat, pulses & beans, eggs & dairy products etc.
1. Different Energy Needs
Energy requirements vary depending on the individual's weight, cancer type, treatment intensity, and overall health at different stages of treatments.
- Cancer Patients (General)
- Cancer Patients Undergoing Intensive Treatment (Chemotherapy, Radiation, Surgery)
- Malnourished or Hyper-metabolic Patients
2. Macronutrient Breakdown
- Protein: Supports tissue repair, immune function, and muscle maintenance.
- Carbohydrates: Primary energy source; focus on whole grains, fruits, and vegetables.
- Fats: Healthy fats (omega-3s from fish, nuts, seeds, and olive oil) help with inflammation control and sustained energy.
3. Special Considerations
- Low Appetite or Early Satiety: Eat small, frequent, nutrient-dense meals.
- Digestive Issues (Nausea, Diarrhea, or Constipation): Adjust fiber intake and hydration.
- Fatigue & Weakness: Ensure adequate calorie and protein intake to prevent malnutrition.
- Stay Physically Active: Mild exercise can help in lowering inflammation keep blood circulations running smoothly.
- Limit Alcohol: Excessive alcohol intake can increase cancer risk.
What is Cancer Cachexia?
Cancer cachexia is a severe, unintentional weight loss syndrome characterized by muscle wasting, fat loss, and metabolic changes. It occurs in up to 80% of advanced cancer patients and contributes to increased fatigue, weakness, poor treatment response, and reduced survival rates
1. Causes of Cancer Cachexia
Cancer triggers metabolic and inflammatory changes that lead to muscle and fat breakdown:
- Increased Metabolic Rate: Cancer cells consume large amounts of energy.
- Inflammation: Tumor-related cytokines (TNF-α, IL-6) promote muscle breakdown.
- Loss of Appetite (Anorexia): Treatment side effects like nausea, taste changes, and depression reduce food intake.
- Hormonal Imbalance: Changes in insulin, cortisol, and leptin contribute to muscle wasting.
  
  cancer cachexia
  source: thelancet.com/journals/lanonc/article/PIIS1470-2045(11)70113-9/abstract
2. Stages of Cachexia
- Pre-cachexia: Small weight loss (<5%), early appetite loss, and metabolic changes.
- Cachexia: Weight loss >5% with muscle wasting, weakness, and reduced food intake.
- Refractory Cachexia: Severe weight loss with little response to nutrition or treatment, often in end-stage cancer.
3. Management of Cancer Cachexia
Since cachexia is not just due to low food intake but also increased metabolism and inflammation, a multi-targeted approach is required:
A. Nutritional Strategies
- High-Calorie, Protein-Rich Diet:
  - Protein: daily adequate & good quality protein intake.
  - Calories: meet everyday energy need with nutritious foods.
  - Frequent, Small Meals: Helps increase intake despite low appetite.
- Oral Nutritional Supplements (ONS):
- High-protein shakes boost energy & nutrients.
- Omega-3 Fatty Acids
- Multivitamins & multi-minerals
B. Pharmacological & Supportive Therapies
- Anti-inflammatory Drugs: May help counteract cytokine-induced wasting.
- Anabolic Steroids or Hormone Therapy: Considered in severe muscle loss cases.
4. Prognosis & Importance of Early Intervention
- Cachexia is associated with poor survival rates and reduced treatment tolerance.
- Early intervention with nutrition therapy, medication, and exercise can improve quality of life and outcomes.
Nutrition plays crucial part through the journey of Cancer treatment and management of cancer. So, be conscious about your nutrition in life & stay tuned for our next blog regarding health and nutrition.