Nutrition and the Cancer Patient For many patients with cancer, receiving an appropriate diet can become a problem. Initially, patients may experience cachexia resulting from abnormal metabolic pathways that shift nutritional supplements from the patient to the tumor. In addition, patient's with cancer of the head and neck or of the gastrointestinal tract, can suffer a decrease in their diet due to inadequate ingestion, digestion, and absorption. In the pre-operative and post-operative period, patients may receive treatment such as chemotherapy or radiotherapy that can alter their ability to receive needed supplements. Cancer cachexia, is a condition that results when patients suffer intractable anorexia and weight loss. Not all tumors produce the same proportion of cachexia. Physical and metabolic characteristics of cachexia are tissue wasting, skeletal muscle atrophy, myopathy, anergy, anemia, and glucose intolerance. Patients may also be unable to absorb and process nutrients adequately. Prior to having an operation, patients may require adjuvant treatment such as chemotherapy or radiotherapy to make the tumor accessible for adequate resection. Medical or radiation oncologists may ask that the patient receive additional nutritional support during treatments. Placement of a percutaneous endoscopic gastrostomy (PEG) tube offer patients a means of receiving liquid supplements, such as Ensure or Sustacal, through a feeding tube that enters the stomach through the abdominal wall. Patients undergoing operations of the head and neck may receive a PEG tube at the time of surgery to assist with feeding post-operatively. Many patients are sent home with their feeding tube in place until they can receive adequate nutrition orally. Using the PEG Tube There are several methods of introducing a liquid diet through the PEG tube. These are syringe, pump and gravity bag. Most often patients are provided with a syringe. After using the PEG tube, it is important to flush the line with tap water. This helps in maintaining the patency of the PEG tube. When administering fluid through the PEG tube, the patient must be sitting upright at 45 to 60 degrees during the feeding and for one hour after each feeding. This will help to avoid regurgitation. Maintenance of the PEG Tube. The PEG tube is kept in place by a collar that rests against the abdominal wall. This collar must be kept snug against the abdomen to prevent leaking. Keep the surrounding skin dry to prevent a rash or fungal infection. If the surrounding skin becomes red or inflamed, consult your physician. Coca-Cola can be used to maintain the patency of the tube. In the event that the tube becomes occluded, inject Coca-Cola through the tube. High Calorie Beverage Recipes In addition to over-the-counter supplements such as Ensure or Sustacal, there are high-calorie shakes that can be easily made at home. The following recipes may be given through the feeding tube, or taken orally to supplement the patient's diet. "Double Strength" Milk- drink as is for a beverage or use in recipes in place of regular milk.
High Calorie High Protein Milkshakes - a delicious basic shake to which your favorite ingredients can be added. Try new ones often to keep it interesting.
Sherbert Shake - a "lighter" shake. Keep calories high even if your tolerance for lactose is low. For a low lactose version, make with Lact-aidŽ milk.
If you have any questions about your diet, please contact the surgical oncology office.
|