Proper nutrition is an essential component of any cancer treatment plan. In the oncology patient, adequate nutritional status has a proven positive impact on clinical outcomes and patient quality of life. Consequently, early intervention by a Registered Dietitian Nutritionist (RDN) is crucial and can make a significant difference, especially for those at the highest risk of malnutrition.
Respiratory cancer places incredible demands on the body. Cancer is a hypermetabolic disease process, which means cancer patients almost always have increased calorie and protein needs. What is mesothelioma cancer? Mesothelioma is a rare group of cancers typically caused by exposure to asbestos. Those with a mesothelioma diagnosis usually have a poor prognosis due to the latency of the illness. In simple terms, these individuals are fighting hard, and they need to fuel appropriately to withstand the fight.
However, it is often not just as easy as eating more and calling it a day. The heightened calorie and protein needs of a person with mesothelioma can be very difficult to meet because many of the side effects of cancer and cancer treatment have direct nutritional implications.
That’s when the Registered Dietitian steps in to help. RDNs are trained to provide individualized, evidence-based medical nutrition therapy, which can significantly improve (and in some cases even eliminate) cancer-related nutritional problems. Oncology is so closely related to the field of Dietetics that RDNs can obtain board certification as a specialist in oncology nutrition, known as the CSO.
Here are five ways that Registered Dietitians can help people with respiratory cancers such as mesothelioma:
Lack of appetite is a common symptom of cancer and cancer treatment. The causes can be multifactorial in nature, and the severity of the lack of appetite can range from mild to severe. Luckily, the RDN is trained in coming up methods to provide adequate nutrition in ways that do not cause any discomfort.
Most RDNs have plenty of tricks up their sleeves and are filled with suggestions on how to bulk up the calories and protein of a meal without increasing the volume. RDNs may also have suggestions regarding meal frequency. Many individuals do better with smaller, more frequent meals. This is especially true for those actively experiencing respiratory symptoms such as shortness of breath.
Food aversions are also common in cancer and cancer treatment. What used to taste good may no longer seem palatable, and these individuals may struggle to find something they can tolerate. The RDN can help the individual come up with alternate choices that are nutritionally sound but still appealing to the patient.
As many of these food aversions seen in the oncology setting are common side effects of the treatments, the RDN is also able to educate the patient on the pathophysiology and suspected duration of the aversion. Most are temporary, and educating the patient on this can bring them a sense of relief.
The RDN is an expert at assessing all aspects of the patient’s nutritional status and, if necessary, will recommend a specific therapeutic diet or feeding regimen that best aligns with their medical history, nutritional needs, and functional status. Some examples of commonly prescribed therapeutic diets include high calorie diets for weight gain, heart healthy diets for cardiac comorbidities, renal diets for impaired kidney function, diabetic diets for blood sugar control, and modified consistency diets for impaired chewing/swallowing.
RDNs are also experts at alternate forms of nutrition such as tube feedings (enteral nutrition) and intravenous feedings (parenteral nutrition). If eating by mouth is not possible, the RDN will calculate the appropriate feeding regimen based on all pertinent assessment data.
Many individuals working with RDNs benefit from nutritional supplementation. RDNs can recommend specific vitamins, minerals, herbs, and oral supplements that may bolster the patients’ nutritional status.
The RDN provides thorough education on the efficacy of the supplements at hand to help the patient make an informed decision regarding beginning supplements. On the flipside, RDNs may also educate patient on specific supplements to avoid if the patient is taking any medications that may interact with the supplement.
As a member of the cancer care team, the RDN may recommend that the doctor prescribe a specific medication to help manage a nutrition problem. While prescribing medication is not within the dietitians’ scope of practice, RDNs suggesting certain medications based on evidence-based research is welcomed in the clinical world. Some examples of nutritionally-relevant medications include appetite stimulants, antiemetics for nausea/vomiting, bowel medications for constipation or diarrhea, iv fluids for hydration, and more.
RDNs are also trained to analyze lab values and may make recommendations based on the most recent lab work. For example, if a patient has lab values suggesting anemia, the RDN would recommend iron supplementation. The dietitian also may order specific labs to be drawn for assessment purposes, such as serum electrolytes, a lipid panel, iron panel, blood glucose, etc.
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Our team of authors collaborates with the advocate team, focusing on writing about asbestos exposure and mesothelioma to spread awareness. They are dedicated to supporting families within the mesothelioma community.