According to the specialist, when it comes to oncology patients, especially those undergoing intensive treatment, it is not always possible to achieve an ideal health-friendly nutrition model.
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“The main task is to avoid malnutrition. We try to adapt food and nutrition as much as possible according to the person’s situation,” says I. Rupšienė.
Now is not the time for ideal nutrition
According to the interviewee, the ability of a person with cancer to eat often varies. It can depend both on the disease itself and on its location and the treatment applied. Due to the effects of medications or symptoms of the disease, the patient may have no appetite, may feel nauseous, have the urge to vomit, or experience other digestive disorders. Mouth or gastrointestinal tract damage and swallowing difficulties are also common.
According to the dietitian, if a person tolerates food well and can eat practically all products, it is worth aiming for as varied and higher quality nutrition as possible – to get proteins, carbohydrates, fats, fibers, and other necessary substances.
The situation changes if the patient can hardly eat due to treatment or illness. “Then we look not so much at ideal health-friendly nutrition, but at what the person can eat, what tastes good to them, what does not make them nauseous, and what they can chew,” explains the interviewee.
In such cases, the consistency, temperature, and portion size of the food may be changed. If swallowing is difficult, solid food may need to be replaced with pureed or soft food. If the throat is irritated, hot food may not be suitable, and instead of three large meals a day, it may be easier to eat more often in small portions.
“Better little by little. We look for the texture that suits the person and cooperate with the patient,” says I. Rupšienė.
When regular food is not enough, specialists may recommend special medical-purpose oral mixtures enriched with proteins, vitamins, and minerals.
Proteins are especially important
Although when talking about nutrition it is common to single out one “most important” product or nutrient, I. Rupšienė emphasizes that a balanced diet primarily means variety.
“Does this mean we should eat only proteins and forget carbohydrates and fats? Definitely not,” notes the dietitian.
However, proteins become particularly significant for oncology patients. They help maintain muscle mass, are important for body recovery, the immune system, tissue, and wound healing.
According to the dietitian, depending on the patient’s condition, a higher protein intake may be recommended. It is important to know that specific needs must be assessed individually and only with the permission and supervision of the treating physician.
“If the patient has various wounds, a lot of protein is also used for their healing,” adds the interviewee.
She emphasizes that nutrition cannot be limited to proteins alone. Carbohydrates and fats are also necessary, and their sources and fiber content must be selected considering the specific disease and the condition of the digestive system.
Weight loss? That’s a signal not to wait
According to her, one of the most important signs that a person may already be lacking nutrients is unplanned weight loss.
“Sudden weight loss is already a very big warning that a consultation with a dietitian doctor is definitely needed,” emphasizes I. Rupšienė.
According to her, one should not wait until the weight drops significantly. Relatives often notice first that the patient starts eating much less, skips meals, or can no longer eat the usual portion. It is already worth telling the treating doctor and their team about this. Specialists can assess the person’s condition, perform necessary tests, adjust nutrition, or, if needed, prescribe additional medical nutrition.
“If we see that the person starts eating less, it is really highly recommended to consult. It is important to notice the body’s exhaustion due to lack of nutrients in time,” says the dietitian.
Food supplements should not be taken independently
Sick people often start looking for additional means that could strengthen the body: vitamins, minerals, omega-3 fatty acids, herbs, or other natural preparations.
This is not bad, but according to I. Rupšienė, one of the most important rules is not to take them secretly from the doctor. “What I definitely would not recommend a patient to do on their own is self-medication and not telling the doctor that the person is taking one or another supplement,” says the specialist.
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The reason is simple but very important: some supplements or herbal preparations can interact with medications prescribed for treatment.
The doctor evaluates how the patient’s body reacts to the prescribed treatment, so not knowing about additional substances taken can lead to unexpected changes.
“Even a ‘harmless’ herb or preparation that seems completely innocent can interact with treatment and distort the picture,” warns the dietitian.
This does not mean that all supplements are forbidden for cancer patients. One patient may lack certain substances and their supplementation may be beneficial, while for another, due to specific treatment, the same preparation may not be suitable. Therefore, decisions should be made together with the doctor and other specialists involved in the patient’s care.
“Sugar feeds cancer” – an overly simplified view
When diagnosed with a serious illness, it is natural to try to understand why it occurred or to look for a remedy that would help heal. This leads to many myths related to cancer and nutrition. “A person needs to find a scapegoat, someone to blame, or a miracle cure that would suddenly fix everything. Unfortunately, that is not the case,” says I. Rupšienė.
One of the most common beliefs is that a person with cancer should completely give up sugar. The dietitian emphasizes that it is worth limiting added sugar intake both for healthy and sick people. However, this does not mean that naturally occurring sugars, for example in fruits, should be avoided.
“Does this now mean that a person with cancer cannot eat a pear or a banana because they contain glucose? We must distinguish added sugar from natural sugar,” she explains.
Sweetened drinks consumed in large amounts daily and heavily processed products are not the basis of a healthy diet, but no single product can be declared the main culprit of cancer.
“The human body is very complex. We cannot say that one product or one habit always causes cancer,” says the dietitian.
Is it beneficial to give up milk and meat?
Another common myth is related to dairy products. According to the interviewee, there is definitely no reason for all cancer patients to automatically give them up. If a person tolerates dairy products, they can be one of the protein sources – and during treatment, an adequate protein intake can be especially important.
The same principle applies to meat. Nutrition should not be based solely on red meat; its amount should be limited, but completely eliminating one food group is not always the most beneficial solution for the patient.
“As I mentioned, cancer patients really need proteins and iron. If a person can tolerate and eat a certain product, sometimes the situation needs to be viewed differently,” says I. Rupšienė.
Fasting during treatment – a risky choice
Another method spreading among patients is various fasting schemes. However, the dietitian views this very cautiously, especially when the person is already undergoing active cancer treatment.
“Our main goal is to maintain weight, maintain muscle mass, and protect against malnutrition. Therefore, for fasting, especially during treatment, I definitely say no,” she says.
She reminded that the body undergoing heavy treatment needs energy and nutrients. “And if we fast and do not provide the body with fuel and nutrients, it can become exhausted. It may be harder for the person to tolerate treatment because they do not get enough nutrients and calories,” explains the dietitian.
Therefore, attempts to independently apply strict dietary regimens during treatment may contradict one of the main goals – to preserve the patient’s nutritional status and muscle mass.
The most important thing is to eat as much as possible
What is the one most important piece of advice I. Rupšienė would give to a person facing cancer? According to her, the most important thing is to avoid malnutrition: “That means eating as much as possible, and when possible.”
During treatment, she says, one should not burden oneself with unfounded prohibitions – categorically cutting out sugar, milk, meat, or fasting just because such advice was read online. It is much more important to monitor whether appetite is decreasing, whether weight is dropping, whether the person is getting energy and enough protein, and to tell the doctors about difficulties in time.
Equally important, according to the interviewee, is the patient’s own involvement in the treatment process. “A person can contribute a lot. With any disease, it is possible to be active and not underestimate oneself, thinking that now nothing can be done. Cooperation with the treatment staff is really very important,” emphasizes I. Rupšienė.
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