20-80% cancer patients are malnourished Are you?

I came across this report to-day.
ABSTRACT: Critical Evaluation of Nutrition Screening Tools Recommended for Oncology Patients
[Cancer Nursing; Subscribe; Sample]

Malnutrition ranges from 20% to 80% in oncology patients. Malnutrition has been associated with reduced response to treatment, survival, and quality of life. Therefore, screening for malnutrition in patients with cancer is recommended by clinical practice groups including the Oncology Nursing Society. Nurses are in an ideal position to carry out nutrition screening. Three nutrition screening tools that have been recommended for use with oncology patients by the Oncology Nursing Society are critically evaluated. The Patient Generated-Subjective Global Assessment (PGSGA) has demonstrated diagnostic value in oncology patients at risk of malnutrition or who are malnourished.

So I then searched on the PGSGA and found you can do it online. For any of you who want to explore this and to discuss the result with a nutritionist/dietician check this out. medicine.nevada.edu/nerp/pgsga.html

It calculates your BMI, basal and energy expenditure in kcal. and this is then adjusted for cancer diagnosis and gives a nutritional status score and advice whether nutritional intervention is required.

Wishing you well and fighting fit whatever your stage,

Jenny

Certainly if you stayed in hospital and ate hospital food for any length of time I can’t see how you could be nourished enough to recover from anything.

No I’m not malnourished thanks! I am actually taking part in a survey of food issues and cancer in stage 4 pateints…conducted through Southampton Uni/Macmillan. Had a great interview a couple of months back.

Enjoying my delicious varied diet as ever.

Jane

Levels of malnurishment WILL vary dramatically among cancer patients. Some never understood what a healthy diet was in the first place. Some live alone and get too ill to look after themselves. Some because of a reduced income simply cannot afford to eat so well any more.

At the other end of the scale, some are stay at home women, still relatively fit and active, with a high family income who can spend hours cooking stuff from their organic fruit and veg boxes.
using their juicers and sprouting seeds. They are the lucky ones and I mean them no offence.

I got malnurished during a long stay in hospital! The food on offer was largely cheap stodge with a low protein content and I lost weight and muscle rapidly. I made a formal complaint to the catering manager who said that as I was a long stay patient, I could have an enlarged choice by picking from the staff menu as well, but the nursing staff were not very accommodating in finding out what was available and getting it for me. I asked if I could order in takeaways and that didn’t suit the nurses either.

Also got malnurished and lost weight during the period I had undiagnosed liver mets (radiologist who did the CT scan missed them) and kept vomiting. Was put on Ensure Plus drinks (oh yes, there are dairy products in them, so some wouldn’t approve) as a supplement and these helped.

Think my diet is currently quite healthy and fulfills usual requirements about protein, 5 servings of fruit and veg, low fat and a normal amount of carbohydrate (wish I had less of a sweet tooth though). My weight is stable again.

Will resort to convenience foods if too tired to cook from scratch (there are days when I find it difficult to get out of bed). Internet shopping and home deliveries from local Indian, Chinese and Thai restaurants can be a godsend sometimes.

Have reduced my alcohol intake drastically because of the liver mets - if for no other reason, now get tipsy too quickly.

jennyw,

My post was not intended to shut everyone up!

I truly believe that if we find answers to to some of the problems connected with the nutrition of breast cancer patients, it will do much to improve quality of life and survival.

I also happen to believe that discussions of the social and financial reasons for malnutrition are much more important that discussions about whether or not it is useful to go dairy-free, vegan, eat or not eat phytoestrogens etc. Macmillan are also concerned about the effects of poverty on the health of long term cancer patients.

Holey.

when you are on benefits, especially when you are single, healthy eating isn’t always an option. It is not a case of being able to chose whether to be dairy free etc but whether it will fill you up. The cheaper foods are full of fats - very filling so you need to buy less. Pre cooked foods just need reheating, saving on fuel. The effects of poverty on nutrition is well documented, when you add in the extra expense of cancer then it would be more amazing if people were not malnourished.
however, thank you jenny for the information, it was very useful. I am grateful.
but until we can address the root cause of malnutrician it really won’t make too much difference.

Hi, Holey - I’m not sure where you’re coming from… I posted the link on malnutrition so that people could check out their nutrition status online and discuss it with their medical team. I have no further comment adn wonder why you choose to take exception to information which I pass on in case it may improve someone’s outlook on their life by presenting real choices. I agree, Quisie that poverty is the biggest limit on nutrition and that the fact is that sugar and fat and dairy products are normally the cheapest choices to fill tummies. I’m single and lived on benefit for 4 years until last year. Fresh fruit and veg is overpriced and usually sold in ridiculously large bags and meat and fat and dairy produce is heavily subsidied. Shame on those who make the food policies - cheap food at any price? that’s been the govt.'s policy since the 1950’s and was the reason why as an ag. and food scientist I decided never to apply for a job in the civil service - the price of widespread nutritionally promoted degenerative diseases is too high a price to pay for junk food. I live on a low income in a very poor country in southern Europe, the poorest in the EU, excluding the new E. european members. Nutrition here has been based on bread, beans and spuds and rice and pasta and tomatoes (canned, pureed, whatever) with the occassional cheap fish (sardines - fresh or canned), for generations spiced up with lots of salt and onions and garlic. The basic diet has consisted of bread or oats for breakfast or lunch, (if lunch then a can of sardines shared between 2 and a chunk of bread has been the standby for labourers) and a mostly vegetable soup for dinner with the beans, spuds, pasta or rice thrown it. It’s alwasy been easier to get veg. in the country than in towns but each town and village still has its fresh produce market where you can buy food in one-off items - by weight. Till recently with the advent of cheap meat products and big supermarkets full of junk food the biggest health problem has been hypertension from too much salt. One of the healthiest meals we can eat cheaply and quickly is baked beans in tomato sauce on wholemeal toast, maybe spread with marmite for the vitamin B. You can also make a very small amount of green veg (if you can get it in small quantities and not all in big pre-packed bags) go a long way by chopping it up finely - any or all of…a bit of water cress or broccoli or cabbage, a few green beans, a few leaves of spinach, a handful of parsley, and throwing it into a tomato and onion and red pepper and garlic sauce for the last 5 minutes of cooking and then throw the sauce over a disk of pasta or potatoes or rice or beans. If you can get hold of some, you can sprout old fashioned mustard and cress in a saucer - put a folded piece of kitchen roll or kleenex type tissue on the saucer, wet it, sprinkle the seeds. Keep them in the dark but remember to water them once a day for 3-5 days then when they’re getting close to 1/2 to an inche tall, put them somewehr in the light and as soon as the leaves have turned green, you can cut them and add them to sandwiches, soups, salads. This cress gives you a huge number of vitamins and minerals and clever cancer fighting chemicals. Try it once a week? Try to get the 5-9 veg or fruit a day - it may be really boring if it’s always, say cabbage, tomatoes, onions, apples, bananas, oranges, but it is surprisingly nourishing. (since I’ve cut out all animalbased foods including dairy and lived only on plant based foods my food bills have gone down but my time in the kitchen has gone up and I’ve lost the excess weight I was humping around with me.) Except for the beans on toast, what I’ve written about takes quite an effort and when you’re feeling ill or low or depressed for reasons of cancer and poverty it’s really difficult to make the effort. Being realistic, that’s why I say try it maybe once a week and try and build up from there. One things for certain sure - no-one’s going to do it for you!

Wishing you well and whatever you eat, hope you thoroughly enjoy it.
Jenny : - )

Jennyw,

I think I am being misinterpreted!

Can I firstly say, I’m impressed with the amount of research you have done into dietary issues, even if we are not in agreement about Jane Plant! Yes, we do all have to make choices based upon very limited real research and, at the end of the day, our instincts about what is good for us. I think debate is always useful.

I’d like to see some real research done into the effects of dietary change and believe it should be done by the NHS. If food producers or manufacturers of food supplements do any research, there will be a suspicion of bias. The NHS will ultimately gain, if they can establish a few well accepted guidelines that will keep patients healthier. It puts more responsibility back onto the patient but also will give empowerment to them?

My reason for the post above, was that I thought you were registering surprise that so many cancer patients are malnurished while I found it unsurprising. Maybe I misinterpreted you?

Quisie has said that her low income makes her susceptible to malnutrition and I often feel too fatigued to food shop or cook, so we are actual examples of people who try but sometimes fail, to look after ourselves properly. For those who are malnurished most of the time (probably not quisie and me) I think this is a Social Services issue that should be addressed with some urgency.

Best wishes,

Holey.

Hi, Holey. No I’m not surprised or a stranger to too tired to even go to the kitchen at times let alone cook - a fruit bowl helped sometimes, after I’d given up chocolate bars! I just thought that an objective online calculator or malnourishment may help to raise awareness and encourage people to get help with their food, from friends and family or from the doc. or as you say, from social services and nursing groups too. We who are aware make an effort. I’m sure there are many poeple less aware than you and me and Quisie.

And I agree with you - if only the research were done about nutrition as vigorously as it is about drugs (RT and its effectsneeds more research too!) we’d all be better off. But this trial ucl.ac.uk/abc-research-group/home.htm that was posted, with access to patients treated by the NHS may provide some answers in 6 or 7 years time. Let’s hope so.

Perhaps these are 2 topics that could be raised in London on 24th??? Maybe there needs to be a group which just starts with needs assessment - dietary and nutritional advice AND SUPPORT! Advice is just hot air without the support.
Wishing you well,
Jenny