Nutritional Support During Lung Cancer Treatment

Registered dietitian nutritionists (RDNs) can guide cancer patients with lung cancer through diet and dietary supplements. These nutrients can help people stay strong and healthy through their treatment.

Researchers analyzed clinical data of 182 patients who had undergone surgery for lung cancer. They compared general nutritional indices and hematological indicators before and after surgery.

Individualized Dietary Assessment

A nutrition assessment involves reviewing your current eating patterns and understanding what nutrients are in your diet. This can be done by a nutritionist, dietitian or by using online tools.

Nutritional assessments can include weighing food diaries, paper-based FFQ or telephone or in-person administered 24 h recalls( Reference Subar, Kirkpatrick and Mittl 38 ). New technology-based methods are becoming available which provide quick and easy assessment of dietary intake, with some evidence of being more effective than traditional instruments for personalised diet feedback( Reference Springvloet, Lechner and de Vries 17 )

Lung cancer patients experience a high level of symptoms which impact their dietary intake, leading to malnutrition that can impact treatment completion, quality of life and survival. Emerging research on nutrition interventions in lung cancer patients shows promise including intensive individualized dietary counseling and fish oil supplementation.

Maintaining Adequate Caloric Intake

Lung cancer treatments often affect a patient’s ability to eat and consume food. Nausea, loss of appetite and difficulty swallowing are common side effects of lung cancer treatment that increase the risk of malnutrition.

A nutritionally adequate diet can help maintain weight, strength and a positive outlook during cancer treatment. A Registered Dietitian can help patients plan a nutritious diet.

In one study, cancer patients who ate more vegetables and fruits experienced less nausea, mouth or throat pain, fatigue and chest, arm or shoulder pain than those who ate fewer of these foods. Patients with cancer should aim for 5 servings of fruits and vegetables a day, whether fresh, canned or frozen. Vegetables and fruits are low in fat and provide important vitamins, minerals and fiber. They also help prevent constipation and promote regularity, and may aid in digestion.

Protein-Rich Diet for Muscle Preservation

Protein provides the building blocks for muscle growth. General guidelines recommend that adults consume 10% to 35% of their calories from protein.5 Protein can be found in many foods including meat, dairy, fish, nuts, and beans.

The type of protein consumed is important to maximize muscle growth. Animal products such as chicken, beef and dairy are considered ‘complete proteins,’ meaning that they provide all of the essential amino acids necessary for body function. Vegetable proteins, like beans, peas and nuts, are also ‘complete’ proteins.

Lung cancer patients often experience symptoms that negatively impact their nutritional intake, such as decreased appetite (anorexia), and early sense of fullness when eating (early satiety). Incorporating a high-protein diet, rich in the right nutrients, can improve strength, maintain muscle mass, and protect quality of life throughout treatment.

Hydration and Fluid Balance

Many patients with lung cancer experience a reduced appetite or early sense of fullness (anorexia), nausea, vomiting and/or oral difficulties including pain, loss of taste, dry mouth and difficulty chewing. This can significantly limit a patient’s ability to meet nutrition needs, increasing their risk for malnutrition and complications during treatment.

Dehydration can also be a serious problem for cancer patients. It can reduce the body’s ability to function normally, so it’s important to encourage fluid intake throughout the day. For patients who find water unpalatable, flavored waters or adding lemon or orange slices can help. Moist foods like soup, yogurt, jello and pudding can be helpful as well.

If a patient isn’t meeting their nutrition needs through diet alone, a registered dietitian nutritionist may recommend enteral nutritional support such as tube feeding or parenteral nutrition. Enteral nutrition can be delivered through a nasogastric tube (tube down the throat into the stomach or small intestine) or through the vein, through a central line or intravenous fluid.

Nutrient-Dense Foods and Supplements

Nutrients supplied with food provide building materials (proteins, minerals), energy (lipids and carbohydrates), and regulating factors (vitamins and some macro- and micronutrients). An adequately balanced diet can support the body during cancer treatment.

A healthful approach to eating is to focus on naturally nutrient-dense foods that offer beneficial nutrients with relatively few calories. This means choosing foods packed with vitamins, minerals, and phytochemicals while being low in things like salt, added sugar, and saturated fat.

Plant-based foods that are nutrient-dense include leafy vegetables, fruits, whole grains, legumes, and nuts and seeds. These foods provide a rich source of antioxidants, fiber, vitamins and minerals, and protein. Lean animal proteins are also nutrient-dense, especially when they come from grass-fed sources. Aim to choose a variety of these foods throughout the day. The Nutrition Facts labels can help you identify nutrient-dense packaged foods.

Collaboration with a Registered Dietitian

Lung cancer and its treatment can cause symptoms that interfere with the body’s ability to eat and absorb nutrients. Cancer-related fatigue, nausea, loss of appetite, esophagitis (abnormal inflammation of the esophagus) and mouth or chest pain can limit food intake. These nutrition impact symptoms place lung cancer patients at an increased risk for malnutrition.

To help reduce malnutrition and improve symptom management, the medical team may work with an RDN or a board-certified specialist in oncology nutrition (CSO). A CSO has additional training and education in how cancer and its treatment can affect a patient’s diet. They are also experienced in developing individualized nutrition care plans and using a variety of feeding strategies. They can offer tips to encourage a healthy diet, including encouraging small, frequent meals and snacks throughout the day and consuming foods that are high in calories and protein. They can also provide information about dietary supplements.