Malnutrition and cancer

Wednesday 4 December, 2013

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On this page: What is malnutrition?  ι Why are cancer patients at risk of malnutrition?  ι How do you know if you are malnourished?   ι Why is malnutrition a problem in cancer patients?   ι How can malnutrition be prevented or managed? ι Further information 


What is malnutrition?

Malnutrition in people with cancer occurs when you are eating less energy and protein than the amount your body needs. This can lead to unplanned weight loss and a reduction in body fat and muscle.
Compared to the rest of the population, people with cancer are at a higher risk of malnutrition. It is important to prevent malnutrition or identify it early, as malnutrition can affect how your body responds to your cancer treatment and your recovery.

Why are cancer patients at risk of malnutrition?

Many factors can increase the risk of malnutrition when you have cancer, including:

  • The cancer itself and the part of the body involved. If the cancer involves the head and neck or gastrointestinal areas (including stomach and bowel) it may be more difficult to swallow and digest food
  • Cancer treatments such as chemotherapy, radiotherapy and surgery can increase your energy and protein needs
  • Side effects from cancer treatment may make it more difficult to eat
  • Being unwell in hospital
  • Stress and anxiety
  • Fatigue and loss of energy. 

How do you know if you are malnourished?

Sometimes it is difficult to know if you are malnourished and changes in food intake and activity can be mistaken for other factors. Some signs to look out for include:

  • Eating less than usual, feeling full quickly or not eating between meals
  • Even a small drop in your weight (3 or 4 kg) without trying can put you at risk of being malnourished. It is possible to be malnourished even if you are overweight
  • Reduced physical performance, such as not being able to walk as fast or far as usual.

The diagram below shows some factors that contribute to malnutrition. These can also be signs that you have or are at risk of malnutrition.

Malnutrition: pain or dryness in your mouth or throat, difficulty chewing or swallowing, taste changes, weight loss, diarrhoea or constipation, nausea and vomiting, poor appetite, fatigue, feeling full quickly

Why is malnutrition a problem in cancer patients?

Malnutrition can lead to a reduced response to cancer treatments, increased side effects and possibly reduced survival. It can increase your risk of infection and the time you spend in hospital. Malnutrition can also reduce your strength and quality of life.  

Even if you are overweight, losing weight during your cancer treatment and recovery can increase your risk of malnutrition. Eating well is therefore very important for your health before, during and after cancer treatments.

How can malnutrition be prevented or managed?

Malnutrition and weight loss can usually be prevented. It should not be considered an expected side effect from cancer or treatments. Your doctor or nurse will regularly ask you questions about your weight and appetite to check your risk of malnutrition. A dietitian can determine whether you have malnutrition. They can work with you to ensure you are following an appropriate and balanced diet, and aim to avoid or minimise weight loss. Your dietitian may suggest some dietary changes and provide you with information on:

  • A diet high in energy (kilojoules/calories) and protein
  • Nourishing drinks including milk drinks
  • Smaller and more frequent meals
  • Different foods that may be easier to chew or swallow
  • Nutritional supplement drinks.

There are no special diets or foods to include or avoid when you have cancer. It is important to ensure you include foods from all food groups. Your dietitian may suggest less focus on including lots of fruits and vegetables and recommend eating more snack foods, desserts, full cream dairy foods and eggs. These foods can help you meet your energy and protein needs. This may be quite different to your normal eating patterns.

In some situations, it is not possible to meet your nutritional needs through eating alone. Your dietitian and doctor may recommend the use of a feeding tube or intravenous nutrition to help.

It is important to let your doctor, dietitian or pharmacist know if you are taking any nutrition, vitamin or herbal supplements as they can sometimes interact with cancer treatments and medications.


Further information

An Accredited Practising Dietitian (APD) can provide you with further information and advice on preventing or managing malnutrition. A referral can be made through your doctor or health service. The Dietitians Association of Australia can direct you to an APD in your local area.


Dietitians Association of Australia

Ph: 1800 812 942
Website: www.daa.asn.au

Cancer Council Victoria

Call a cancer nurse - 13 11 20
Website: www.cancervic.org.au
Cancer Council Victoria has some useful information booklets and factsheets about nutrition and cancer. These resources, including this factsheet, can be found on the website or by contacting the Cancer Council Helpline on 13 11 20. This is a confidential service staffed by cancer nurses.


Reviewed by: Jenelle Loeliger, Head - Nutrition Department, Peter MacCallum Cancer Centre; Kathryn Marshall, Senior Project Dietitian, Peter MacCallum Cancer Centre; Lauren Muir, Clinical Dietitian, Peter MacCallum Cancer Centre
Updated: 04 Dec, 2013