Abstract
Background: Cancer and its therapy is commonly associated with a variety of side effects that impact eating behaviors that reduce nutritional intake. This review will outline potential causes of chemotherapy and radiation damage as well as approaches for the amelioration of the side effects of cancer during therapy. Methods: Information for clinicians, patients, and their caregivers about toxicity mitigation including nausea reduction, damage to epithelial structures such as skin and mucosa, organ toxicity, and education is reviewed. Results: How to anticipate, reduce, and prevent some toxicities encountered during chemotherapy and radiation is detailed with the goal to improve eating behaviors. Strategies for health care professionals, caregivers, and patients to consider include (a) the reduction in nausea and vomiting, (b) decreasing damage to the mucosa, (c) avoiding a catabolic state and muscle wasting (sarcopenia), and (d) developing therapeutic alliances with patients, caregivers, and oncologists. Conclusions: Although the reduction of side effects involves anticipatory guidance and proactive team effort (e.g., forward observation, electronic interactions, patient reported outcomes), toxicity reduction can be satisfying for not only the patient, but everyone involved in cancer care.
Highlights
Cancer remains a major public health problem in North America [1,2,3] and world-wide with >10 million deaths/year attributable to cancer [4]
State-of-the-art cancer therapy utilizes advanced surgery and complex systemic treatments for this often life-threatening condition. Organizations such as the Multinational Association for Supportive Care in Cancer (MASCC), the European Society of Clinical Oncology (ESMO), the American Society of Clinical Oncology (ASCO), and the National Comprehensive Cancer Network (NCCN) have provided guidelines to help with information and education about chemotherapy and radiation induced mucositis, nausea and vomiting [14,15,16,17,18,19,20,21]
Ensuring that consultations are made with our allied health partners serves to promote regular physical activity and avoid deconditioning that so often accompanies chemotherapy and radiation therapy toxicity
Summary
Cancer remains a major public health problem in North America [1,2,3] and world-wide with >10 million deaths/year attributable to cancer [4]. Chemotherapy drugs (Table 1) and radiation (Table 2) affect cancer cells and normal tissue differently. One of the most common questions of cancer patients and caregivers is “what should I eat or drink to improve my situation?” [58] This topic is very important but sometimes relatively neglected because of many time-consuming tasks associated with accurately prescribing chemotherapeutics and radiation therapy accurately and on time [58,59,60,61,62,63,64,65]. Dietitians with oncology experience can provide tools and information to patients regarding food choices, eating behavior, and issues including poor oral intake and intermittent fasting when patients get chemotherapy and/or radiation [66,67,68]. Quality metrics in the hospital and oncology clinic can assist programs to achieve less toxicity and better resource utilization both routinely [81] and when efforts like TPN [49,82,83] and hospitalization [7,12] are utilized
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