Cancer Related Wasting Syndrome
Cancer cells produce biochemicals, called cachexins, which circulate in your blood and cause fatigue, loss of appetite(anorexia) and general wasting of muscle. Technically up to half of all cancer patients die of malnutrition, not catastrophic complications from the cancer. This is an even bigger problem in ovarian cancer because the intestine itself is attacked by tumor implants which mechanically interferes with nutritional support. Avoiding protein-calorie malnutrition is critical to immune function, which is also compromised in cancer patients.Indicators of Nutritional Status
Society is pre-occupied with weight as a measure of health. The problem is that your total weight is largely based on water weight. Aside from staying away from crash fad diets that produce rapid weight loss from dehydration, the part you can influence the most is your fat and muscle. An individual may not be overweight but have too high of a fat percentage to be healthy. This is especially important for nutritional management in cancer and ovarian cancer in particular.Weight is a particularly poor indicator of nutritional status in ovarian cancer. Weight gain can be related to fluid retention in your abdomen(ascites) and tissue edema (swelling), but in fact you may be in a severe state of protein-calorie malnutrition with wasting of muscles and low proteins circulating in your blood stream. Circulating proteins support your immune system in a number of ways, so this is not a good situation when you're facing cancer treatment.
In the worst case, but all too typical, scenario an average American who is often too fat already comes in with suspected ovarian cancer and rapid weight GAIN due to ascites and edema. Meanwhile, due to anorexia and diminished food intake, along with suboptimal exercise, the muscle and other protein stores have been wasting away, along with your immune system. It gets worse. If you're older, say over 50 years of age, your protein stores were markedly decreased to start with. Even worse, during stress response, like cancer, protein degradation is substantially increased. If this resembles the road you came in on, we've got a lot of work to do!
Rapid Malnutrition Reversal Plan
First order of business is to regain some appetite. The best bets are Marinol, which is a medical marijuana extract, or Megace, a synthetic female hormone. But by itself, an increased appetite is not enough.What you eat counts, before, during and after treatment. Taking on calories is important,but concentrate on protein intake. The standard recommended protein intake for a healthy woman is about 0.8 grams for every kilogram(2.2 pounds) of body weight. In the face of malnutrition, it is recommended that you amp that up to about 1.2 grams per kilogram just to maintain. Be careful, you can't go too far or you CAN overdose and literally poison your body. So, make sure you stay hydrated, even though there is an abnormal fluid accumulation in your abdomen (ascites).
Excellent protein sources include skinned chicken, lean red meat,and fish, especially cold water fish such as salmon. In addition, go to your health food store and buy some powdered whey protein to make protein shakes.
Supplement your diet with Omega-3 fatty acids, which can be found in both fish and flax seed oil. There is more evidence on the fish oil, and encouraging research has been done. These fatty acids act as natural anti-inflammatory agents which reduce some of the cachexin induced protein wasting biochemical cascades.
One of the challenges is taking in enough food to meet requirements. That is obviously hard to do in the face of nausea and poor appetite. Consider taking anti-nausea medications which your doctor will be prescribing during chemo. These include Kytril(granisetron), Zofran (ondansetron), Anzemet (dolasteron), and Emend (aprepitant). Take them as directed, but before eating.
Timing and volume of your meals may need to be adjusted. Consider taking in a small amount of food and fluids all day long as opposed to three square meals. This may mean more food in a soft or fluid state, like protein shakes and vegetable juices like V-8.
Finally, although you are likely fatigued, get some moral support and exercise as much as possible. Especially resistance exercises (weight lifting or isometrics) force the muscle to maintain mass. You do not have to go to the gym for this. Improvise using inexpensive aids like elastic rubber training bands and ankle or wrist weights. The data on this is clear: Patients who exercise live longer.
