Cancer Patients and Lactose Intolerance

Unfortunately, cancer and its treatments produce a wide variety of aftereffects in its sufferers.

A report on the nbc30.com website, was reviewed by William McGee, M.D., M.H.A., Assistant Professor of Medicine and Surgery, Tufts University School of Medicine, Boston, MA, and Director ICU Quality Improvement, Critical Care Division, Baystate Medical Center, Springfield, MA.

People with cancer are at risk for developing nutritional deficiencies. The deficiencies may be the result of the cancer itself, or the side effects of common cancer treatments such as surgery, chemotherapy , and radiation therapy .

Malignancies directly compromise nutritional status by altering metabolism and causing loss of appetite . Changes in metabolism include an increased basal metabolic rate and increased spending of energy. This increase in energy use means you'll require more calories to maintain your current weight and lean body mass.

There are also individual alterations in carbohydrate , protein , and fat metabolism. These changes lead to the loss of muscle and fat stores. Cancer-associated loss of appetite is probably the result of physical changes but may also be due to a psychological response to the disease.

There are several factors that may contribute to the type and degree of nutrient deficiencies:

• The primary organ where the malignancy occurs
• The severity of the cancer at the time of diagnosis
• The symptoms experienced by the person with cancer
• The type and frequency of the cancer treatment being used and the side effects associated with that treatment (surgery, radiation, or chemotherapy)
• The effect of the malignancy or disease on food and nutrient ingestion, tolerance, and utilization

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BODY WEIGHT LOSS AND MUSCLE WASTING

• Increase protein and calories in the diet.
• Eat smaller, but more frequent meals.
• Add powdered milk to foods and beverages.
• Drink mainly calorie-containing beverages such as juices, milk, or sweetened drinks.
• Add extra eggs or egg whites to foods. Never use raw eggs! They may contain salmonella, which would be dangerous for a person who is immune-suppressed. Raw eggs also contain a vitamin binder.
• Add diced meat or cheese to sauces, vegetables, soups, and casseroles.
• Snack throughout the day on calorie-dense foods such as nuts, hard candy, and dried fruits.
• Consider using commercially available nutrition supplements.
• Make your own high-calorie shake by using an instant breakfast drink mix with milk, fruit, cookies, peanut butter, or other favorite mixers.
• Increasing fats in the diet is an excellent way to increase energy consumption, if you are tolerating fats. Add margarine or butter to breads and vegetables. Add gravies and sauces to foods in liberal amounts.

If you are unable to digest fat, consult with your physician or dietitian for alternative fat sources. Supplements containing medium-chain triglycerides are often recommended for this purpose.

LACTOSE INTOLERANCE

Some cancer patients become unable to digest dairy products, which is called lactose intolerance . Symptoms include bloating, gas, and diarrhea immediately after eating lactose-containing foods.

People with lactose intolerance have trouble digesting the sugar in milk. Lactose intolerance is due to an inability to produce lactase, the enzyme that digests milk. The wall of the gastrointestinal tract produces this enzyme. Fortunately, lactase can be synthetically produced, purchased over-the-counter, or can be taken orally with milk.

You can also buy lactose-free milk at most grocery stores. Cultured dairy products such as yogurt, cheeses, and buttermilk will have less lactose as the active cultures help to digest it. You may be able to tolerate small amounts of lactose occasionally. You may have to restrict lactose entirely from the diet until you have fully recovered from your cancer therapy.