Dr. Roach: Malnutrition a worry for cancer patients

Keith Roach
To Your Health

Dear Dr. Roach: I recently read that eight out of 10 cancer patients have malnutrition. My question is: Even if a person is very slim to begin with, if he or she follows an extremely healthful diet, can he or she still face malnutrition? What are its symptoms?


Dear P.M.: Malnutrition is defined as having two or more of: insufficient calorie intake to maintain weight; weight loss; loss of muscle mass; loss of fat; fluid accumulation; and diminished function, as measured by hand strength. How often this happens in cancer patients really depends on the type and severity of cancer. For example, 85 percent of pancreatic cancer patients will have malnutrition, but the rates are much less for other cancers.

You’ll notice many of the defining characteristics of malnutrition have to do with change. So, if a person were slim to begin with, that person would still need to have a lot of change to be considered malnourished by most criteria in the standard definition.

I think that the type of foods eaten is important, as well. A calorie isn’t just a calorie: The micronutrients, such as vitamins and minerals, in fruits and vegetables are very different from those contained in junk food, or even those in processed white bread or white rice. Thus, even someone whose cancer is preventing him or her from eating all the calories he or she needs to maintain weight still will do better by eating healthy foods.

Doctors and nutritionists are seeing how important nutrition is in chronic illness.

Dr. Roach Writes: Many people wrote in to tell me of stores that sell generic medication (like the lisinopril a writer was unable to get) at very low cost. The issue isn’t always just the cost of the medicine, it’s seeing the doctor. Also, many doctors will see their patients for free during a period of no insurance, but not all can or will do so, and people on many medications, including lisinopril, need blood-test monitoring periodically. Lab tests can be prohibitively expensive, but there are low-cost options.

Email questions to ToYourGoodHealth@med.cornell.edu.