I must confess that, at one point, I also was part of the medical community who brushed off questions pertaining to nutritional support by advising patients to eat like a 12 year old boy and forget focusing on healthy ingredients.
A few years ago I have come to realize that this is not really helpful to an already debilitated patient seeking support.
So, who are the experts in the field and to whom should you turn to?
Many believe that their oncologist practices in a vacuum not welcoming input from others outside of the field of oncology but this is not so. In most academic practices we are taught to interface with our colleagues from other fields as their input can have a positive impact on patient care. Nutritionists play a vital role in determining the needs of the cancer patient.
To prepare for an appointment with a nutritionist, begin a diary recording meals and snacks as well as fluids. The ideal is to provide the nutritionist 2 days’ worth of records. It is best if the caregiver is the one to record, so the diet is not changed when focus on recording takes place. The nutritionist will not only use the diary as a guide, but will also order a series of blood tests that may pinpoint some irregularities that might need to be corrected.
If problems are found, there are two main types of intervention. They are the PPN (partial parenteral nutrition), delivered through a vein, or EN (enteral nutrition) – a tube feed. These are generally covered by both private and public insurance and should be investigated early in the process of recognized malnutrition. The goal of both of these interventions is to return the patient to oral nutrition as soon as possible.
Why do you need to add yet another practitioner into your already complicated plan of care?
It is well known that cancer patients are at risk for malnutrition due to many factors which include nausea, vomiting, diarrhea and bowel obstructions, changes in taste and smell, and severe loss of appetite. Most of the aforementioned problems fall outside of the patient’s ability to self-correct and interventions often fail thus necessitating either PPN or EN.
Ultimately, working with a nutritionist is important because a patient with good nutritional status is able to fight infection, evidences less depression and has more energy to actively partner with their caregiver and health care team to strive for the best possible outcomes despite the diagnosis of mesothelioma.
If you have more questions about this topic, or any others pertaining to mesothelioma, please contact Mary Hesdorffer, Nurse Practitioner at [email protected].
