A leading cancer hospital is tackling a big problem that keeps many patients from healing-loss of appetite. The innovative program, getting under way at NYU Langone’s Perlmutter Cancer Center in New York City, will design customized diets for patients after assessing their particular reasons for not eating enough, such as nausea, difficulty swallowing or depression.
Patients will receive prepared meals at home from a nonprofit group called God’s Love We Deliver. A randomized controlled trial will assess whether patients benefit from the program. Cancer patients traditionally get dietary advice, but it may provide little help in overcoming eating difficulties. The NYU program aims to offer patients more concrete solutions.
“We are providing a nutritional ‘intervention’ for them.” Omar Ishaq, chief resident in radiation oncology at NYU who came up with the nutrition-study idea, says even though patients are getting the very latest in cancer therapies, many of them stop eating and become malnourished.
NYU doctors are beginning to enroll 180 patients with advanced, stage 4 lung and gastrointestinal cancers to participate in the randomized controlled trial. Half the group will be assessed for eating problems and receive customized meals, while the rest will get just the nutrition counseling that NYU typically provides its cancer patients. Patients’ weight will be monitored and levels of anxiety, depression, and appetite will be assessed.
Severe nausea and vomiting is a common problem in cancer patients, brought on by the treatment or from anxiety. Ms. Jennings, the oncology dietitian, counsels those patients to stick with bland foods, such as soups, mashed potatoes, puréed butternut squash or scrambled eggs. Still other patients complain that food tastes differently during treatment-flat, unpleasant, even metallic.
“It happens a lot,” says Ms. Jennings, who advises those patients to make their food more flavorful by adding olive oil, butter or lemon juice and various herbs and spices.
“Malnutrition and a loss of muscle mass are frequent in cancer patients and have a negative effect on clinical outcome,” according to the guidelines, published in the journal Clinical Nutrition in July.
Depression may be the hardest hurdle to overcome in getting cancer patients to eat, says Linda Chio, another NYU oncology dietitian and a co-investigator on the trial. Many of those patients end up at risk both from their cancer and not eating enough.
Ms. Chio encourages patients with depression to have small snacks every couple of hours, rather than trying to sit down to whole meals.
For some patients, the NYU dietitians suggest high-calorie and nutrient-dense foods, such as avocado, pumpkin seeds, peanut butter or cheese and crackers. God’s Love We Deliver, the nonprofit preparing and delivering the customized meals, began in the 1980s bringing meals to AIDS patients. The organization is paying for the NYU cancer patients’ meals through its own fundraising.