Managing cachexia, especially if you are underweight

Q:  How should a very thin (underweight) cancer patient manage their diet; do they need to gain weight and if so how would they do it without following the NHS advice to eat lots of dairy and feast on slabs of chocolate! They are particularly concerned about giving me chemotherapy and a risk of cachexia. Can I manage cachexia to minimize my risk? I’d be grateful if you could point me in the right direction.

A:  There are two parts to this answer, and both come straight out of research:

a) The fear of cachexia - hospitals particularly in the UK are afraid of cancer patients dying of cachexia. What is this? It is when the chemotherapy drug actually causes severe weight loss and this leads to death. And we can’t have people dying from the drug, can we? So dieticians (who are rushed off their feet in UK Hospitals) produce booklets encouraging patients to eat cheeseburgers, sugary and milky foods and ’feed themselves up’! This advice feeds the very cancer you are trying to kill off, it is the opposite of new recommendations in America (to eat nutritiously), it is the opposite of general UK ’Healthy eating’ guide lines, and it is totally opposed to the latest research on the benefits of, say, fasting which can stop a cancer progressing and Calorie Restriction with radiotherapy and chemotherapy.

Managing cachexia - It has now been shown in research that consuming fish oils helps prevent cachexia in lung cancer patients (and I am pretty sure this could be widely extrapolated to include most, if not all, cancers).

Boston College biology Professor Dr Seyfried goes further. He has shown that attacked cancer cells produce the pre-cursor agent for cachexia because of their glucose-burning activity, and fish oils can stop this‘It is important to recognize that pro-cachexia molecules such as proteolysis-inducing factor are released from the tumor cells into the circulation and contribute to the cachexia phenotype. By targeting the glycolytically active tumor cells that produce pro-cachexia molecules, restricted diet therapies can potentially reduce tumor cachexia. These therapies could be supplemented with omega-3 fatty acids, which can also reduce the cachexia phenotype. Omega-3 fatty acids from fish oil also have the benefit of maintaining low glucose while elevating ketone levels. Once the tumor becomes managed, individuals can increase caloric consumption to achieve weight gain’.

b) Using your diet in a positive way

In 2012 there were a number of very important research studies on cancer stem cells found to lie at the heart of most, if not all, tumours. No drug currently kills off these stem cells, and so reducing a cancer in size by 60, 70 or 80% is not the same as getting rid of it. Cancer stem cells can regrow the tumour and their is even evidence that they use the chemotherapy attack on adjacent healthy cells (which make a defensive protein) to protect themselves against further chemo.

However the National Cancer Institute researchers have shown that a number of bioactive ingredients (including sulphoraphanes and resveratrol, curcumin, piperine, vitamins A and E, theanine, choline, genisteine, EGCG from green tea) could stop the re-growth of cancer stem cells, even stating that these all could be tgaken as supplements.

Next, there is actually no harm in being slightly underweight; in fact exactly the opposite. People with lean Body Mass Index scores are usually healthier. People who by design or enforced during times of war, who ’suffer’ Calorie Restriction are generally healthier. And Calorie Restriction has been shown to aid both radiotherapy and chemotherapy outcomes. In 2008 to 2012 there were several studies showing how fasting could stop the progression of a cancer.

The basic principles of a good anti-cancer diet are:               

1. Eat nutritiously - avoiding all cows’ dairy, salt, glucose, high fructose corn syrup, bad fats, refined food and packaged, prepared food.

2. Eat 6 small to medium meals a day, not one or two big ones.

3. Eat colourful vegetables across the week, and supplement with quality bioactive supplements.

4. Eat plenty of good fats like extra virgin olive oil, flaxseed oil, nuts, fish oils and coconut oil.

5. If you have to eat carbs, eat low glycaemic carbs - whole grains, whole oats, whole root vegetables. Please do not juice fruits and use during the day.

6. Eat quality fresh meat (for example, game) and fish, never preserved.

7. Avoid all ’bad’ fats, saturated fats, trans fats and cows’ dairy.

8. Nourish your healthy body, not the cancer - Treat your body to the good things in life.

So, for example, if you want carbs, eat whole oat porridge with blueberries and flaxseed on it for breakfast. Snack on nuts and seeds. Lunch of grilled fish and salads. Dine on grilled meats and greens. Use good fats to provide your calories.

The key is to be nutritious and nourishing. Less is more.

 See our articles:

A Diet for Chemotherapy

The Ketogenic Diet

Fasting and cancer

The Rainbow Diet

 At last - the definitive, research-based book on how to build a diet to help beat cancer. Click here to read about it.

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