Articles
Nutrition for Liver Cancer
The liver has a number of different functions, some of which are involved in digestion. For example, the liver secretes bile to aid the digestion and absorption of fats and fat soluble vitamins, and it eliminates potentially harmful by-products and toxins by incorporating them into urea which is then eliminated via the kidneys. The liver also produces, stores and processes fats and cholesterol, synthesises proteins and metabolises and stores carbohydrate as a storage source of energy. The liver is a remarkable organ, as it can function normally with only a small portion of it in working order and will actually regenerate if an area is removed or damaged. This is why live donors are able to donate a part of their liver to someone requiring a liver transplant.
Liver cancer commonly has no symptoms in the early stages. As the cancer progresses, symptoms such as pain in the abdomen, fever, yellowing of the skin and eyes (known as jaundice), loss of appetite, fatigue and weight loss begin to occur. The liver has no nerves and therefore pain will not be felt in the liver itself. Pain is likely to be felt in the area surrounding the liver and is due to the inflammation and irritation of the liver. Treatment may include surgery and/or chemotherapy and radiotherapy. Surgery is the best chance for long term survival and can include removal of the cancerous area or a complete liver transplant. However not all liver cancer patients are surgery candidates and surgery will depend on how much of the liver is affected, where the cancer cells are located, how well the liver is still functioning, the extent of other tumours in the body and the patients general health and wellbeing.
Dietary intervention will depend on the stage of the liver cancer and physical health pre-treatment. Weight loss is a huge issue for liver cancer patients and can lead to malnutrition prior to and post treatment. Surgery and chemo/radiotherapy further compound this issue. A dietitian is vital in helping any cancer sufferer to ensure their diet is adequate prior to and post surgery to give their body the energy and nutrition it needs to fight and repair. Liquid food supplements are usually recommended. In the case of a sub-optimally functioning liver, particular attention will be paid to the fat soluble vitamins. Absorption of these vitamins may be impaired while the body is adjusting to impaired bile secretion. As the liver is the storage centre of carbohydrate used to fuel the cells when blood sugars are low, special attention is paid to blood sugar levels to ensure there is an adequate carbohydrate source available.
Post liver surgery, partial removal or complete transplant, a loss of appetite is common and may last a couple of weeks. This can lead to further weight loss and will certainly impact energy levels. Fatigue is common and it is recommended to take it easy, resting the majority of the day, for up to three months. Regular light exercise is still important to help build back strength and cardiovascular fitness post surgery. Each patient’s nutrient requirements differ, so a dietitian will help to ensure an adequate and nutritious diet. Recovery from surgery requires additional nutritional needs for repair, to regain weight lost, help fight infection and due to the physical stress placed on the body from surgery. A diet high in kilojoules/calories and protein will help to regain lost weight and rebuild muscle tissue and restore protein levels.
It is quite normal to have a loss of appetite, feel nauseated and bloated after any cancer treatment. A dietitian can offer advice to help boost intake.
If you have a poor appetite it is recommended that you eat a number of smaller meals throughout the day and consume high protein/high kilojoule snacks in between these meals. High protein/high kilojoule liquids are also an option if sipping fluids is easier. If bloating and distension are an issue, avoid gaseous foods and stick to high protein/high carbohydrate foods rather than high fat options. Nausea can drastically affect food intake, so go for bland high carbohydrate foods such as plain pasta, noodles, bread and crackers such as pretzels. Sipping dry ginger ale or lemon soda may help. Long term nausea is a bigger issue, and should be reported to the doctor who may offer anti-nausea medication. Changes in taste are common with chemo and radiotherapy, and can affect the enjoyment of food and therefore food intake. Try using a variety of flavours such as seasonings and herbs, marinades for proteins and flavoursome sauces such as gravies. Sucking hard candy can help if there seems to be a constant bad taste in the mouth.
Diet post-recovery from liver surgery, partial removal or complete transplant, is important and should be discussed with a dietitian. There is no special diet rather a healthy diet should be adopted. A weight within the healthy weight range should be reached and maintained, as being overweight can lead to further health complications, such as diabetes and heart disease and place extra stress on the liver. A varied diet, low in saturated fats and sugars and high in lean proteins, complex carbohydrates, low fat dairy and a variety of fruits and vegetables is recommended to maintain a healthy weight and prevent further health complications.
Added to site on : Thursday, 1 November 2012