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LIFESTYLE
MEDICINE

Diet and Nutrition in Patients with

Gastrointestinal Cancers

By Hycienth Ahaneku MD, PhD

T he digestive system is responsible for processing food through ing about 65 percent of patients developing moderate malnutrition and

ingestion and digestion as well as absorption. Adequate diet
22 percent developing severe malnutrition at some point in their cancer
and nutrition are important for promoting growth, maintain-
percent and 10 to 17 percent of developing moderate and severe mal-
ing health and preventing disease. Emerging evidence highlights the history. For patients with lower GI cancers, the risk is about 20 to 60
interplay between the digestive and immune systems in maintaining nutrition, respectively.
3,4
the health and well-being of humans. The development of gastrointestinal cancers can compromise nutri-
The dual role of nutrition and diet, as well as the integrity of the gas- tional status via various mechanisms. These include reduced dietary in-
trointestinal system, are of particular interest in patients with gastroin- take, compromised digestive/absorption process, effect of cancer
testinal (GI) cancers. “Gastrointestinal cancers” is a collective term used treatment (including surgery, systemic therapy and radiotherapy), and
for cancers affecting the gastrointestinal tract, including the esophagus, increased catabolic state because of cancer.
stomach, liver, pancreas, small intestine, colon and rectum. GI cancers Changes in dietary intake are usually due to poor appetite, physical
account for 26 percent of the global cancer incidence and 35 percent obstruction of food, especially in patients with esophageal and gastric
of all cancer-related deaths. In 2023, GI cancers were estimated to ac- cancers, easy satiety and changes in taste perception. Additionally, phys-
1
count for about 18 percent of new cancers in the United States, with ical debilitation, as well as depression and psychological stress from can-
2
colorectal cancers being the most common among the GI cancers. cer, can affect appetite, and influence both quantity and quality of food
The vast majority of patients with gastrointestinal cancers experience intake.
malnutrition at some point in their cancer history. Upper GI cancers Cancer has been shown to induce a pro-inflammatory environment
have the highest risk of developing malnutrition, with one study show- that drives an increased catabolic state, which, when combined with

18 SAN ANTONIO MEDICINE • January 2024