As a surgeon, I always emphasize the importance of excellent nutrition to my patients, especially those with cancer.I compare a patient’s experience to one of a world-class athlete. Both face tremendous pressure on the mind and body. However, the patient is playing for much more than a medal or a trophy. Their life is on the line, and they must adequately prepare.When you take great care of your body, it will take great care of you, particularly under stressful conditions.
Surgery, chemotherapy, and radiation certainly qualify as being stressful. Frankly, the treatment may seem as debilitating as the disease, itself. Nutritional stability is the foundation required to help yourself obtain a good outcome.This is especially true concerning protein. Protein plays a key role in maintaining all body functions, as it makes up critical cell structures in muscle, organs, blood cells, connective tissue, and skin. Protein is a vital component in many of the body’s functions, such as: enzymatic reactions, hormonal structure, and keeps the immune system functional. It is the loss of protein which produces the complications of malnutrition. You simply cannot heal without adequate protein intake, and this is even truer with a surgical wound.
One breast cancer patient’s story drives home this point. After a post-operative mastectomy follow-up, she was cleared to receive chemotherapy and radiation next. She, more than most, could simply not eat, and as a result, she became a “skeletonized” version of herself, despite all appropriate interventions. I barely recognized her. By not eating enough protein, she had no ability to fight infections. She developed pneumonia and lost her battle. Here, all treatment protocols were followed to the letter, but the cause of death was secondary to protein malnutrition. What a terrible thing to witness. Even though everything was done perfectly, we still lost the patient. The medical and surgical literature lists a wide range of percentages, 20%-90%, concerning cancer patient deaths related to protein malnutrition. No one may know the actual figure, but it is unacceptably high.This problem can be fixed: We must do better.
I know it is work to eat the daily recommendation of protein, but if you are a cancer patient, you must find a way. To find how many grams of protein you need per day, divide your weight in pounds by 2.2 to obtain your weight in kilograms. It is recommended healthy adults need to eat 0.8 grams of protein, per kilogram of body weight, per day, (g/kg/d). One kilogram equals 2.2 pounds.For example, if a person weighs 200 pounds, then divide this number by 2.2, which rounds out to 90 kilograms. Multiply the number of kilograms by 0.8. 90 x 0.8 equals 72 grams of protein. This is the amount of protein recommended per day for a healthy person weighing 200 pounds.
However, as a patient, this requirement is higher. Patients’ recommendations are 1-1.5 g/kg/d. When calculating how much protein you need if you are a patient, substitute 0.8 grams with 1-1.5 grams. In a 200 pound patient, the minimum requirement would then increase to 90 grams of protein per day. I recommend increasing protein intake to meet these requirements on the day of diagnosis.
Please remember the best possible outcome begins and ends with meeting this recommended intake of protein. Equate lean, quality protein as fuel for your body.
Author Steven L. Snodgrass, MD, FACS
Steven L. Snodgrass, MD, FACS is a former Chief of Surgery at HCA Greenview Hospital in Bowling Green, Kentucky. University of Kentucky College of Medicine: 1980-1984 Surgical Resident Greenville Hospital System, Greenville South Carolina: 1984-1988 Chief Resident General Surgery, Greenville Hospital System: 1989 Private Practice General/Vascular Surgeon: 1989-2004, which included two years as Chief of Surgery Fellow of the American College of Surgeons Member of the American Medical Association Author of books, both fiction and non-fiction, as well as medical/surgical articles. Married to Mary Lee Snodgrass, a registered pharmacist since 1984. Has two sons, Jack, 27 and Lee, 23. Jack is a professional baseball pitcher in the San Francisco Giants Organization, (AAA Sacramento). Lee begins law school this fall at Washington University in St. Louis. 3rd degree black belt in ARC-RYU (form of martial arts) Avid bicyclist I retired from a very busy surgical practice, because I recognized a significant problem which had to be solved. It is found not only in the general population, but it is also harming patient care to the point of causing complications, and even death. The problem is protein malnutrition. Being a surgeon and the father of a professional athlete, I realized how difficult it was to obtain a convenient, great-tasting protein snack. Carbohydrates are easy to find, but not lean protein which can be eaten on-the-go. Dr. Steve’s Nutri Snax were created for this reason. The product is also Gluten-Free and non-GMO. I worked with some of the most talented people in the food industry to make this become reality. Sure, the product is great for athletes and/or anyone looking for healthier snack choices, but I saw where the REAL NEED is present: PATIENTS. All patients need extra protein to help them heal properly. Some of the patient groups where a special focus was placed include: post-operative; geriatric medicine/long-term care; chronic wound care; renal/failure dialysis; diabetes/pre diabetes; Celiac Disease; bariatric; anorexia/bulimia; and cardio-vascular, etc.). All of these patient groups will no doubt reap the benefits of my protein snack, but the main area of concentration has been cancer patients. Protein malnutrition leads to increased morbidity, mortality, complications and healthcare costs in every patient group, but none are as severely, negatively impacted as patients diagnosed with cancer. Protein malnutrition in the cancer patient is much more costly in every respect. In my lifetime, I have been involved in thousands of cancer cases, and my mom is an ovarian-cancer survivor. Cancer has profoundly affected both my professional and personal life. I promised myself to do something about solving cancer patient protein needs, and this snack has now been created for that purpose. I have involved myself with clinical research and the use of my product in all the aforementioned patient care groups, especially cancer care centers including both hospital inpatients and outpatient clinics. In no instance has any patient not been able to tolerate my product. No one became ill. No nausea, vomiting or diarrhea occurred as often seen with liquid forms of nutrition; period. Even patients with mouth ulcers or having the inability to chew food, simply dissolved the product under their tongues to receive the benefits of the protein. My ultimate goal is to bring the dangers of protein malnutrition to the forefront of consciousness to patients, their families, and my colleague caregivers, so no one, or no family will have to watch themselves or one of their loved ones waste away because they couldn’t eat enough protein. Protein malnutrition can be prevented in a significant number of cases. We simply must do better. Most certainly, there will be cases, many of them, where patients will not have a satisfactory outcome. Some, we know will succumb to their disease, and this is very disheartening. This being said, in the not-too-distant future, we will provide this protein source as a choice patients otherwise would not receive. My plan is to do everything possible to give patients a fighting chance not only to survive, but thrive and ultimately, return to wellness.