Nutrition for cancer patients after gastric bypass surgery
Dear OncoLink "Ask The Experts,"
My friend has stage II ovarian cancer (OC) and is currently undergoing chemotherapy - 2nd treatment following debulking surgery. Prior to her diagnosis, she had stomach reduction surgery. She is having an exceptionally hard time with dehydration and low potassium levels after her chemo treatments.
I am an OC Survivor myself, and know the "excitement of chemo", but without [the additional problem of] reduced stomach capacity. What should she be eating/drinking to maximize essential nutrients during this difficult time?
Katrina Claghorn, MS, RD, Registered Dietitian at the Abramson Cancer Center of the University of Pennsylvania, responds:
This is tough, but with the right support, she will be ok. The post- gastrectomy (stomach removal for cancer) diet would be appropriate for your friend, since her bariatric surgery is so similar to the roux-en-Y and Whipple surgeries used for cancers of the stomach and pancreas.
Patients who have had these surgeries have to monitor their tolerance for simple carbohydrates initially, so the guidelines recommend using low-sugar supplements. She should certainly be followed by a dietitian at her cancer center. She needs to know what her nutrition needs are for maintaining her weight and how to maximize her intake. This can be especially very difficult for somebody who has a weight-loss mind set. I tell patients that they have to do "reverse dieting", meaning they have to do the opposite of what they are used to doing. Their nutritional markers need to be carefully followed. It may be difficult for your friend to meet her fluid needs, since she is limited on how much she can tolerate to drink. Also, we do not want her drinking so much she that she fills up on fluid and then can not eat, so she may need regular IV fluids. Also, if she can't maintain her weight, nutrition support may need to be considered. I have patients who have undergone bariatric surgery and then been treated for cancer, and most have done well, but they do need a lot of nutritional support.