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How many people each year suffer some type of preventable harm that contributes to their death after a hospital visit?
from 46,000 to 78,000
from 78,000 to 132,000
from 132,000 to 210,000
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 Nutritional Medicine: Malnutrition Among Cancer Patients 
Howard Hughes, the multi-billionaire, died of malnutrition. It is hard to believe that there can be malnutrition in this agriculturally abundant nation of ours--but there is. At the time of the Revolutionary War, 96% of Americans farmed while only 4% worked at other trades. Tractors and harvesting combines became part of an agricultural revolution that allowed the 2% of Americans who now farm to feed the rest of us. We grow enough food in this country to feed ourselves, to make half of us overweight, to throw away enough food to feed 50 million people daily, to ship food overseas as a major export, and to store enough food in government surplus bins to feed Americans for a year if all farmers quit today. With so much food available, how can Americans be malnourished?

The answer is: poor food choices. Americans choose their food based upon taste, cost, convenience and psychological gratification--thus ignoring the main reason that we eat, which is to provide our body cells with the raw materials to grow, repair and fuel our bodies. The most commonly eaten foods in America are white bread, coffee and hot dogs. Based upon our food abundance, Americans could be the best nourished nation on record. But we are far from it.

Overwhelming evidence from both government and independent scientific surveys shows that many Americans are low in their intake of:1

Meanwhile, we also eat alarmingly high amounts of: fat, salt, sugar, cholesterol, alcohol, caffeine, food additives and toxins.

This combination of too much of the wrong things along with not enough of the right things has created epidemic proportions of degenerative diseases in this country. The Surgeon General, Department of Health and Human Services, Center for Disease Control, National Academy of Sciences, American Medical Association, American Dietetic Assocation, and most other major public health agencies agree that diet is a major contributor to our most common health problems, including cancer.

The typical diet of the cancer patient is high in fat while being low in fiber and vegetables--"meat, potatoes, and gravy" is what many of my patients lived on. Data collected by the United States Department of Agriculture from over 11,000 Americans showed that on any given day:
  • 41 percent did not eat any fruit
  • 82 percent did not eat cruciferous vegetables
  • 72 percent did not eat vitamin C-rich fruits or vegetables
  • 80 percent did not eat vitamin A-rich fruits or vegetables
  • 84 percent did not eat high fiber grain food, like bread or cereal3

The human body is incredibly resilient, which sometimes works to our disadvantage. No one dies on the first cigarette inhaled, or the first drunken evening, or the first decade of unhealthy eating. We misconstrue the fact that we survived this ordeal to mean we can do it forever. Not so. Malnutrition can be blatant, as we see in the starving babies in third world countries. Malnutrition can also be much more subtle.

It was the Framingham study done at Harvard University that proclaimed: "Our way of life is related to our way of death." Typical hospital food continues or even worsens malnutrition. While many Americans are overfed, the majority are also poorly nourished. If proper nutrition could prevent from 30 to 90% of all cancer, then doesn't it seem foolish to continue feeding the cancer patient the same diet that helped to induce cancer in the first place?

Malnutrition Among Cancer Patients

From 25-50% of hospital patients suffer from protein calorie malnutrition. Protein calorie malnutrition leads to increases in mortality and surgical failure, with a reduction in immunity, wound healing, cardiac output, response to chemo and radiation therapy, plasma protein synthesis and generally induces weakness and apathy. Many patients are malnourished before entering the hospital and another 10% become malnourished once in the hospital. Nutrition support, as peripheral parenteral nutrition, has been shown to reduce the length of hospital stay by 30%. Weight loss leads to a decrease in patient survival. Common nutrient deficiencies, as determined by experts at M.D. Anderson Hospital in Houston, include protein, calorie, thiamin, riboflavin, niacin, folate and K.

So nutrition therapy has two distinct phases:

1. Take the clinically malnourished patient and bring them up to "normal" status.

2. Take the "normal" sub-clinically malnourished person and bring them up to "optimal" functioning. For at least the few nutrients tested thus far, there appears to be a "dose-dependent" response-- more than RDA levels of intake provide for more than "normal" immune functions.

Not only is malnutrition common in the "normal" American, but malnutrition is extremely common in the cancer patient. A theory has persisted for decades that one could starve the tumor out of the host. That just ain't so. The tumor is quite resistant to starvation and most studies find more harm to the host than the tumor in either selective or blanket nutrient deficiencies.4 Pure malnutrition (cachexia) is responsible for at least 22% and up to 67% of all cancer deaths. Up to 80% of all cancer patients have reduced levels of serum albumin, which is a leading indicator of protein and calorie malnutrition.5 Dietary protein restriction in the cancer patient does not affect the composition or growth rate of the tumor, but does restrict the patient's well being.6

A commonly used anti-cancer drug is methotrexate, which interferes with folate (a B vitamin) metabolism. Many scientists guessed that folate in the diet might accelerate cancer growth. Not so. Depriving animals of folate in the diet allowed theirs tumor to grow anyway.7 Actually, in starved animals, the tumors grew more rapidly than in fed animals, indicating the parasitic tenacity of cancer in the host.8 Other studies have found that a low folate environment can trigger "brittle" DNA to fuel cancer metastasis.

There is some evidence that tumors are not as flexible as healthy host tissue in using fuel. A low carbohydrate parenteral formula may have the ability to slow down tumor growth by selectively starving the cancer cells.9 Overall, the research shows that starvation provokes host wasting while tumor growth continues unabated.10

A position paper from the American College of Physicians published in 1989 basically stated that TPN had no benefit on the outcome of cancer patients.11 Unfortunately, this article excluded malnourished patients, which is bizarre, since TPN treats malnutrition, not cancer.12 Most of the scientific literature shows that weight loss drastically increases the mortality rate for most types of cancer, while also lowering the response to chemotherapy.13

Parenteral feeding improves tolerance to chemotherapeutic agents and immune responses.14 Of 28 children with advanced malignant disease, 18 received parenteral feeding for 28 days with resultant improvements in weight gain, increased serum albumin, and transferrin and major benefits in immune functions. In comparing cancer patients on TPN versus those trying to nourish themselves by oral intake of food, TPN provided major improvements in calorie, protein, and nutrient intake but did not encourage tumor growth. Malnourished cancer patients who were provided TPN had a mortality rate of 11% while the group without TPN feeding had a 100% mortality rate.15 Pre-operative TPN in patients undergoing surgery for GI cancer provided general reduction in the incidence of wound infection, pneumonia, major complications and mortality.16 Patients who were the most malnourished experienced a 33% mortality and 46% morbidity (problems and illness) rate, while those patients who were properly nourished had a 3% mortality rate with an 8% morbidity rate. In 49 patients with lung cancer receiving chemotherapy with or without TPN, complete remission was achieved in 85% of the TPN group versus 59% of the non-TPN group.17 A TPN formula that was higher in protein, especially branched chain amino acids, was able to provide better nitrogen balance in the 21 adults tested than the conventional 8.5% amino acid TPN formula.18

A finely tuned nutrition formula can also nourish the patient while starving tumor cells. Enteral (oral) formulas fortified with arginine, fish oil and RNA have been shown to stimulate the immune system, accelerate wound repair and reduce tumor burden in both animals and humans. Diets with modified amino acid content, low tyrosine (2.4 mg/kg body weight) and low phenylalanine (3.5 mg/kg body weight), were able to elevate natural killer cell activity in 6 of 9 subjects tested.19

In 20 adult hospitalized patients on TPN, the mean daily vitamin C needs were 975 mg, which is over 16 times the RDA, with the range being 350-2250 mg.20 Of the 139 lung cancer patients studied, most tested deficient or scorbutic (clinical vitamin C deficiency).21 Another study of cancer patients found that 46% tested scorbutic while 76% were below acceptable levels for serum ascorbate.22 Experts now recommend the value of nutritional supplements, especially in patients who require prolonged TPN support.23 The Recommended Daily Allowance (RDA) is inadequate for many healthy people and nearly all sick people.

The take-home lesson here is that:

1. At least 20% of Americans are clinically malnourished, with 70% being sub-clinically malnourished (less obvious), and the remaining "chosen few" 10% in good to optimal health.

2. Once these malnourished people get sick, the malnutrition oftentimes gets worse through higher nutrient needs and lower intake

3. Once at the hospital, malnutrition escalates another notch

4. Cancer is one of the more serious wasting diseases known

5. A malnourished cancer patient suffers a reduction in quality and quantity of life, with higher incidences of complications and death

6. The only solution for malnutrition is optimal nutrition


1. Quillin, P., HEALING NUTRIENTS, p.43, Vintage Books, NY, 1989

2. Kune, GA, and Kune, S., Nutrition and Cancer, vol.9, p.1, 1987

3. Patterson, BH, and Block, G., American Journal of Public Health, vol.78, p.282, Mar.1988

4. Axelrod, AE, and Traketelis, AC, Vitamins and Hormones, vol.22, p.591, 1964

5. Dreizen, S., et al., Postgraduate Medicine, vol.87, no.1, p.163, Jan.1990

6. Lowry, SF, et al., Surgical Forum, vol.28, p.143, 1977

7. Nichol, CA, Cancer Research, vol.29, p.2422, 1969

8. Norton, JA, et al., Cancer, vol.45, p.2934, 1980

9. Dematrakopoulos, GE, and Brennan, MF, Cancer Research, (sup.),vol.42, p.756, Feb.1982

10. Goodgame, JT, et al., American Journal of Clinical Nutrition, vol.32, p.2277, 1979

11. Annals of Internal Medicine, vol.110, no.9, p.735, May 1989

12. Kaminsky, M. (ed.), HYPERALIMENTATION: A GUIDE FOR CLINICIANS, Marcel Dekker, NY, Oct.1985

13. Dewys, WD, et al., American Journal of Medicine, vol.69, p.491, Oct.1980

14. Eys, JV, Cancer, vol.43, p.2030, 1979

15. Harvey, KB, et al., Cancer, vol.43, p.2065, 1979

16. Muller, JM, et al., Lancet, p.68, Jan.9, 1982

17. Valdivieso, M., et al., Cancer Treatment Reports, vol.65, sup.5, p.145, 1981

18. Gazzaniga, AB, et al., Archives of Surgery, vol. 123, p.1275, 1988

19. Norris, JR, et al., American Journal of Clinical Nutrition, vol.51, p.188, 1990

20. Abrahamian, V., et al., Journal of Parenteral and Enteral Nutrition, vol.7, no.5, p.465, 1983

21. Anthony, HM, et al., British Journal of Cancer, vol.46, p.354, 1982

22. Cheraskin, E., Journal of Alternative Medicine, p.18, Feb.1986

23. Hoffman, FA, Cancer, vol.55, 1 sup.1, p.295, Jan.1, 1985

(Excerpted from Beating Cancer with Nutrition: Clinically Proven and Easy-To-Follow Strategies to Dramatically Improve Quality and Quantity of L ISBN: 0963837281)
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 About The Author
Patrick Quillin PhD, RDDr. Patrick Quillin, an internationally respected expert in the area of nutrition and cancer, has served as the Director of Nutrition for Cancer Treatment Centers of America (800-577-1255) for the past ten years.......more
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