Nutrition is an integral part of cancer care, particularly for cancer of gastrointestinal origin, such as cholangiocarcinoma (CCA).1
At the 2024 Cholangiocarcinoma Foundation Annual Conference, Shelby Yaceczko, MS, RDN-AP, CNSC, an advanced practice dietitian nutritionist, reviewed nutrient metabolism relevant to CCA, nutrition impact symptoms during CCA treatment, and diet principles to follow.
At the outset, Ms Yaceczko stressed the importance of nutrition and that it is often not prioritized or overlooked during disease management. She noted, “If we get a diagnosis of a life-changing condition [such as CCA], we often forget that if we don’t have the proper fuel and are not eating and nourishing our body, we cannot get to the next step.”
Nutrition-impact symptoms may arise due to the disease itself and/or those emergent with CCA treatment, including surgery and chemotherapy, and the role of nutrition in CCA largely focuses on managing these related symptoms.
Ms Yaceczko stated that the disease and/or treatment can affect appetite and food interest, impacting overall nutrition. Moreover, nutritional needs are dynamic and can change during the disease, with nutritional status worsening as it progresses. She recommended maintaining a nutritional log during the cancer continuum to better track diets that worked well and those that compromised nutrition to make necessary adjustments.
Inadequate nutrition over time can lead to malnutrition, which is associated with negative outcomes, such as feeling tired and weak, and may make the patient unable to complete cancer therapy or fight infection. Therefore, the main goals of nutritional interventions are to maintain energy and overall well-being, eat a balanced diet focused on nutrient-dense foods for fuel, prevent loss of muscle mass, and maintain defenses against infection.
Nutrition-impact symptoms may be specific to the CCA treatment received, including the type of surgery (eg, removal of bile ducts, partial liver resection, Whipple procedure, liver bypass, liver transplantation, stent placement), chemotherapy, radiation, and combination therapy.
Nutritional considerations after surgery include delayed gastric emptying, diabetes, malabsorption, malnutrition, loss of appetite, early satiety, abdominal discomfort, altered bowel habits, and pancreatic insufficiency.
Nutritional considerations during cancer treatment include loss of appetite, mouth sores, dry mouth, unintentional weight loss, vomiting, diarrhea and/or constipation, taste or smell changes, and nausea.
Ms Yaceczko made suggestions for improving appetite, such as making mealtime more social, honoring daily food preferences, trying favorite foods, and recreating settings that will make the patient eat more consistently and more frequently instead of just pressurizing them to eat, and replacing liquid meals with more solid foods.2
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