Nutrition is critically important during chemotherapy, especially for patients aged 0 to 18 years. In this age group, the body requires essential building blocks like proteins, carbohydrates, fats, and other nutrients to sustain growth and development. However, chemotherapy, while targeting cancer cells, also damages healthy cells. This can lead to weight loss, malnourishment, and other health complications.

Cuddles Foundation, a nonprofit organisation based in India, recently published a report that highlights the pressing need for nutritional support for paediatric cancer patients. The report, titled "Food Heals Report 2024," was released on September 5 to coincide with Childhood Cancer Awareness Month. The report estimates that annually, 76,000 children and adolescents aged 0-19 develop cancer in India. The organisation, which collaborates with 40 public hospitals across the country, emphasises the vital role nutrition plays in the treatment of childhood cancer.

The report reveals a concerning trend between 57% and 61% of childhood cancer patients are malnourished at the onset of chemotherapy. These figures have remained consistent over the past three years. Malnourishment has a significant impact on how well patients can tolerate chemotherapy, often reducing patient compliance. This can lead to severe complications, adverse drug reactions, and an increased susceptibility to opportunistic infections.

According to the report, 65% of paediatric cancer patients consume less than half the required intake of proteins and calories necessary for their growth and development. Of these patients, 23% are below the age of five, 36% are between the ages of five and ten, and 41% are over ten years old. The most common cancers in these children are hematological cancers (60%), with solid tumors making up the remaining 40%.

The gender distribution shows that 3% of boys and 1.8% of girls in the 0-14 age group are affected by cancer. This distribution has remained consistent over the past four years.

Nutrition can play a pivotal role in improving the efficacy of chemotherapy, radiation, and surgical treatments for pediatric cancer patients. However, nutritional support is often overlooked. Hospitals and oncologists need to recognize the importance of providing nutritional care as part of their patient services.

The report delves further into the issue by highlighting the shortage of nutritionists in cancer care. In accredited cancer hospitals, the ratio of nutritionists to patients is 1:54, meaning one nutritionist is responsible for 54 patients. In non-accredited hospitals, the ratio is even more alarming, with one nutritionist caring for 407 patients. With such a heavy workload, mistakes and oversights in patient care become more likely. As a result, the report emphasises the urgent need for increased investment in nutritional services, more trained nutritionists, and the integration of structured nutrition care processes into paediatric oncology programs.

Undernourishment among pediatric cancer patients has remained a persistent issue over the past three years. The percentage of malnourished patients was 57% in 2021-22, 61% in 2022-23, and 58% in 2023-24. Research suggests that children with cancer require 20% to 90% more calories than healthy children to support the production of healthy cells and sustain overall bodily functions. Despite this, chemotherapy treatments often result in side effects such as appetite suppression, vomiting, and nausea, which make it difficult for children to meet their increased calorie needs.

This nutritional deficit not only hinders the effectiveness of cancer treatments but also places children at higher risk of complications during their treatment journey. Addressing these challenges requires a comprehensive approach that includes improving hospital infrastructure, hiring more nutritionists, and educating healthcare professionals on the importance of nutrition in paediatric oncology.

The report stresses the importance of proper nutrition to improve the efficacy of chemotherapy, radiation, and surgery. However, there is a shortage of nutritionists in hospitals, leading to inadequate care. Addressing this issue is crucial for enhancing recovery and quality of life for pediatric cancer patients.

Reference :

1. Kalra, Manas, and Pradeep Chandrakar. “FoodHeals^TM Report: Exploring Nutritional Aspects of Childhood Cancer in India,” 2024. https://www.cuddlesfoundation.org/wp-content/uploads/2024/09/FoodHeals-Report-2024.pdf.

(Input from various sources)

(Rehash/Yash Kamble/MSM)