Improper nutrition in clinics puts cancer patients at risk

keel.According to expert medical associations, cancer patients are exposed to unnecessary risks if they are given inadequate nutrition in hospitals. The warnings are becoming more urgent, but have so far gone unheeded in many institutions. This was the result of a consultation in German university hospitals.

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Low-germ food was standard for a long time

The background is a discussion of the concept of a “low-germ diet.” It has long been standard for patients undergoing chemotherapy or stem cell transplant: Fungal spores or bacteria such as salmonella must be avoided at all costs to protect immunocompromised patients from foodborne infections. Many clinics not only rely on heating foods for a long time, but also avoid foods with higher risk, such as raw meat and vegetables, salads, fresh fruits, and in some cases, tap water.

Studies: low-germ diet brings no benefit

Recently, however, science has moved further and further away from this. Large studies did not find a significant reduction in risk of infection compared to normal hospital food. “Anyone who still relies on low-germ nutrition is moving into the field of alternative medicine,” says Jutta Hübner, chair of the German Cancer Society’s (DKG) working group on prevention and integrative medicine in oncology.

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DKG: “No advantage, but significant risks”

In a statement published a few weeks ago together with other specialized societies and associations, the DKG even warned of the danger of following a germ-free diet, which “does not entail any advantage, but considerable risks” for cancer patients, we are talking about a “major mistake.” take care” of those affected.

Malnutrition can be deadly

In clinics, one in four patients is considered malnourished, that is, with an insufficient supply of important nutrients such as proteins, vitamins and minerals; in cancer medicine even more so. Numerous studies also show that this is associated with poorer healing processes and more complications: malnourished patients have to stay in hospital longer and are at higher risk of dying. In up to 20 percent of tumor patients who die, it is not the cancer that is the cause of death, but the consequences of malnutrition.

Decreased quality of life.

Scientific societies argue that not eating a lot of nutritious and tasty food will have a boomerang effect because it promotes malnutrition. Already in 2021, the Commission for Hospital Hygiene and Infection Prevention of the Robert Koch Institute warned that “such a diet significantly affects the quality of life of patients.” Rather than dispense with, particularly strict kitchen hygiene is the method of choice.

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Most university hospitals do not implement the findings

However, scientific knowledge has not yet reached many clinics, not even referral university hospitals. When asked, 12 of 38 university hospitals did not provide any information on their nutritional management. Of the 26 facilities that responded, 17 said they continue to regularly provide low-germ diets to patients undergoing chemotherapy or stem cell therapy.

UKSH: the nutritional status of patients is evaluated

This also includes the University Medical Center of Schleswig-Holstein (UKSH). The dangers of malnutrition are clearly visible here: according to the hospital, all hospitalized tumor patients are screened for nutritional status and, if necessary, cared for by an “interprofessional nutrition team”; both have been required by professional associations for a long time. , but they are by no means implemented in all hospitals . In certain cases, however, low-germ foods still exist.

Motto: peel, fry, cook or leave alone

Anne Letsch, senior physician and head of the Kiel Campus Oncology Center, first refers to a basic rule that has since become obsolete: “peel it, boil it, cook it, or forget it.” When questioned, the UKSH finally made it clear that they were seriously thinking about strengthening the nutritional aspects of treating cancer patients. “We are aware that there are not sufficiently valid data for a strict implementation of the low-germ diet,” says a statement signed by Letsch and two other clinic directors from Lübeck and Kiel.

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Avoid raw vegetables and lots of fruit.

“However,” the special diet will be maintained in part to avoid “high-risk foods.” Catering for certain leukemia patients and stem cell transplant patients is based on a separate list, which prohibits raw milk cheese, nuts, fried eggs, raw unpeeled vegetables, green lettuce, tomatoes, muesli bars, peppers and numerous fruits such as strawberries, grapes, peaches, plums and cherries.

Recommendations should be reviewed

This is not in line with current recommendations, but the contradiction seems to have been recognized. In the course of the next stem cell transplant chair replacement, internal recommendations will be reviewed, according to the statement. How is it still open?

By Martin Rucker

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