The Hunger Games

The Weight of Cancer: When Hunger Tips the Scale

“There is no disease more devastating than hunger, for what disease is there that gnaws at the body from within, that strips a man of his strength, his dignity, and finally, his will to live?”

—Plutarch

It was late in the afternoon when I noticed them—just beyond the glass doors of Nourish, our in-house food pantry. The waiting area outside was nearly empty, save for a few patients curled into chairs, their heads resting against the cool walls, the sterile hum of the hospital surrounding them. But the mother and son stood apart.

She sat in a wheelchair, her teenage son behind her, his hands lightly gripping the chair’s handles. His posture was careful, deliberate—not the impatient stance of a teenager forced to run errands, but the watchful stillness of someone who had learned too early what it meant to guard the person they loved. His mother was frail, her body hollowed out by months—maybe years—of treatment. Cancer has a way of consuming not just cells but entire lives; it spares nothing, leaving behind only the unrelenting struggle to stay alive.

A cloth bag sat in her lap, its edges creased from use, slowly filling with a few days’ worth of food. The shelves of the pantry held the basics: cans of green beans stacked neatly in rows, vacuum-sealed bags of rice, and peanut butter in plastic jars that glowed dully under the fluorescent lights. She reached for a box of cereal but hesitated. Her hand hovered, fingers barely grazing the cardboard. Then, slowly, she set it back down. And then—after a pause—picked it up again.

I watched from a distance, unseen, how one might observe a delicate moment unfolding behind glass. What had caused her hesitation? Was she thinking about the cost of milk, wondering if her nausea would allow her to stomach it? Or was it something more profound—unspoken, more painful—the quiet guilt of taking more than she believed was her fair share?

Her son did not speak. He stood behind her, patient and unmoving. There was no urgency in his hands on the wheelchair, no restless shifting of feet. He was there, present, watching. Protecting.

I looked down at the six-dollar latte in my hand, its warm surface. A swirl of foam softened the bitterness of the espresso. Something tightened in my chest.

The Impossible Choice Between Food and Treatment

Hunger is not simply an absence of food. It is an erosion. It begins slowly, imperceptibly at first—a missed meal here, a smaller portion there. Then it becomes something sharper, more insistent, a gnawing absence that takes up residence in the body and mind. It weakens not just muscles but resolve. It breaks not just bodies but spirits.

And yet, here, in one of the better-resourced cancer centers in the country, I had just watched a mother, sick from chemotherapy, deliberate over whether she could afford to take a box of cereal. It was not just about hunger. It was about scarcity, about the calculations that those who have never known real deprivation cannot begin to understand. Take too much now, and there may be less for someone else later. Take too little and suffer the consequences alone.

This is not an isolated story or an anomaly. It is happening everywhere.

Between 17% and 55% of cancer patients in the U.S. experience food insecurity (Raber et al., 2022). That means up to half of all patients battling cancer do so on empty stomachs. They endure chemotherapy while undernourished, face radiation while their bodies waste away, and swallow their pills with nothing but water and hope. The very treatment designed to save them often pushes them into financial ruin, leaving them to choose between food and survival. Malnutrition is not an inconvenience. It is a direct threat to survival.

The Biology of Hunger in Cancer Care

Cancer is, at its core, a disease of hunger.

A tumor is not a passive thing. It is voracious, insatiable. It hijacks metabolic pathways, diverts nutrients meant for healthy cells, and always demands more. The patient—already weakened—becomes host to a parasite of their own making, their body turning against itself in an act of desperate, unintended self-destruction.

Now, imagine adding true hunger to this equation. Imagine a body already ravaged by disease, stripped of nutrients, being asked to endure chemotherapy without the fuel to withstand it. Imagine a patient walking into an infusion center lightheaded from hunger; their stomach knotted with more than just nausea.

The consequences are catastrophic:

• Weakened Immunity: Malnourished patients are far more susceptible to infections, which can halt treatment altogether. Deprived of essential vitamins and proteins, their bodies lack the reserves to fight even minor illnesses (Khera et al., 2020).

• Delayed Wound Healing: Surgery, often a necessary step in cancer treatment, becomes exponentially riskier. Incisions that should close in days take weeks. The risk of infection skyrockets (Patel et al., 2023).

• Cognitive Decline: Hunger is not just physical—it is cognitive. The ability to make complex medical decisions deteriorates, increasing distress and reducing adherence to life-saving treatments (Jager et al., 2021).

A Final Plea: We Can—and Must—Do Better

Plutarch was right. There is no disease more devastating than hunger.

Cancer is cruel. It is a thief of time, a dismantler of futures. It steals birthdays, graduations, retirements, and quiet mornings at the kitchen table. It is ruthless in its demands. But hunger is a cruelty of our own making. It is not an inevitability, not an unchangeable force of nature. Hunger is a policy failure, a moral failure, and a collective failure of will. And unlike cancer, we already know how to cure it.

We cannot let patients fight their disease while starving in silence. We cannot claim to offer “comprehensive” cancer care while ignoring the most fundamental human need. Food is medicine. Food is survival. Food is dignity.

What Can You Do?

1. Donate to programs that provide food for cancer patients (e.g., Feeding America, Meals on Wheels, Community Servings).

2. Support policy changes to expand Medically Tailored Meals (MTMs) through Medicare and Medicaid.

3. Demand hospitals take action. Ask: Does this hospital screen for food insecurity? Does it offer a food pantry?

4. Volunteer at hospital-based or community food programs.

5. Spread the word. Hunger in cancer patients is an invisible epidemic because we allow it to be invisible. Make it impossible to ignore.

If we have the means to map the human genome, then surely, we have the means to ensure that no cancer patient is left to starve.

This is not charity. This is justice.

And justice, like medicine, should never be optional.

References

• Khera, N., Chang, H. Y., Hashmi, S., et al. (2020). Cancer, 126(14), 3312-3318.

• Jager, J., Schootman, M., Hendren, S., et al. (2021). Oncol Nurs Forum, 48(1), 29-40.

• Patel, K., Rohde, S., O’Rourke, L., et al. (2023). CA Cancer J Clin, 73(1), 22-41.

• Raber, M., Jackson, A., Basen-Engquist, K., et al. (2022). J Natl Cancer Inst, 114(12), 1577-1583.