Cancer treatment is also about a proper diet. What?

Medical nutrition is a complement to the therapeutic “golden triad” in oncology – chemotherapy, radiotherapy and surgery. The introduction of medical nutrition in an oncological patient should take place as soon as possible.

1. In the presence of cancer, malnutrition often occurs in patients
2. Weight loss may result from various factors, both physiological and psychological
3. In the case of malnutrition in an oncological patient, it is better to take care of his diet first than to operate, explains Paweł Kabata, MD, PhD from the University Medical Center in Gdańsk
4. More current information can be found on the Onet homepage.

We talk about the state of malnutrition in patients when there is a loss of body weight of more than 5% in the last 6 months or more than 10%. Regardless of the time, the BMI value is low (below 20) or the patient eats less than 50% for more than a week. your daily requirement. Assuming that the average man should weigh about 80 kg, and the average woman about 60 kg, with 5 percent. this loss is – respectively – 4 and 3 kg.

Malnutrition – for physical or mental reasons

Factors causing malnutrition can be classified into two groups. The first includes factors that make it difficult or impossible to take food orally. We can observe it in neoplasms in which there is a mechanical obstruction of the gastrointestinal tract by a growing tumor. The sick person then does not receive the right amount of nutrients. The second category includes hypercatabolic tumors which develop with a high metabolic rate. Then the nutrients are delivered to the body – because the patient can eat normally – but they are quickly consumed by the growing cancer. Here, the supply of nutrients is lower than the demand for them.

Malnutrition in cancer can also cause psychological disorders (depression, stress) and mechanisms related to diagnostics and treatment. Due to the specificity of neoplastic disease and its diagnosis, proper nutrition – a factor of key importance for the success of therapy – becomes the least important for the patient. A sick person often does not feel like eating – even if there is no damage to the gastrointestinal tract. Oncological treatment, on the other hand, may be associated with nausea and vomiting caused by chemotherapy, as well as mechanical disorders such as esophagitis or disturbances in food passage caused by radiation therapy. These factors can severely limit the ability to ingest food by mouth and also lead to reluctance to eat.

First we feed, then we operate

International recommendations indicate that a greater long-term benefit will be obtained from surgery performed two weeks later, but in a patient with improved metabolic status, than surgery two weeks earlier, when the patient is in a state of hypercatabolism, i.e. a tight metabolism. The validity of this principle has been confirmed, among others, by the results of my doctoral dissertation and the results of the work of other research teams. It has been shown that through appropriate and controlled medical nutrition it is worth supporting oncological patients who do not have malnutrition yet.

During the courses for doctors that we run, we are often surprised when we say that if we have a cancer patient who is under diagnosis and has features of malnutrition, we admit him to the ward or look after him on an outpatient basis. and for 10-14 days we feed in a controlled manner instead of operating immediately. If a patient has lost a lot of kilograms, we will not make up for these losses in about 2 weeks, because it is physically impossible, but using medical nutrition, we can slow down the process of hypercatabolism. This is very important because the patient will have to face another hypercatabolic period immediately afterwards, i.e. an operation that is very strenuous and involves the body’s increased demand for various nutrients, mainly protein.

Satisfy your protein needs

In a healthy person, the average protein requirement is approx. 1 g per kg of body weight, while in an oncological patient it is much higher – it is recommended, if possible, to provide protein at the level of 1,5 g / kg bw / day, and sometimes it is necessary provide up to 2 g of protein per kilogram of body weight in the diet. Proteins provide amino acids that are essential in the processes of tissue healing and regeneration of the body – especially after surgery or radiotherapy. The resources of these ingredients are also depleted by a rapidly developing cancer. Two amino acids – glutamine and arginine – are very important for the efficient healing of wounds from the entire pool of proteins supplied to the body of a patient undergoing oncological treatment. They are included in the so-called immunomodulating substances, i.e. substances that affect our immunity.

Medical nutrition – orally, enterally or intravenously?

We can feed an oncological patient orally, enterally, intravenously. There is no universal and only best method. The general rule for choosing a nutritional method is: we choose the one that will be optimal for a given patient in his specific situation. Therefore, we can nourish the same patient with each of the above-mentioned methods, depending on the current nutritional options and based on the current demand.

Ready-made oral preparations intended for supporting the nutrition of oncological patients who are unable to meet the body’s nutritional requirements with their usual diet, are generally available in pharmacies. Most often, in the case of cancer patients, high-protein and high-energy preparations are used – in a small volume they provide a concentrated amount of energy, protein and other nutrients. Since adjusting the preparation to the needs of a particular patient is very important, before buying, consult a physician, preferably the therapist, dietician or pharmacist – they will advise which preparation will be optimal for a given patient.

The article comes from the “Diagnosis: Cancer” campaign prepared by Warsaw Press and whose media partner is medTvoiLokony. All materials can be found on http://www.warsawpress.com/

Also read:

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2. «Terrible tragedies take place behind the walls of the hospital. Nobody sees it »
3. Polish women die of breast cancer. Money from the government is not helping
4. WHO: Breast cancer is the most commonly diagnosed cancer in the world. Not lung cancer anymore
5. Poland: more and more malignant tumors

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