The Outcomes of Nutritional Support Techniques in Patients with Gastrointestinal Cancers (original) (raw)
Related papers
Cancer Treatment Reviews, 2008
Introduction: In patients with gastrointestinal (GI) cancer, severe malnutrition is associated with increased morbidity and mortality, reduction of treatment efficacy, and increased length of hospital stay. Therefore, systematic screening and care of malnutrition is mandatory. Materials and methods: Data for this review were identified by searches of Medline with and without MeSH database and Cancerlit. Studies were selected only if they were randomised clinical trials or historical reports. References were also identified from reference lists in relevant preciously published articles. Recent guidelines and meta-analyses were included. Only articles published in English were taken into consideration. Results: For surgical patients, practical information such as weight loss or subjective global assessment would provide a better basis for deciding whether or not to delay surgery. At least 10 days of nutritional support is recommended in severely malnourished patients before major digestive surgery. In non-severely malnourished patients, preoperative oral immunonutrition is associated with a 50% decrease in postoperative complications. The benefit of immune-enhancing diets in severely malnourished patients remains to be proven. For patients undergoing radiochemotherapy, dietary counselling should be proposed to all patients. In cases of severely malnourished patients or if dietary counselling suffers a setback, enteral nutrition should be recommended. Parenteral nutrition should be reserved for patients with severe digestive intolerance when enteral nutrition is not possible.
Nutritional Support Indications in Patients with Gastroesophageal Cancer – A Review
Journal of Medical & Radiation Oncology, 2022
Nutritional support is an essential part of cancer care. Malnutrition is a common feature in cancer patients and has a negative impact on the quality of life and treatment tolerance. Patients with digestive cancers are at higher risk of malnutrition due to the gastrointestinal impairment caused by their disease. However, most of them have insufficient access to nutritional support. Early identification of patients at risk of malnutrition is crucial in order to start an adequate nutritional support. Robust evidence showed that nutritional support can reduce length of hospitalisation, decrease treatment-related toxicity, and improve quality of life and physical function. Nutritional intervention can improve outcomes and help patients in the successful completion of oncological treatments by preventing malnutrition. The aim of this review is to provide a comprehensive overview of nutritional interventions for patients with gastroesophageal cancers.
Nutritional Support in Surgical Gastro-Oncology Patients
A paradoxical relationship exists between nutrition and cancer. Nutritional support when accompanied with the therapy in cancer patients has been proven to increase the response to treatment, decrease the rate of complications and also reduce the morbidity and mortality associated with the disease and the therapy. In palliative care also, nutritional support aims at improving patient’s quality of life.
The impact of nutrition on the lives of patients with digestive cancers: a position paper
Supportive Care in Cancer
Nutritional intervention is an essential part of cancer treatments. Research and clinical evidence in cancer have shown that nutritional support can reduce length of hospitalisation, diminish treatment-related toxicity, and improve nutrient intake, quality of life, and physical function. Nutritional intervention can improve outcomes and help patients in the successful completion of oncological treatments by preventing malnutrition. Malnutrition is a very common hallmark in patients with cancers. Almost one-fourth of cancer patients are at risk of dying because of the consequences of malnutrition, rather than cancer itself. Patients with digestive cancers are at higher risk of suffering malnutrition due to the gastrointestinal impairment caused by their disease. They are at high nutritional risk by definition, yet the majority of them have insufficient or null access to nutritional intervention.Inadequate resources are dedicated to implementing nutritional services in Europe. Univers...
Effects of nutritional support in patients with colorectal cancer during chemotherapy
Collegium antropologicum, 2008
Nutritional support, addressing the specific needs of this patient group, is required to help improve prognosis, and reduce the consequences of cancer-associated nutritional decline. Early intervention with nutritional supplementation has been shown to halt malnutrition, and may improve outcome in some patients. In our study we tried to assess the influence of nutritional support (counseling, oral liquids, megestrol acetate) on nutritional status and symptoms prevalence in patients with colorectal cancer during chemotherapy. Group I consisted of 215 (55%) patients with medium age 68 +/- 2.6 years who were monitored prospectively and were given nutritional support. Group II included 173 (45%) patients (medium age 67 +/- 2.9 years) without the proper nutritional counseling, in whom the data were collected retrospectively during a 6 years period of time. After evaluation Nottingham Screening Tool Score, Appetite Loss Scale and Karnofsky Performance Status) all patients in the group I r...
Nutritional support in patients with advanced cancer: permission to fall out?
Proceedings of the Nutrition Society, 2004
Data from the European Society for Parenteral and Enteral Nutrition Home Artificial Nutrition Survey suggest that the use of home parenteral nutrition (HPN) in patients with cancer as the primary diagnosis varies markedly between different countries in Europe, being highest in The Netherlands and low in the UK. This finding is difficult to explain on the basis of cancer incidence. The main indication for HPN remains malignant gastrointestinal tract obstruction, which occurs most frequently in gynaecological and colon cancers. The use of HPN should be planned in the light of the proposed cancer treatment and should be discussed beforehand with the patient. Before HPN is considered, a patient should typically require intravenous fluids to maintain hydration, be capable of self care, be able to control the treatment, have an expected survival of ≥3 months and have no other available route of feeding. The effect of HPN on quality of life remains controversial, but nutrition is only one ...
Role of nutrition in gastrointestinal oncological patients
2010
A paradox exists in the relationship between nutrition and cancer. Excessive dietary intake of nutrients and decreased physical activity represent two modifiable factors responsible for cancer development, namely for cancers of the gastrointestinal (GI) tract, and the present epidemics of obesity and diabetes is likely to increase the incidence of GI and metabolically-derived liver in the next few years. At the same time, in subjects diagnosed with cancer, malnutrition represents a risk factor of poor outcome following surgical resection, as well as of increased toxicity following chemo-and radiotherapy. Any effort should be made to modify the current trend of obesity for cancer prevention, as well as to provide enteral or parenteral nutritional support in cancer patients, to cope with nutritional needs and prevent cancer-related cachexia.
The annals of clinical and analytical medicine, 2022
Aim: Cancers affecting the gastrointestinal tract are common worldwide, and cancers of the stomach and pancreas have a poor prognosis. Supporting nutritional status before, during and after cancer treatment improves the effectiveness of treatment and quality of life. Malnutrition is seen in cancer patients due to loss of appetite, nausea, vomiting, diarrhea, chewing or swallowing problems, taste and smell changes, therefore malnutrition should be evaluated in all cancer patients and appropriate nutritional support should be initiated. In this study, we aimed to evaluate the effect of nutritional status on malnutrition and quality of life in patients with gastrointestinal system cancer. Material and Methods: The cross-sectional study included 60 patients who received gastrointestinal system treatment and met the inclusion criteria. The Quality of Life Test (EORTC QLQ-C30) and NRS-2002 were administered to the patients by the investigator using a face-to-face method. Socio-demographic information, anthropometric measurements and biochemical findings were obtained from patient files with hospital permission. Results: In the study, most of the patients were at risk of malnutrition; however, no significant correlation was found between NRS 2002 and quality of life and cancer stages. There was an inverse relationship between albumin levels and malnutrition risk (p<0.05). Discussion: Cancer patients are at risk of malnutrition due to the heavy treatment brought by the disease, therefore, malnutrition risks should be determined in the early period, appropriate nutritional support should be provided and their quality of life should be improved.
Nutrients, 2021
Gastric cancer treatments are rapidly evolving, leading to significant survival benefit. Recent evidence provided by clinical trials strongly encouraged the use of perioperative chemotherapy as standard treatment for the localized disease, whereas in the advanced disease setting, molecular characterization has improved patients’ selection for tailored therapeutic approaches, including molecular targeted therapy and immunotherapy. The role of nutritional therapy is widely recognized, with oncologic treatment’s tolerance and response being better in well-nourished patients. In this review, literature data on strategies or nutritional interventions will be critically examined, with particular regard to different treatment phases (perioperative, metastatic, and palliative settings), with the aim to draw practical indications for an adequate nutritional support of gastric cancer patients and provide an insight on future directions in nutritional strategies. We extensively analyzed the la...
New perspective for nutritional support of cancer patients: Enteral/parenteral nutrition
Experimental and Therapeutic Medicine, 2011
Cancer and its treatment result in severe biochemical and physiological alterations associated with a deterioration of quality of life (QoL). Cancer-related malnutrition may evolve into cancer cachexia due to complex interactions between proinflammatory cytokines and the host metabolism. Depending on the type of cancer treatment (either curative or palliative), the clinical condition of the patient and nutritional status, adequate and patient-tailored nutritional intervention should be prescribed (diet counseling, oral supplementation, enteral or total parenteral nutrition). Nutritional support has been widely advocated as adjunctive therapy for a variety of underlying illnesses, including surgery and medical oncotherapy (radiation or chemotherapy for cancer). Glutamine, n-3 fatty acids and probiotics/prebiotics are therapeutic factors that potentially modulate gastrointestinal toxicity related to cancer treatments. Enteral and parenteral nutrition may help improve patient survival, functional status and QoL, yet the benefits appear to be primarily limited to patients with good functional status and with gastrointestinal disease affecting nutritional intake. Parenteral nutrition offers the possibility of increased or maintenance of the nutrient intake in patients for whom normal food intake is inadequate and for whom enteral nutrition is not feasible, is contraindicated or is not accepted by the patient. This article reviews evidence on issues relevant to enteral and parenteral nutrition in patients with cancer. Contents 1. Introduction 2. Cancer cachexia 3. Nutritional support for cancer patients 4. Conclusion