Nutrition as an important component of treatment and rehabilitation in cancer patients

The article deals with the importance of nutritional support for cancer patients. The high frequency of malnutrition and impaired absorption of macro and micronutrients in cancer patients and, which, at its maximum, is anorexia-cachexia syndrome, is the direct cause of the patient’s death. The progression of the tumor process is always accompanied by a violation of nutritional status, which is manifested in changes in weight, weakness, decreased physical activity, and disorders of the digestive system. It is estimated that about half of cancer-related deaths can be prevented, many of which are due to diet and lifestyle. Dietary factors can be involved in the initiation of tumor growth (carcinogens), promote growth, or have protective activity against the development of cancer. Therefore, nutritional support is one of the important components of a multidisciplinary approach in the treatment of cancer. Based on the analysis of the literature, the main tasks of nutritional support, indications, methods and criteria for the effectiveness of therapeutic nutrition are determined for the practitioner, a brief overview of the diets that are used by cancer patients is presented, and a list of anticarcinogenic products is compiled. Key words: anticarcinogenic products, diet, nutritional support, cancer patient, cancer prevention, nutrition.

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Feasibility and first results of a prospective cohort study to investigate cisplatin-associated ototoxicity amongst cancer patients in South Africa

BMC Cancer ◽

10.1186/s12885-021-08567-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jessica Paken ◽

Cyril D. Govender ◽

Mershen Pillay ◽

Birhanu T. Ayele ◽

Vikash Sewram

Keyword(s):

South Africa ◽

Cervical Cancer ◽

Hearing Loss ◽

Cohort Study ◽

Cancer Patients ◽

Prospective Cohort Study ◽

High Frequency ◽

Prospective Cohort ◽

Multidisciplinary Approach ◽

Limited Resource

Abstract Background Cervical cancer, one of the most common cancers affecting females in South Africa, commonly requires a cisplatin-based-treatment regimen, which has been associated with ototoxic side effects. However, cisplatin-associated ototoxicity is largely under-reported in South Africa, despite its impact of hearing loss having serious overt ramifications on the quality of life of these patients. Hence, a prospective cohort study was undertaken to assess the audiological changes in female cervical cancer patients receiving cisplatin therapy. Objective To present details of the feasibility study and initial results on hearing patterns in cervical cancer patients receiving cisplatin chemotherapy. . Methods Fifty cervical cancer patients commencing with cisplatin chemotherapy underwent audiological assessments at a hospital in South Africa at various time intervals. Assessments included case history, otoscopic examination, immittance audiometry, pure tone audiometry (including high-frequency audiometry), speech audiometry, and distortion product otoacoustic emission testing. Data analysis involved the use of descriptive statistics and the Cochran-Armitage trend test for a linear trend in proportions. Results Fifty participants, aged between 32 and 79 years (Mean: 53 years; SD = 11.00), were recruited. Clinical findings revealed an incidence of 100% ototoxic hearing loss at the one-month post-treatment, i.e., 98% after three cycles of cisplatin and 2% at one-month post-chemotherapy. Sensorineural hearing loss and high-frequency tinnitus were most common. Deterioration in hearing thresholds was more evident in the extended high-frequency range, with the number of “no-responses,” from 11,200 Hz to 20,000 Hz, increasing with each successive audiological evaluation. This study further indicated that recruitment and follow-up of study participants within a limited resource setting are possible. However, cognizance must be given to a multidisciplinary approach and constant engagement with participants through regular contact either telephonically or via a short-message-system. Conclusion Exposure to cisplatin treatment contributed to hearing loss in females with cervical cancer, highlighting the need for ototoxicity monitoring during chemotherapy treatments. Furthermore, the results indicate that it is possible to conduct prospective cohort studies, using a multidisciplinary approach in limited-resource environments with appropriate planning and training strategies, as this study was able to achieve its aim successfully.

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Anorexia-cachexia syndrome in cancer patients: pathogenetic aspects and treatment options

Oncohematology ◽

10.17650/1818-8346-2020-15-4-91-102 ◽

2020 ◽

Vol 15 (4) ◽

pp. 91-102

Author(s):

A. V. Snegovoy ◽

V. B. Larionova ◽

I. V. Kononenko

Keyword(s):

Radiation Therapy ◽

Nutritional Status ◽

Cancer Patients ◽

Nutritional Support ◽

Control Group ◽

Outpatient Basis ◽

Treatment Results ◽

Long Term Treatment ◽

Usual Diet ◽

Cachexia Syndrome

Background. Modern standards for the treatment of both solid tumors and tumors of the blood system provide a mandatory assessment of the objective status of the patient. One of the important criteria of which is nutritional status. Underestimating the role of nutritional support in the treatment of cancer patients leads to a deterioration of treatment results due to the progressive deterioration of nutritional status and the development of cancer anorexia cachexia syndrome (CACS), which is an independent adverse factor leading to the death of the patient. The increase in the number of cancer patients with risk factors for CACS development requires not only close attention of clinicians to this problem, but also the development of clear recommendations for the diagnosis and management of such patients. This can contribute to solving several problems at once. First, it will allow optimizing monitoring of cancer patients predisposed to CACS development during anticancer treatment. Secondly, it will provide an opportunity to develop a diagnostic algorithm to prevent it. Third, the use of the identified criteria for predicting and outcome of complications both on an outpatient basis and in a hospital will be aimed at creating favorable conditions for anticancer therapy and thereby improving long-term treatment results and patients quality of life. Studying the mechanisms of development of CACS, the possibilities of correcting this condition, indicate the need for a multimodal concept and the rejection of the search for a “magic pill”. The results of a multicenter, prospective randomized study conducted in the oncology and hematology departments of healthcare institutions.Objective: to evaluate the effectiveness of FortiCare oral nutritional support in cancer patients under the real clinical practice.Materials and methods. The study included 96 patients with stage II–IV tumors. Radiation therapy was received by 28 patients, chemotherapy ‒ by 68 patients. Patient information was collected using an individual registration card. The patients were randomized according to nutritional support tactics (1:1). In the study group, with radiation (n = 14) and chemotherapy (n = 34), patients received enteral nutrition Forticare orally 125 ml 3 times a day in parallel with their usual diet. Patients in the control group during radiation therapy (n = 14) received the required amount of calories from their usual diet. During chemotherapy, patients in the control group (n = 34) with a lack of daily calorie intake received additional parenteral nutrition.Results and conclusion. While taking FortiCare, there was a smaller loss of body weight (p ≤0.05), a frequency of mucositis of the oral cavity, and esophagitis (p >0.05). With chemotherapy, the incidence of diarrhea (p <0.001) and constipation (p <0.05) was detected less frequently than in the control group. A decrease in the frequency of hematological toxicity (leukopenia, thrombocytopenia) was noted (p >0.05).

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