Nutrition support in cancer patients PART II / Nutritional strategies for oral feeding during cancer treatment

in #hive-1196702 years ago

Greetings MED-HIVE community!

A few days ago, I shared a post talking about the importance of maintaining an adequate nutritional status in cancer patients, an indispensable condition to be able to complete chemotherapy or radiotherapy treatments. Today, I want to delve a little deeper into the qualitative strategies to achieve oral intake in these patients despite the adverse effects of treatments on food consumption.

Diet in cancer prevention.png

Source edited with Canva

cintillo atardecer definitivo.png
Optimal nutritional status is defined as a set of assessments that predict that a patient's immune system is prepared to fight a nosology. The basic aspect to take into account is a healthy weight whose BMI is between 18.5 kg/m2 to 24.9 kg/m2. However, it is essential to take anthropometric measurements to determine muscle mass, and fat mass and even to determine the degree of hydration. It is fundamental since chemotherapy doses are calculated according to the patient's weight. If the patient's weight changes by 10% (under or over) this will affect the protocol previously established with the oncologist (1).

image.png

Source

Another factor that affects the patient's nutritional status is the quantity and quality of food intake. It should be remembered that oncological treatments cause toxicity (to a greater or lesser degree) in some tissues as mucous membranes, blood cells, hepatocytes, to mention a few. This toxicity can generate changes in food intake, malabsorption of nutrients and sarcopenia (1). If we add to all this a depressive condition of the patient, oral food intake is greatly compromised increasing the mortality rate.

It is important to inform the patient and his/her caregivers from the beginning of the oncologic treatment about the possible symptoms that will affect his/her diet in order to anticipate and establish nutritional strategies. It is also essential to clarify to the patient that these strategies will be variable over time as they will depend on the patient's response and adaptation. This will avoid feelings of frustration as a strategy may be useful at the beginning of cancer treatment but may lose effectiveness over time.

cintillo atardecer definitivo.png

How to ensure that cancer patients undergoing cancer treatment eat properly?

This is the question always asked by patients and caregivers. It is a real concern for many of them. To answer this question it is vital to remind both the patient and their caregivers that appetite is variable, not because they have cancer, but because appetite is influenced by individual physiological needs, emotional aspects and the social environment. It is necessary to understand that this occurs even when we are healthy. Therefore, the first thing the patient should know is that he/she should take advantage of the moments of appetite to feed him/herself adequately without the risk of malnutrition, but neither should he/she visit extremes such as obesity.

Regardless of where the cancer cells are lodged (in a defined tumor or disseminated in various organs) the therapeutic conduct to follow in the patient can be with chemotherapy or radiotherapy, which can cause secondary symptoms in the eater that affect their diet and therefore, their nutritional status (here I exclude surgery). Some of these side effects can be nausea, vomiting, dysgeusia, xerostomia, anorexia, mucositis, dysphagia, diarrhea, constipation (2).

image.png

Source

Here are some strategies for the patient undergoing oncologic treatment to maintain oral intake despite symptoms that limit feeding.

Nutritional strategies for oral feeding during cancer treatment

Symptom / SignAdvisableNot advisable
Fractionate feeding in small intakes.
Use textures that do not require a lot of chewing (crushed, semi-liquid, liquid).
Nausea/ VomitingUse easily digestible foods represented in simple preparations, low fat, and mild flavors.Don't give different textures in the same meal.
Continually rehydrate with preparations such as broths, fruit juices, sweetened drinks, oral rehydration serum, and liquid jellies.Don't serve food too cold or too hot.
Give food at room temperature or lukewarm.
Frequent but low volume intakes.Don't give low-calorie foods
AnorexiaProvide preparations with high caloric density (*).Don't provide a monotonous diet or dry food.
Take advantage of moments of hunger by giving attractive and varied preparations.Don't abuse fats,
Easy to chew preparations (crushed, semi-liquid, liquid).Avoid drinking liquids before eating.
Supplementation
DysphagiaUse preparations with easy-to-swallow textures (crushed, semi-liquid, liquid).Don't give very fibrous meats.
Soften the texture of foods with jellies, sauces, or unctuous ingredients.Don't drink and eat at the same time.
Provide food in liquid or semi-liquid form (wet preparations).Don't give acidic and irritant (pepper, mustard, chili)foods.
MucositisProvide supplementation.Don't give foods that adhere to the mucous membranes (grits, potatoes).
Give non-citrus fruit juices in ice cubes.Don't give foods that break the mucous membranes (toasted bread, cereal).
Don't give milk.
Provide foods that provide pectin (fruits such as apples and green bananas).
DiarrheaThe fruit and vegetables should be cooked, not raw.Don't give fatty foods such as nuts, yellow or ripened cheeses, mayonnaise, egg yolk, butter, or margarine.
Give yogurt. It helps to recover the intestinal villi.Avoid dairy products such as fresh cheese and whole milk.
Constantly provide fluids to improve stool consistency.
ConstipationProvide foods rich in fiber as fruits, vegetables, cereals, and whole-grain bread.Do not give food such as tea, cinnamon, wine, rice, or green banana.
Give wet preparations. Use vegetable fats in moderation.

(*)High caloric density:High caloric content in a small volume of food.

I must emphasize that each patient should be assessed individually and not take as standard the general recommendations. In the case of supplementation with existing products on the market rich in carbohydrates, proteins (amino acids), vitamins, and minerals, it must be indicated by a health professional and never self-medicated by the patient or his family members. For these cases, there are highly qualified health professionals to provide the best advice from your oncologist to your nutritionist.


image.png
Source

Thanks for reading. See you in next post!

cintillo atardecer definitivo.png

References:

(1) Strategies to Mitigate Chemotherapy and Radiation Toxicities That Affect Eating

(2) La nutrición en el tratamiento del cáncer (PDQ®)–Versión para pacientes

No appetite? How to get nutrition during cancer treatment

cintillo atardecer definitivo.png

English (2).gif

Sort:  

Your awareness on the role nutrition place for cancer patient is very strong and really true. Thanks so much for sharing.
To support, we encourage any one who knows or who is a patient not to give up on good nutrition as it helps by all means. It is best if such nutrition is administer by a professional Nutritionist and not just anyone.

Congratulations! You have won 50 ecency points!

Thank you for participating in this HEALTH WEEKLY DISCUSSION. The MED-HIVE community is grateful for your contribution on our primary goal of bringing health awareness to Hive.

We hope to grow more with your help and support!

Please consider supporting the med-hive community by subscribing and joining our Discord Channel. You can also go the extra mile and follow our voting trail, give this comment an upvote or even make HP delegations to the @med-hive account using the links bellow

100HP|250HP|500HP|1000HP

INTRA-COMMUNITY BANNER (2).png

Use Ecency! Did you know you can earn Ecency Points just for your regular Hive activity such as posting, doing comments, and upvotes? Use those points to boost and promote your or others’ hivers posts. You can even tip your favourite authors directly! How cool is that?!

It is best if such nutrition is administer by a professional Nutritionist and not just anyone.

This is fundamental and makes a difference in the patient's evolution.

Thank you very much for your kind words, it is a pleasure to share information of interest to the community.

Congratulations @chaodietas! You have completed the following achievement on the Hive blockchain And have been rewarded with New badge(s)

You received more than 95000 upvotes.
Your next target is to reach 100000 upvotes.

You can view your badges on your board and compare yourself to others in the Ranking
If you no longer want to receive notifications, reply to this comment with the word STOP

Check out our last posts:

The Hive Gamification Proposal

Thanks for your contribution to the STEMsocial community. Feel free to join us on discord to get to know the rest of us!

Please consider delegating to the @stemsocial account (85% of the curation rewards are returned).

You may also include @stemsocial as a beneficiary of the rewards of this post to get a stronger support. 
 


The rewards earned on this comment will go directly to the people( @chaodietas ) sharing the post on Twitter as long as they are registered with @poshtoken. Sign up at https://hiveposh.com.

Management of most encouraging cases are mostly multidisciplinary involving almost all the faculties of the Health sciences to come together and it is very very true you've stated the nutritionist play a very huge role.

Thank you for scheming out how these place a major role in helping in your post. It is one that will always come in handy.

And I wish for more support of your post.

Patients deserve the best care from all sides.

Thank you very much for your kind words, I appreciate it.