Oncology

Cancer patients tend to present with significant nutritional deficits that affect their quality of life. There is a very high prevalence of malnutrition among oncological patients:

  • Diagnosis: 15 – 40% depending on cancer type.
  • Advanced disease: up to 80 %.

The presence of malnutrition has a negative effect on the evolution of patients with cancer, increasing their rate of infection, length of hospital stay and risk of death.

TUMOURS Mechanical and functional alterations, especially in tumours of the eye/nose/throat (ENT) and digestive system. The release of catabolic hormones, cytokines and mobilising factors that favour hyper-metabolism and emaciation.
THE PATIENT Personal habits, physical deterioration, anorexia and psychological factors.
THE TREATMENT Secondary effects of surgery, radio therapy, chemo-therapy and immuno-therapy. Mucositis, emesis and diarrhoea make ingestion difficult and foster malabsorption and nutrient loss.
HEALTH SERVICES Lack of nutritional assessment, delay in commencing adapted and adequate enteral and parenteral nutrition.

Malnutrition is triggered by four mechanisms:

  • Limited intake of energy and nutrients.
  • Alterations in the digestion and/or absorption of nutrients.
  • Increase in basal energy expenditure.
  • Alterations in the metabolism of the nutrients

Consequences of malnutrition for the oncological patient:

  • Deterioration of body image, functionality and quality of life combined with greater risk of toxicity due to oncological treatments
  • Lower responsiveness and tolerance with respect to antineoplastic treatments.
  • Deterioration of the immune system, which fosters infections and reduction of digestive enzymes, thus risking malabsorption.
  • Delayed healing, which risks fistulas and open sutures.
  • Prolonged hospital stays and increased health costs.
  • Increased mortality.

The objectives of nutritional support are as follows:

  • To avoid malnutrition and its complications
  • To improve the tolerance for oncological treatment and diminish the risk of complications
  • To provide a general feeling of well-being
  • To improve the quality of life

“For the oncological patient, early detection, assessment and nutritional intervention represent improvements in the patient’s quality of life and tolerance for oncological treatments, thus preventing treatment complications.”

 

Camblor Álvarez M, Ocón Bretón MJ, Luengo Pérez LM, Virizuela JA, Sendrós Madroño MJ, Cervera Peris M, Grande E, Álvarez Hernández J, Jiménez Fonseca P. Soporte nutricional y nutrición parenteral en el paciente oncológico: informe de consenso de un grupo de expertos. Nutr Hosp 2018;35:224-233.

M.A.E. de van der Schueren. Use and effects of oral nutritional supplements in patients with cáncer. Nutrition 67_68 (2019) 110550.

Arends J, et al., ESPEN guidelines on nutrition in cancer patients, Clinical Nutrition (2016), http://dx.doi.org/ 10.1016/j.clnu.2016.07.015.

Tdiet 2

Complete high protein and high energy tube feed with fiber indicated for the dietary management of patients with diseases accompanied by malnutrition and patients with high protein and high energy requirements

Diaba plus

Complete high-protein, high-calorie diet with fiber

Atémpero

Complete high-protein, high-calorie diet with a mix of fibers

Supressi plus

Complete high-protein, high-calorie diet with fiber

Peptisens

High protein and high energy complete oligomeric diet, partly hydrolyzed

Dienat G

Complete protein and energy balanced tube feed with fermentable fiber, 100% hydrolyzed guar gum

Medplus

Complete high protein and high energy powder diet