Nutrition
-
In elderly cancer patients tube feeding, via a nasogastric tube or a (percutaneous) gastrostomy may be an efficient way of nutritionally supporting patients with extreme anorexia or dysphagia caused by a head&neck tumor or with an oro-pharyngeal-esophageal mucositis due to radiation therapy and/or chemotherapy. There is no definite difference, with regard to the clinical benefit, between nasogastric and gastrostomy feeding. Both procedures achieve good results in allowing the proper completion of the oncologic therapy. Whether to use a nasogastric tube or a (percutaneous) gastrostomy and whether to perform the procedure prophylactically or a la demande is a matter of controversy and depends more on the policy of the single institution and preferences of the patients than on evidence-based results.
-
There has been considerable interest in both clinical and preclinical research about the role of phytochemicals in the reduction of risk for cancer in humans. The aim of this study was to determine the antineoplastic effects of Chlorella pyrenoidosa in experimental breast cancer in vivo and in vitro. ⋯ This study is the first report on the antineoplastic effects of C. pyrenoidosa in experimental breast cancer in vivo and in vitro.
-
The elderly cancer patient (ECP) population is a heterogeneous group, ranging from competent, active, and fit individuals to those who are frail and cognitively impaired. A continuum exists from an increased vulnerability to stressors that results from the usual decreases in physiologic reserves (=aging) to the deregulation of multiple physiologic systems (=frailty). ⋯ Gait speed, handgrip strength, and cognitive tests along with simple laboratory tests to rule out the presence of increased inflammatory state and/or a particular hormonal deficiency may guide interventions and allow for monitoring of clinical outcomes over time. An organized social network, collaborative support from the team of caregivers and sufficient home care services comprise a comprehensive care approach that guarantees successful treatment outcomes for the ECP population.
-
For patients with cancer at the end of life the goal of nutritional care is to optimize quality of life and comfort. Food and drink should be served as requested by the patient but without exerting pressure. For patients who have developed cachexia and are potentially candidates to receive artificial nutrition, discussions between the patient, family and health care team are needed to set the goals of nutritional care, considering both the risk of adverse effects of the treatment and ethical issues. The premise for a benefit from parenteral nutrition is that survival of the tumor spread exceeds that of starvation (usually by about 2-3 months).