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Background: Patients during radiotherapy due to head and neck cancers experience a lot of side effects which may have a considerable impact on the patients’ ability to meet individual daily energy demands by means of oral diet. Methods: The study included 104 head and neck cancer patients who qualified for radical radiotherapy. Radical treatment takes 6 weeks and every week the patients were assessed for dietary intake. The subjects were covered with the constant care of a dietician, received FSMP (food for special medical purposes), and, if necessary, enteral nutrition. Results: In the first week of treatment, the patients, from the kitchen diet alone, met 91.5% of the energy demand, while in the last week of treatment, only 40.9%. After introducing the FSMP or enteral nutrition, the patients met 120% of the demand in the first week of therapy and 95% in the last week, respectively. The patients who followed the dietary recommendations were characterized by significantly lower weight loss (3.07 kg) compared to non-adherent patients (5.56 kg). Conclusions: The used therapy significantly contributed to decreasing nutritional intake in the subsequent weeks of treatment. On the other hand, incorporating FSMP in the diet and enteral nutrition with industrial diets significantly increased the fulfilled energy demand of patients. [ABSTRACT FROM AUTHOR]

The radical treatment for advanced gastric cancer is gastrectomy. This procedure disrupts the anatomy and physiology of the gastrointestinal tract. After surgery, nausea, heartburn, biliary regurgitation, feeling early satiety, belching, lack of appetite and swallowing problems are reported to affect food intake. Decreased absorption, loss of nutrients and increased energy requirements of cancer patients lead to weight loss and the development of malnutrition. After gastrectomy, the composition of the intestinal microbiome changes, the exocrine activity of the pancreas decreases and deficiency-metabolic disorders (including iron, vitamin B12, zinc, and vitamin D) develop. Approximately 60-70% of gastrectomy patients experience a clinically significant deterioration in their quality of life. Nutritional management should include dietary modification, appropriate nutritional supplementation and close monitoring of the nutritional status of these patients. [ABSTRACT FROM AUTHOR]

Malnutrition in cancer patients is a severe clinical problem. One of the factors determining nutritional status is nutritional intake. The ability to provide adequate oral nutrition in cancer patients is mainly determined by the location and advancement of the disease, the type of oncological treatment, as well as the severity of the side effects of the therapy. Food intake is often reduced in cancer patients, leading to weight loss. Assessment of the nutritional intake requires a unique approach due to various limitations and conditions that do not occur in healthy people and the frequent deficiencies of multiple nutrients. In the context of preventing and treating malnutrition, cooperation between a doctor and a dietitian is crucial. Dietary counselling is the first step of nutritional intervention and can be offered to most patients. According to The European Society for Clinical Nutrition and Metabolism (ESPEN) recommendations, dietary counselling supported by oral nutritional supplements has a recommendation grade of “A” according to Evidence Based Medicine (EBM). Success in maintaining or improving the patient’s nutritional status depends on efficient cooperation between the doctor and dietitian. This publication aims to present the tasks of a dietitian and the principles of collaboration with a doctor in the nutritional care of cancer patients. [ABSTRACT FROM AUTHOR]

The article introduces a series of articles on clinical nutrition in oncology, emphasizing the significant role of nutritional support in improving the outcomes of cancer treatment. It highlights how nutritional support can extend overall survival, disease progression-free time, reduce complications, hospital stays, and treatment costs, especially in patients with malnutrition, which is common in cancer patients.

A beneficial effect of nutrition treatment on multiple aspects of oncological therapy is chiefly demonstrated by preventing and in treating the wasting syndrome and cancer cachexia accompanying the cancer disease. The presence of the wasting syndrome prior to commencing treatment is associated with shorter time for developing complications along with a shorter overall survival (OS), worse response to oncological treatment, deteriorating quality of life, poorer general status; moreover, cachexia strongly affects treatment tolerance. Clinical nutrition is one of the most significant pillars supporting oncological treatment, nonetheless, one has to be mindful of certain cases where nutritional intervention, especially parenteral nutrition, does not bring benefits, and may even be harmful to the patient. Such cases include: PN (parenteral nutrition) for patients with normal body mass and a correctly functioning gastrointestinal tract; PN due to hypoalbuminemia, in patients where feeding via the gastrointestinal tract is possible (orally or enterally); lack of refeeding syndrome prevention for cachectic patients starting PN or EN; use of feeding mixtures containing only soya oil as the sole fatty nutrient; incomplete nutrition (macronutrients or micronutrients only); inclusion of PN in patients in the terminal phase of cancer undergoing persistent nutrition therapy. [ABSTRACT FROM AUTHOR]

Oncological patients requiring parenteral nutrition (PN) will often be at risk of excessive inflammatory responses and immunosuppression. Traditionally used in artificial nutrition soybean oil (rich in omega-6 fatty acids) could promote inflammation and immunosuppression. Parenteral administration of fish oil has been demonstrated to modify the fatty acids (FA) composition of plasma lipids, cells and tissues. increased content of omega-3 FA in cell membranes can influence cell function through various mechanisms: alteration fluidity of the cell membrane, effects on cell signaling pathways and gene expression, alterations in the pattern of lipid mediators produced e.g. eicosanoids. [ABSTRACT FROM AUTHOR]

Oncological patients requiring parenteral nutrition (PN) will often be at risk of excessive inflammatory responses and immunosuppression. Traditionally used in artificial nutrition soybean oil (rich in omega-6 fatty acids) could promote inflammation and immunosuppression. Parenteral administration of fish oil has been demonstrated to modify the fatty acids (FA) composition of plasma lipids, cells and tissues. Increased content of omega-3 FA in cell membranes can influence cell function through various mechanisms: alteration fluidity of the cell membrane, effects on cell signaling pathways and gene expression, alterations in the pattern of lipid mediators produced e.g. eicosanoids. [ABSTRACT FROM AUTHOR]

Pain in advanced cancer can have many causes, and they are not necessarily associated with the presence of cancer. Invalid daily food rations in terms of energy, nutritional value, and cooking techniques used can significantly impair quality of life, increase patients' pain and other somatic symptoms and aggravate malnutrition and cachexia. Basic dietary factors affecting the quality of life and severity of somatic symptoms are the nutritional value of the diet, the frequency of meals and their consistency, the presence of fiber, fat, sugars, lactose, gluten and nutraceuticals. Extremely important is the role of a team of specialists, that offers professional nutritional advice to the patients and their carers.