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Despite significant improvements in screening, diagnosis and targeted therapy, cancer remains the second leading cause of death in the world. It is becoming increasingly clear that diet and lifestyle play a significant role in the development and progression of cancer. Thus, various dietary combinations can be proposed to reduce the risk of cancer and to improve the impact of basic therapy. Nutrition is closely linked to cancer. Food carcinogens, macronutrients, micronutrients such as vitamins A, C and D, dietary fiber, modulation of metabolism by diet, dietary supplements and anticancer agents in food affect the development of cancer. This article discusses research on the relationship between nutrition and cancer, as well as current dietary guidelines for reducing the risk of cancer. The aim of the study is to analyze information from the professional literature on the influence of various nutritional regimes in cancer patients. Conclusions. Proper nutrition can prevent the risk of cancer and improve the impact of treatment on the disease. Ketogenic diet is useful in combination with standard therapy on the basis of its ability to enhance the antitumor effects of classical chemotherapy and radiation therapy, its overall good safety and tolerability, as well as improving the quality of life. Mediterranean diet is a protective factor against cancer, due to the antioxidant and anti-inflammatory properties of the ingredients. Fasting is also a potentially effective strategy for inducing the differential stress resistance of cancer and normal cells as an adjunct to standard treatment. Promising benefits of vitamins in the prevention and treatment of cancer can be achieved through the use of new potent analogues, as well as combinations of vitamins in the early stages of cancer.

Breast cancer is one of the most widespread malignant neoplasm in Ukraine (20.6 % of all malignant neoplasms). The usual incidence of breast cancer (BC) in women, as of 2019, is 70.3 cases per 100 thousand population. At the moment, BC during pregnancy is rare (only in 0.4 % of all BC cases in women aged 16 to 49 years), the decision on treatment remains difficult for a patient as well as an oncologists. Despite the fact that the treatment of malignant breast disease is usually carried out in non-pregnant women, the problem of tactics for managing patients with different gestation lengths remains unresolved. Thus, the treatment of pregnant women with BC should be guided a multidisciplinary integrated approach to maximize the benefits and minimize the risk to both a mother and a fetus, including the optimal tactics of surgical treatment and chemotherapy. Therapeutic decisions should be based on the stage of disease, tumor morphology, gestational age at diagnosis, and possible pregnancy risks. A promising way of addressing this problem is to conduct more studies to determine the most effective and safest treatment strategies for BC in pregnant women.

Lung cancer is one of most actual problem of modern oncology. The III-IV stages of non-small cell lung cancer (NSCLC) in Zaporizhzhia region are diagnosed in more than 75 % of patients. Chemotherapy is a standard of advanced NSCLC treatment. But results of such treatment are still unsatisfactory due to tumoral chemoresistance. So, it's very important question to search for new clinical factors with significant prognostic and predictive value. Objective. To evaluate the expression of ERCC1, p53 in patients at advanced stages of NSCLC, to examine the association of marker expression with various clinical and morphological factors, and to evaluate the prognostic and predictive value of ERCC1 in patients at advanced stages of NSCLC. Methods. 45 patients with IIIA, IIIB, IV stages of NSCLC were included in this study. ERCC1 was assessed by immunohistochemistry. According to received data relationship of ERCC1 expression with clinico-morphological factors and ERCC1 clinical significance were assessed. Results. Clinically significant relation of ERCC1 expression with stage and p53 expression was observed in our study. It was revealed that patients with high ERCC1 expression had better survival than patients with low ERCC1 expression (106.5 vs 38 weeks, P = 0.002). It was also mentioned that using of platinum-based chemotherapy greatly improved patients’ survival. ERCC1, p53 and stage disease were proved to be as independent prognostic factors in patients which received chemotherapy. Conclusions. ERCC1 is important prognostic factor and could be used to determine efficacy of platinum-based chemotherapy in patients with the IIIA–IV stages of NSCLC.

Objective. The impact of early peroral feeding on concentration of the serum interleukin-6 in patients after pancreaticoduodenectomy was analyzed. Materials and methods. Results of pancreaticoduodenectomy in 39 patients, suffering the pancreatic head and periampullar zone tumors, was analyzed, in whom various methods of nutritive support were applied through period 2015 - 2017 yrs. With the aim of comparative analysis accomplishment of immunological reactivity the patients were divided into two groups: the first - 24 patients, to whom in postoperative period a combination of peroral and enteral feeding was conducted, and in the second - 15 patients, to whom peroral feeding was applied only. There were studied concentration of the serum interleukin-8 preoperatively and on the third postoperative day, as well as the levels of general protein and albumin on the first, third and 7th postoperative days. Results. In the patients, to whom nutritive support was done in a combined way (through microjejunostomy and in a peroral way), the level of interleukin-6 was higher (p=0.05), than in the patients, who used a peroral feeding only postoperatively: mediana 76.2 [51.5; 96.4] and 63.4 [43.5; 65,7] pg/ml, accordingly (p=0.055). While application of various methods of feeding in the patients a trustworthy difference between middle levels of albumin and general protein in the blood on the first, third and 7th days after pancreaticoduodenectomy was not observed (p > 0.05) while application of different feeding methods. Conclusion. Application of combined enteral and peroral feeding in patients after pancreaticoduodenectomy has no advantages upon a peroral one. Early peroral feeding promotes the reduction of immunological reactivity of organism as an answer on operative trauma, and the proteins levels, comparing with combined feeding in patients in postoperative period up to the 7th day do not differ essentially.

Objective. To analyze the various ways for enteral feeding after pancreaticoduodenectomy. Materials and methods. There were investigated the results of pancreaticoduodenectomy, performed in 78 patients, suffering tumors of pancreatic head and periampullary zone, in whom various methods of nutritive support, in 2003 - 2017 yrs were applied. For comparative analysis the patients were divided into two groups: the first - 39 patients, perioperative treatment of whom was conducted in accordance to the ERAS program, and the second - 39 patients, who were treated using a standard method. In patients of the first group the effects of a peroral way of nutrition were compared, as well as combined peroral and enteral nutrition via microjejunostomy. There were studied the terms of restoration of peroral feeding, the gastrostasis rate, the nutrition calorage during 7 postoperative days, levels of general protein and albumin on the first, third and seventh postoperative day. Results. In 33 (84.6%) patients of the first group the peroral nutrition restoration have occurred in complete order to the protocol. The gastrostasis rate in patients of the first group was essentially lesser, than in patients of the second group. In the first group this complication have occurred in 6 (15.4%) patients, in the second group - in 14 (35.9%) patients (p = 0.009). Dynamics of level of general protein and albumin of the blood in postoperative period did not depend on method and energetic estimate of the nutrition. Conclusion. Application of peroral feeding, in accordance to the concept of the program for accelerated restoration of the patients, survived after pancreaticododenectomy, constitutes an optimal way for the nutrient support of an organism and permits to reduce the gastrostasis rate trustworthily.