Cancer is a large, heterogeneous class of diseases in which a group of cells display uncontrolled growth, invasion that intrudes upon and destroys adjacent tissues, and often metastasises, where the tumour cells spread to other locations in the body.
Undernutrition in paediatric oncology patients is often related to the location and extent of the disease and the complications of therapy.[2-5] There are several causes which may contribute to the development of undernourishment in patients with cancer, such as reduced food intake, malabsorption, metabolic disturbances and abnormal inflammatory responses.
Studies suggest that children with cancer who are undernourished have a higher risk of developing chemotherapy toxicity, have a higher incidence of infectious complications, and are less able to tolerate chemotherapy when compared to children with good nutritional status.[7-9] Adult patients with cancer who lost weight showed a shorter overall survival than those without weight loss.
Therefore, the goal of nutritional therapy in cancer is the improvement of function and outcome by:
- preventing and treating undernutrition,
- enhancing anti-tumour treatment effects,
- reducing adverse effects of anti-tumour therapies,
- improving quality of life.
The European Society for Parenteral and Enteral Nutrition (ESPEN) guidelines on nutrition in cancer state that enteral nutrition in the form of oral nutritional supplements or tube feeding should be started if undernutrition already exists or if food intake is markedly reduced for more than 7-10 days.
- From Wikipedia, the free encyclopedia 2001-07-18.
- Novy MA, Saavedra JM. Nutrition therapy for pediatric cancer patients. Top Clin Nutr 1997;12:16-25.
- Bechard LJ, Adiv OE, Jaksic T, et al. In: Pizzo P, Poplack DG, eds. Principles and Practice of Pediatric oncology. 4th ed. Lippincott Williams & Wilkins, Philadelphia, PA, 2002:1285-1300.
- Reilly JJ, Weir J, McColl JH, et al. Prevalence of protein-energy malnutrition at diagnosis in children with acute lymphoblastic leukemia. J Pediatr Gastroenterol Nutr 1999;29:194-7.
- Elhasid R, Laor A, Lischinsky S, et al. Nutritional status of children with solid tumors. Cancer 1999;86:119-25.
- Stratton RJ, et al. Disease-related malnutrition: an evidence based approach to treatment. CABI Publishing, Wallingford, 2003.
- Mauer AM, Burgess JB, Donaldson SS, et al. Special nutritional needs of children with malignancies: a review. J Parenter Enteral Nutr 1990;14:315-24.
- Sala A, Pencharz P, Barr RD. Children, cancer, and nutrition - a dynamic triangle in review. Cancer 2004;100:677-87.
- Ladas EJ, Sacks N, Meacham L, et al. A multidisciplinary review of nutrition considerations in the pediatric oncology population: a perspective from children's oncology group. Nutr Clin Pract 2005;20:377-93.
- Andreyev HJN, Norman AR, Oates J, et al. Why do patients with weight loss have a worse outcome when undergoing chemotherapy for gastrointestinal malignancies? Eur J Cancer 1998;34:503-9.
- Arends J,Bodoky G, Bozzetti F, et al. ESPEN Guidelines on enteral nutrition: non-surgical oncology. Clin Nutr 2006;25:245-59.