What are the basic principles of nutrition support during therapy?
Side effects of cancer or cancer treatment can hinder normal eating, limiting a patient’s ability to obtain critical nutrients. Eating foods that are high in calories, protein, vitamins, and minerals is essential. Meals should be adjusted to a patient’s nutrition needs, changes in taste buds, and evolving preferences for food textures and smells.
What are guiding principles in obtaining nutrition following a hemopoietic cell transplantation (HCT)?
The main principle is to maintain adequate nutritional status, protein stores, and daily caloric intake. The American Society for Parenteral and Enteral Nutrition recommends that patients undergoing HCT who are malnourished and anticipated to be unable to ingest or absorb adequate nutrients for a prolonged period of time (>7–14 days) receive nutrition support; if a patient has a functioning GI tract, enteral nutrition is recommended.
Given the high risk of neutropenia following HCT, these patients are at an increased risk for multiple infections. To reduce the risk of infections related to HCT, patients can receive dietary counseling regarding safe food handling and avoidance of foods that may pose an infection risk. More information about reducing risk of food borne illness in immunocompromised cancer patients linked here.
What is the role of nutrition therapy in advance cases when any food is intolerable?
Nutrition goals will be different for each patient. For advance cases, the overarching goal of wholistic care is to provide patients with the best possible quality of life and control of symptoms that cause distress. Your provider team will likely offer anticancer therapy and palliative care, palliative care alone, or hospice care — according to the wishes of the patient and family members. Some types of treatment may be stopped all together if they are not helping the patient.
As the focus of care goes from cancer treatment to hospice or end-of-life care, nutrition goals may become less aggressive, and a change to care meant to keep the patient as comfortable as possible.
Sources
What are guiding principles in obtaining nutrition following a hemopoietic cell transplantation (HCT)?
The main principle is to maintain adequate nutritional status, protein stores, and daily caloric intake. The American Society for Parenteral and Enteral Nutrition recommends that patients undergoing HCT who are malnourished and anticipated to be unable to ingest or absorb adequate nutrients for a prolonged period of time (>7–14 days) receive nutrition support; if a patient has a functioning GI tract, enteral nutrition is recommended.
Given the high risk of neutropenia following HCT, these patients are at an increased risk for multiple infections. To reduce the risk of infections related to HCT, patients can receive dietary counseling regarding safe food handling and avoidance of foods that may pose an infection risk. More information about reducing risk of food borne illness in immunocompromised cancer patients linked here.
What is the role of nutrition therapy in advance cases when any food is intolerable?
Nutrition goals will be different for each patient. For advance cases, the overarching goal of wholistic care is to provide patients with the best possible quality of life and control of symptoms that cause distress. Your provider team will likely offer anticancer therapy and palliative care, palliative care alone, or hospice care — according to the wishes of the patient and family members. Some types of treatment may be stopped all together if they are not helping the patient.
As the focus of care goes from cancer treatment to hospice or end-of-life care, nutrition goals may become less aggressive, and a change to care meant to keep the patient as comfortable as possible.
Sources
- August DA, Huhmann M: Nutrition support of the cancer patient. In: Ross AC, Caballero B, Cousins RJ, et al., eds.: Modern Nutrition in Health and Disease. 11th ed. Philadelphia, Pa: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, pp 1194-1213.
- McGuire M: Nutritional care of surgical oncology patients. Semin Oncol Nurs 16 (2): 128-34, 2000.
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