Management of Nutritional Problems in Oncology Patients and the Role of the Nurse

Yıl 2021, Sayı: 15, 681 - 691, 31.12.2021

Necmiye Çömlekçi , Gülbeyaz Can

https://doi.org/10.38079/igusabder.981033

Cited By: 2

Öz

Nutritional problems develop in cancer patients due to the type of tumor, type of treatment applied, and side effects related to treatment. If nutritional problems are not diagnosed and treated in the early period, they cause serious problems such as refractory cachexia and negatively affect the patient's quality of life. For this reason, it is important to regularly screen and evaluate patients for malnutrition risk from the moment of diagnosis in terms of nutritional problems. In the management of nutritional problems of patients with malnutrition, nutritional counseling, additional food supplements, physical activity, pharmacological treatment and enteral or parenteral nutrition steps are included in cases where oral intake is insufficient. Providing nutritional support in cancer treatment is very important for the effective continuation of cancer treatment without interruption. For this reason, oncology nurses, who have important roles and responsibilities in the treatment team, have a key role in providing nutritional support. In providing nutritional support, oncology nurses play a role in the evaluation of the patient's nutritional status and risk screening, management of symptoms that adversely affect nutrition due to antineoplastic treatment, administration of enteral and parenteral nutrition, prevention of complications and patient education. Oncology nurses should be supported to participate in training programs on the management of nutritional problems in order to develop their knowledge and skills on nutritional support and management and to take a more active role.

Anahtar Kelimeler

Oncology, cancer, nutrition, malnutrition, oncology nursing

Onkoloji Hastalarında Beslenme Sorunlarının Yönetimi ve Hemşirenin Rolü

Öz

Kanser hastalarında tümörün tipi, uygulanan tedavi türü, tedaviye bağlı gelişen yan etkiler nedeniyle beslenme sorunları gelişmektedir. Beslenme sorunları erken dönemde tanılanıp tedavi edilmezse refrakter kaşeksi gibi ciddi sorunlara neden olmakta ve hastanın yaşam kalitesini olumsuz etkilemektedir. Bu nedenle hastaların beslenme sorunları açısından tanı anından itibaren düzenli olarak malnütrisyon riski açısından tarama ve değerlendirmesinin yapılması önemlidir. Malnütrisyon gelişen hastaların beslenme sorunlarının yönetiminde ise beslenme danışmanlığı, ek gıda takviyeleri, fiziksel aktivite, farmakolojik tedavi ve oral alımın yetersiz olduğu durumlarda enteral veya parenteral beslenme adımları yer almaktadır. Kanser tedavisinde beslenme desteğinin sağlanması kanser tedavisinin ara vermeden etkin şekilde sürdürülmesinde oldukça önemlidir. Bu nedenle tedavi ekibinde önemli rol ve sorumlulukları bulunan onkoloji hemşireleri beslenme desteğinin sağlanmasında da anahtar role sahiptirler. Beslenme desteğinin sağlanmasında onkoloji hemşireleri, hastanın beslenme durumunun değerlendirilmesi ve risk taramasının yapılması, antineoplastik tedavi nedeniyle beslenmeyi olumsuz etkileyen semptomların yönetimi, enteral ve parenteral beslenmenin uygulanması, komplikasyonların önlenmesi ve hasta eğitimi adımlarında rol almaktadırlar. Onkoloji hemşirelerinin beslenme desteği ve yönetimi konusunda bilgi ve becerilerinin geliştirilmesi ve daha etkin rol almaları için beslenme sorunlarının yönetimine ilişkin eğitim programlarına katılmaları desteklenmelidir.

Anahtar Kelimeler

Onkoloji, kanser, beslenme, malnütrisyon, onkoloji hemşireliği

Kaynakça

• Kruk JMU, Kleeberg KKJ, Erickson DBN. Nutritional care of cancer patients : A survey on patients’ needs and medical care in reality. Int J Clin Oncol. 2017;22(1):200-206. doi:10.1007/s10147-016-1025-6.
• Barrett M, Uí Dhuibhir P, Njoroge C, et al. Diet and nutrition information on nine national cancer organisation websites: a critical review. Eur J Cancer Care (Engl). 2020;29(5):1-22. doi:10.1111/ecc.13280.
• Sirvent Ochando M, Murcia Lopez A, Sangrador Pelluz C, Espla S, Garrido Siles M, Abiles J. NUTRI-ONCOCARE: Nuevo modelo integral de atención nutricional para prevenir y tratar la desnutrición en pacientes con cáncer. Farm Hosp. 2021;45(3):109-114. doi:10.7399/fh.11299.
• Arends J, Bachmann P, Baracos V, et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr. 2017;36(1):11-48. doi:10.1016/j.clnu.2016.07.015.
• Virizuela JA, Camblor Álvarez M, Luengo Pérez LM, et al. Nutritional support and parenteral nutrition in cancer patients: an expert consensus report. Clin Transl Oncol. 2018;20(5):619-629. doi:10.1007/s12094-017-1757-4.
• Hopkinson JB. Nutritional support of the elderly cancer patient: The role of the nurse. Nutrition. 2015;31(4):598-602. doi:10.1016/j.nut.2014.12.013.
• Loeliger J, Dewar S, Kiss N, Drosdowsky A, Stewart J. Patient and carer experiences of nutrition in cancer care: a mixed-methods study. Support Care Cancer. 2021;29(9):5475-5485. doi:10.1007/s00520-021-06111-1.
• Ravasco P. Nutrition in cancer patients. J. Clin. Med. 2019;8(1211):1-13. doi:10.3390/jcm8081211.
• Shahvazi S, Onvani S, Heydari M, Mehrzad V, Nadjarzadeh A, Fallahzadeh H. Assessment of nutritional status using abridged scored patient-generated subjective global assessment in cancer patient. J Cancer Res Ther. 2017;13(3):514-518. doi:10.4103/0973-1482.177500.
• Lee JLC, Leong LP, Lim SL. Nutrition intervention approaches to reduce malnutrition in oncology patients: A systematic review. Support Care Cancer. 2016;24(1):469-480. doi:10.1007/s00520-015-2958-4.
• Arends J, Baracos V, Bertz H, et al. ESPEN expert group recommendations for action against cancer-related malnutrition. Clin Nutr. 2017;36(5):1187-1196. doi:10.1016/j.clnu.2017.06.017.
• Caccialanza R, De Lorenzo F, Gianotti L, et al. Nutritional support for cancer patients: Still a neglected right? Support Care Cancer. 2017;25(10):3001-3004. doi:10.1007/s00520-017-3826-1.
• Muhsiroglu O. Medical nutrition treatment in cancer patients. Gulhane Med J. 2018;59(4):79-88. doi:10.26657/Gulhane.00005.
• Hopkinson JB. The nursing contribution to nutritional care in cancer cachexia. Proc Nutr Soc. 2015;74(4):413-418. doi:10.1017/S0029665115002384.
• Ziętarska M, Krawczyk-Lipiec J, Kraj L, Zaucha R, Małgorzewicz S. Chemotherapy-related toxicity, nutritional status and quality of life in precachectic oncologic patients with, or without, high protein nutritional support. A prospective, randomized study. Nutrients. 2017;9(10):1108. doi:10.3390/nu9101108.
• Baracos VE, Arribas L. Sarcopenic obesity: Hidden muscle wasting and its impact for survival and complications of cancer therapy. Ann Oncol. 2018;29(March):ii1-ii9. doi:10.1093/annonc/mdx810.
• Strulov S, Williams GR, Muss HB, Nishijima TF. Prognostic value of sarcopenia in adults with solid tumours : A meta-analysis and systematic review. Eur J Cancer. 2016;57:58-67. doi:10.1016/j.ejca.2015.12.030.
• Vergara-Fernandez O, Trejo-Avila M, Salgado-Nesme N. Sarcopenia in patients with colorectal cancer: A comprehensive review. World J Clin Cases. 2020;8:1188-1202.
• Erickson N, Paradies K, Buchholz D, Huebner J. Nutrition care of cancer patients-a survey among physicians and nurses. Eur J Cancer Care (Engl). 2018;27(4):1-6. doi:10.1111/ecc.12855.
• Greenlee H, Santiago Torres M, McMillen KK, Ueland K, Haase AM. Helping patients eat better during and beyond cancer treatment: continued nutrition management throughout care to address diet, malnutrition, and obesity in cancer. Cancer J (United States). 2019;25(5):320-328. doi:10.1097/PPO.0000000000000405.
• Langius JAE, Zandbergen MC, Eerenstein SEJ, et al. Effect of nutritional interventions on nutritional status, quality of life and mortality in patients with head and neck cancer receiving (chemo)radiotherapy: A systematic review. Clin Nutr. 2013;32(5):671-678. doi:10.1016/j.clnu.2013.06.012.
• Kiss N. Nutrition support and dietary interventions for patients with lung cancer: Current insights. Lung Cancer Targets Ther. 2016;7:1-9. doi:10.2147/LCTT.S85347.
• Tank M, Franz K, Cereda E, Norman K, Norman K. Dietary supplement use in ambulatory cancer patients : A survey on prevalence , motivation and attitudes. J Cancer Res Clin Oncol. 2021;(0123456789). doi:10.1007/s00432-021-03594-7.
• Cereda E, Cappello S, Colombo S, et al. Nutritional counseling with or without systematic use of oral nutritional supplements in head and neck cancer patients undergoing radiotherapy. Radiother Oncol. 2018;126(1):81-88. doi:10.1016/j.radonc.2017.10.015.
• Roeland EJ, Bohlke K, Baracos VE, et al. Management of cancer cachexia: ASCO guideline. J Clin Oncol. 2020;38(21):2438-2453. doi:10.1200/JCO.20.00611.
• Engelen MPKJ, Safar AM, Bartter T, Koeman F, Deutz NEP. High anabolic potential of essential amino acid mixtures in advanced nonsmall cell lung cancer. Ann Oncol. 2015;26(9):1960-1966. doi:10.1093/annonc/mdv271.
• Sánchez-lara K, Turcott JG, Juárez-hernández E, et al. Effects of an oral nutritional supplement containing eicosapentaenoic acid on nutritional and clinical outcomes in patients with advanced non-small cell lung cancer : Randomised trial q. Clin Nutr. 2014:1-7. doi:10.1016/j.clnu.2014.03.006.
• Koshimoto S, Arimoto M, Saitou K, Uchibori M, Hashizume A, Honda A. Need and demand for nutritional counselling and their association with quality of life, nutritional status and eating-related distress among patients with cancer receiving outpatient chemotherapy : A cross-sectional study. Support Care Cancer. 2019;27(9):3385-3394. doi: 10.1007/s00520-018-4628-9.
• Stout NL, Baima J, Swisher A, Winters-stone KM, Welsh J. A systematic review of exercise systematic reviews in the cancer literature (2005-2017). PM R. 2017;9(9S2):S347-S384. doi:10.1016/j.pmrj.2017.07.074.
• Lønbro S. The effect of progressive resistance training on lean body mass in post-treatment cancer patients – a systematic review. Radiother Oncol. 2014;110(1):71-80. doi:10.1016/j.radonc.2013.07.008.
• Bye A, Sandmael JA, Stene GB, et al. Exercise and nutrition interventions in patients with head and neck cancer during curative treatment : A systematic review and meta-analysis. Nutrients. 2020;12(11):3233. doi:https://doi.org/10.3390/nu12113233.
• Abu Sharour L. Improving oncology nurses’ knowledge, self-confidence, and self-efficacy in nutritional assessment and counseling for patients with cancer : A quasi-experimental design. Nutrition. 2019;62:131-134. doi:10.1016/j.nut.2018.12.004.
• Van Veen M, Hoedjes M, Versteegen J, Van de Meulengraaf-Wilhelm N, Kampman E, Beijer S. Improving oncology nurses’ knowledge about nutrition and physical activity for cancer survivors. Oncology Nursing Forum. 2017;44(4):488-496. doi:10.1188/17.ONF.488-496.
• Dempsey L, Orr S, Lane S, Scott A. The clinical nurse specialist’ s role in head and neck cancer care : United Kingdom National Multidisciplinary Guidelines. The Journal of Laryngology & Otology. 2016;130:212-215. doi:10.1017/S0022215116000657.
• Kapucu S. Nutritional issues and self-care measures adopted by cancer patients attending a university hospital in Turkey. Asia-Pacific J Oncol Nurs. 2016;3(4):390. doi:10.4103/2347-5625.196500. 36. Xu X, Parker D, Ferguson C, et al. Where is the nurse in nutritional care ? Contemp Nurse. 2017;53(3):267-270. doi:10.1080/10376178.2017.1370782.
• Isenring EA, Teleni L. Nutritional counseling and nutritional supplements: A cornerstone of multidisciplinary cancer care for cachectic patients. Curr Opin Support Palliat Care. 2013;7(4):390-395. doi:10.1097/SPC.0000000000000016.
• Xu X, Parker D, Ferguson C, et al. Where is the nurse in nutritional care ? Contemp Nurse. 2017;53(3):267-270. doi:10.1080/10376178.2017.1370782.
• Martin L, Leveritt MD, Desbrow B, Ball LE. The self perceived knowledge, skills and attitudes of Australian practice nurses in providing nutrition care to patients with chronic disease. Fam Pract. 2014;31(2):201-208. doi:10.1093/fampra/cmt070.
• Van Veen MR, Hoedjes M, Versteegen JJ, Van De Meulengraaf Wilhelm N, Kampman E, Beijer S. Improving oncology nurses’ knowledge about nutrition and physical activity for cancer survivors. Oncol Nurs Forum. 2017;44(4):488-496. doi:10.1188/17.ONF.488-496.
• De Pinho NB, Martucci RB, Rodrigues VD, et al. High prevalence of malnutrition and nutrition impact symptoms in older patients with cancer: Results of a Brazilian multicenter study. Cancer. 2020;126(1):156-164. doi:10.1002/cncr.32437.
• Gillespie L, Raftery A. Nutrition in palliative. Br J Community Nurs. 2014;sup7(s15):15-20.
• Özcan S, Vatansever S. Kanser kaşeksi. In: Can G, ed. Onkoloji Hemşireliği. 1. baskı. İstanbul: Nobel Tıp Kitapevleri; 2014:407-418.
• Bishop S, Reed WM. The provision of enteral nutritional support during definitive chemoradiotherapy in head and neck cancer patients. J Med Radiat Sci. 2015;62(4):267-276. doi:10.1002/jmrs.132.
• Durán Poveda M, Jimenez Fonseca P, Sirvent-Ochando M, et al. Integral nutritional approach to the care of cancer patients: Results from a Delphi panel. Clin Transl Oncol. 2018;20(9):1202-1211. doi:10.1007/s12094-018-1846-z.