Skip to main content
SpringerLink
Log in

Dietary Care and Support During Radiotherapy

  • Chapter
  • First Online:
Basics of Planning and Management of Patients during Radiation Therapy

  • 1193 Accesses

Abstract

Almost half of the cancer patients worldwide present with weight loss, insufficient nutritional intake, a poor psychosocial outlook and dehydration. Weight loss is one of the most disabling aspects of cancer as it not only affects the patient’s ability to withstand intensive cancer therapy but may also play a decisive role in deciding their modality of treatment; it may also worsen the patient’s reactions to the treatment given and may result in increased late reactions and decreased quality of life. Weight loss leads to a marked decrease in body fat and muscle mass which leads to muscle wasting, physical weakness and susceptibility to infections. This condition is called “cachexia”. Accompaniments of cachexia include anorexia, muscle wasting, early satiety, marked weight loss, anaemia, generalized oedema with progressive development of malabsorption, vitamin and protein deficiencies, disturbances in glucose, protein and fat metabolism and gradual progressive organ dysfunction. All these can adversely affect quality of life and life expectancy as well as compliance and response to therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  1. Kern KA, Norton JA. Cancer cachexia. JPEN J Parenter Enteral Nutr. 1988;12:286–98.

    Article  CAS  PubMed  Google Scholar 

  2. Bruera E. ABC of palliative care, anorexia, cachexia and nutrition. BMJ. 1997;315:1219–22.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. MacDonald N, Easson AM, Mazurak VC. Understanding and managing cancer cachexia. J Am Coll Surg. 2003;197:143–61.

    Article  PubMed  Google Scholar 

  4. Lee JH, Machtay M, Unger LD, et al. Prophylactic gastrostomy tubes in patients undergoing intensive irradiation for cancer of the head and neck. Arch Otolaryngol Head Neck Surg. 1998;124:871.

    Article  CAS  PubMed  Google Scholar 

  5. Donaldson SS. Nutritional problems associated with radiotherapy. In: Newell GR, Ellison NM, editors. Nutrition and cancer: etiology and treatment. New York: Raven Press; 1981.

    Google Scholar 

  6. Mitchell EP, Schein PS. Gastrointestinal toxicity of chemotherapeutic agents. Semin Oncol. 1982;9:52–64.

    CAS  PubMed  Google Scholar 

  7. Bozzetti F, Gavazzi C, Miceli R, et al. Perioperative total parenteral nutrition in malnourished, gastrointestinal cancer patients: a randomized, clinical trial. JPEN J Parenter Enteral Nutr. 2000;24:7.

    Article  CAS  PubMed  Google Scholar 

  8. Bozzetti F, Braga M, Gianotti L. Postoperative enteral versus parenteral nutrition in malnourished patients with gastrointestinal cancer: a randomised multicentre trial. Lancet. 2001;358:1487.

    Article  CAS  PubMed  Google Scholar 

  9. Heyland DK, Montalvo M, MacDonald S, et al. Total parenteral nutrition in the surgical patient: a meta-analysis. Can J Surg. 2001;44:102.

    CAS  PubMed  Google Scholar 

  10. Heber D, Byerly LO, Chlebowski RT. Medical abnormalities in the cancer patient. Cancer. 1985;55:225–9.

    Article  CAS  PubMed  Google Scholar 

  11. Lundholm K, Edstrom S, Karlberg I, et al. Glucose turnover, gluconeogenesis from glycerol in estimation of net glucose cycling in cancer patients. Cancer. 1982;50:1142.

    Article  CAS  PubMed  Google Scholar 

  12. Waterhouse C. Lactate metabolism in patients with cancer. Cancer. 1974;33:66–71.

    Article  CAS  PubMed  Google Scholar 

  13. Norton JA, Burt ME, Brennan MF. In vivo utilization of substrate by human sarcoma-bearing limbs. Cancer. 1980;45:2934–9.

    Article  CAS  PubMed  Google Scholar 

  14. Warnold I, Lundholm K, Schersten T. Energy balance and body composition in cancer patients. Cancer Res. 1978;38:1801–7.

    CAS  PubMed  Google Scholar 

  15. Shaw JHF, Humberstone DM, Douglas RG, et al. Leucine kinetics in patients with benign disease, non-weight losing cancer, and cancer cachexia: studies at the whole body and tissue level and the response to nutritional support. Surgery. 1991;109:37–50.

    CAS  PubMed  Google Scholar 

  16. Kralovic RC, Zepp A, Canedella RJ. Studies of the mechanism of carcass fat depletion in experimental cancer. Eur J Cancer. 1977;13:1071–9.

    Article  CAS  PubMed  Google Scholar 

  17. Legaspi A, Jevanandam M, Staves HF, et al. Whole body lipid and energy metabolism in the cancer patient. Metabolism. 1987;36:958–63.

    Article  CAS  PubMed  Google Scholar 

  18. Beck SA, Tisdale MJ. Production of lipolytic and proteolytic factors by a Murine tumor producing cachexia in the host. Cancer Res. 1987;47:S919–23.

    Google Scholar 

  19. Vlassara H, Spiegel RJ, Doval DS, et al. Reduced plasma lipoprotein lipase activity in patients with malignancy-associated weight loss. Horm Metab Res. 1986;18:698–703.

    Article  CAS  PubMed  Google Scholar 

  20. Magne N, Marcy PY, Foa C, et al. Comparison between nasogastric tube feeding and percutaneous fluoroscopic gastrostomy in advanced head and neck cancer patients. Eur Arch Otorhinolaryngol. 2001;258:89.

    Article  CAS  PubMed  Google Scholar 

  21. Mekhail TM, Adelstein DJ, Rybicki LA, et al. Enteral nutrition during the treatment of head and neck carcinoma: is a percutaneous endoscopic gastrostomy tube preferable to a nasogastric tube? Cancer. 2001;91:1785.

    Article  CAS  PubMed  Google Scholar 

  22. Souba WW. Nutritional support. N Engl J Med. 1997;336(1):41–8.

    Article  CAS  PubMed  Google Scholar 

  23. Klein S, Simes J, Blackburn G. Total parenteral nutrition and cancer clinical trials. Cancer. 1986;58:1378–86.

    Article  CAS  PubMed  Google Scholar 

  24. McGeer AJ, Detsky AS, O’Rourke KO. Parenteral nutrition in cancer patients undergoing chemotherapy: a meta-analysis. Nutrition. 1990;6:233–40.

    CAS  PubMed  Google Scholar 

  25. Weisdorf SA, Lysne J, Wind D, et al. Positive effect of prophylactic total parenteral nutrition on long-term outcome of bone marrow transplantation. Transplantation. 1987;43:833–8.

    Article  CAS  PubMed  Google Scholar 

  26. Szeluga DJ, Stuart RK, Brookmeyer R, et al. Nutritional support of bone marrow transplant recipients: a prospective randomized clinical trial comparing total parenteral nutrition to an enteral feeding program. Cancer Res. 1987;47:3309–16.

    CAS  PubMed  Google Scholar 

  27. Roberts S, Miller J, Pineiro L, et al. Total parenteral nutrition vs oral diet in autologous hematopoietic cell transplant recipients. Bone Marrow Transplant. 2003;32:715–21.

    Article  CAS  PubMed  Google Scholar 

  28. Herrmann FR, Safran C, Levkoff SE, et al. Serum albumin level on admission as a predictor of death, length of stay, and readmission. Arch Intern Med. 1992;152:125–30.

    Article  CAS  PubMed  Google Scholar 

  29. Apovian CM, McMahon MM, Bistrian BR. Guidelines for refeeding the marasmic patient. Crit Care Med. 1990;18:1030–3.

    Article  CAS  PubMed  Google Scholar 

  30. Moncada S, Higgs A. The L-arginine-nitric oxide pathway. N Engl J Med. 1993;329:2002–12.

    Article  CAS  PubMed  Google Scholar 

  31. Hall JC, Heel K, McCauley R. Glutamine. Br J Surg. 1996;83:305–12.

    Article  CAS  PubMed  Google Scholar 

  32. Calder PC. More good news about glutamine. Nutrition. 2000;16:71–2.

    Article  CAS  PubMed  Google Scholar 

  33. Aspen Board of Directors. Guidelines for the use of total parenteral nutrition in the hospitalized patient. JPEN J Parenter Enteral Nutr. 1986;10:441–4.

    Article  Google Scholar 

  34. Lowry SF, Brennan MS. Intravenous feeding in the cancer patient. In: Rombeau JL, Caldwell MD, editors. Parenteral nutrition. Philadelphia, PA: WB Saunders; 1986. p. 445–70.

    Google Scholar 

  35. Harrison LE, Brennan MF. The role of total parenteral nutrition in the patient with cancer. Curr Probl Surg. 1995;32(10):833–924.

    Article  CAS  PubMed  Google Scholar 

  36. Rombeau JL, Rolandelli RH, Wilmore DW. Nutritional support. In: Wilmore DW, Brennan MF, Harken AH, et al., editors. American College of Surgeons. Care of the surgical patient. New York: Scientific American; 1994. p. 1–40.

    Google Scholar 

  37. Parker P, Stroop S, Greene H. A controlled comparison of continuous versus intermittent feeding in the treating of infants with intestinal disease. J Pediatr. 1981;99:360–4.

    Article  CAS  PubMed  Google Scholar 

  38. Raynard B, Nitenberg G, Gory-Delabaere G, Bourhis JH, Bachmann P, Bensadoun RJ, Desport JC, Kere D, Schneider S, Senesse P, Bordigoni P, Dieu L. Summary of the standards, options and recommendations for nutritional support in patients undergoing bone marrow transplantation. Br J Cancer. 2003;89:S101–6.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiotherapy, Regional Cancer Centre, JIPMER Department of Radiotherapy, Puducherry, India

    Ashutosh Mukherji

Authors
  1. Ashutosh Mukherji
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Mukherji, A. (2018). Dietary Care and Support During Radiotherapy. In: Basics of Planning and Management of Patients during Radiation Therapy. Springer, Singapore. https://doi.org/10.1007/978-981-10-6659-7_28

Download citation

  • DOI: https://doi.org/10.1007/978-981-10-6659-7_28

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-10-6658-0

  • Online ISBN: 978-981-10-6659-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation