Physical Activity in Cancer Patients

Presnovne spremembe pri kaheksiji povzročajo pospešeno izgubo funkcionalnih tkiv v telesu, predvsem so prizadete mišice. Nezadostna telesna aktivnost in podhranjenost telesno propadanje še pospešujeta. Učinki vadbe pri bolnikih z rakom tako kot pri drugih kroničnih bolnikih neposredno zmanjšujejo negativen vpliv bolezni na telo. Z redno telesno vadbo v aerobnem območju se povečujejo funkcionalne sposobnosti obtočil, srca, mišic in presnovnih procesov, ki vodijo do večje vzdržljivosti telesa. Z vajami za moč pa se vzdržuje zmogljivost mišic in zavira njihovo propadanje.Telesna vadba naj bo redna, 3- do 5-krat na teden. Če je bolnik močno presnovno iztirjen in ima hudo prizadet imunski sistem, telesne vadbe ne priporočamo.Cachexia-induced metabolic changes stimulate an enhanced loss of functional tissue in human body, particularly muscles. Inadequate physical activity and undernourishment further increase the loss of tissue. In cancer patients as well as in chronic patients, physical activity inhibits straightforwardly the negative effect of the disease on the body organs. Regular aerobic exercise enhances functional capacity of blood circulation, heart, muscles and metabolic processes, which help to sustain better physical condition. The strength training exercises help to maintain the muscles in good condition, thereby inhibiting their weakening. Physical exercises should be regularly performed, at least 3 to 5 times per week. A patient with derailed metabolism or severely impaired immune system is not advised to perform exercises

[Nutritional support for a cancer patient]

Bolniki z rakom požiralnika in želodca zelo pogosto izgubljajo telesno maso, kar vodi v podhranjenost ter pospešuje razvoj kaheksije. Hujšanje in razvoj podhranjenosti pospešujeta razvoj kaheksije, znižujeta funkcionalno stanje bolnikov ter njihovo kakovost življenja. Funkcionalno stanje in kakovost življenja bolnikov sta slabša. Slabši je odziv tumorja na zdravljenje, to spremlja več neželenih sopojavov in slabše preživetje. Vzroki za hujšanje in razvoj podhranjenosti so pri bolnikih s tumorji zgornjih prebavil številni ter se pogosto pojavijo že ob začetku bolezni. Zato naj diagnostika kaheksije in prehranska obravnava bolnika potekata vzporedno z zdravljenjem rakaste bolezni. Izvajata se na enak način kot vsaka druga medicinska terapija. Prehransko intervencijo, kot osnovni ukrep preprečevanja podhranjenosti in razvoja kaheksije, je treba pričeti dovolj zgodaj, da preprečimo in/ali zmanjšamo nadaljnjo izgubo telesne celične mase. Energetske potrebe bolnikov z rakom so primerljive z energetskimi potrebami bolnikov, ki nimajo raka. Potrebe po beljakovinah so 1,2 do 2,0 g/kg telesne teže/dan. Pri bolnikih s kaheksijo lahko uporabimo modulacijo presnove z omega-3 maščobnimi kislinami.Oesophageal cancer patients very frequently lose their body weight, which leads to malnutrition and accelerates the development of cachexia. Weight loss and development of malnutrition accelerate the development of cachexia and deteriorate the functional state of patients and their quality of life. Functional state and quality of life of patients thus become worse. This also results in poorer tumour response to treatment, which is accompanied by adverse events and decreased survival. There are numerous causes of weight loss and development of malnutrition in patients with gastrointestinal tumours, which often develop already at the onset of the disease. Therefore, the diagnosis of cachexia and nutritional management of the patient should be undertaken at the same time as treatment of the cancerous disease. They are performed in the same manner as any other medical therapy. Nutritional intervention, as the basic measure for preventing malnutrition and development of cachexia, must be started early enough to prevent and/or minimise further loss of body cell mass. The energy needs of cancer patients are comparable to those of patients who do not have cancer. Protein requirements are 1.2-2.0 g/kg of body weight/day. In patients with cachexia, we can use modulation of metabolism by omega-3 fatty acids

Vloga prehranske obravnave pri zdravljenju bolnikov z rakom glave in vratu

Prehranska ogroženost bolnikov z raki glave in vratu je zelo velika in pomeni resno oviro za optimalno zdravljenje teh bolnikov. Klinično stanje bolnikov pogosto opišemo kot sindromom glave in vratu. Ker je izguba telesne mase > 10 % značilno povezana s slabšim preživetjem bolnikov z rakom, sta prehranska podpora in terapija motenj prehranskega stanja integralni del zdravljenja bolnikov z rakom glave in vratu. V prispevku so prikazani rezultati pregleda literature, na osnovi katerih lahko sledimo strokovnim priporočilom klinične prehrane, ki jih individualno prilagajamo bolnikom in načinom zdravljenja. Prehranska obravnava bolnikov z rakom glave in vratu je paralelna terapevtska pot, ki je integrirana v proces zdravljenja rakave bolezni. Upoštevanje strokovnih priporočil klinične prehrane izboljša kakovost življenja bolnikov in učinkovitost zdravljenja rakov glave in vratu

Prehranska podpora bolnika z rakom

Oesophageal cancer patients very frequently lose their body weight, which leads to malnutrition and accelerates the development of cachexia. Weight loss and development of malnutrition accelerate the development of cachexia and deteriorate the functional state of patients and their quality of life. Functional state and quality of life of patients thus become worse. This also results in poorer tumour response to treatment, which is accompanied by adverse events and decreased survival. There are numerous causes of weight loss and development of malnutrition in patients with gastrointestinal tumours, which often develop already at the onset of the disease. Therefore, the diagnosis of cachexia and nutritional management of the patient should be undertaken at the same time as treatment of the cancerous disease. They are performed in the same manner as any other medical therapy. Nutritional intervention, as the basic measure for preventing malnutrition and development of cachexia, must be started early enough to prevent and/or minimise further loss of body cell mass. The energy needs of cancer patients are comparable to those of patients who do not have cancer. Protein requirements are 1.2-2.0 g/kg of body weight/day. In patients with cachexia, we can use modulation of metabolism by omega-3 fatty acids.Bolniki z rakom požiralnika in želodca zelo pogosto izgubljajo telesno maso, kar vodi v podhranjenost ter pospešuje razvoj kaheksije. Hujšanje in razvoj podhranjenosti pospešujeta razvoj kaheksije, znižujeta funkcionalno stanje bolnikov ter njihovo kakovost življenja. Funkcionalno stanje in kakovost življenja bolnikov sta slabša. Slabši je odziv tumorja na zdravljenje, to spremlja več neželenih sopojavov in slabše preživetje. Vzroki za hujšanje in razvoj podhranjenosti so pri bolnikih s tumorji zgornjih prebavil številni ter se pogosto pojavijo že ob začetku bolezni. Zato naj diagnostika kaheksije in prehranska obravnava bolnika potekata vzporedno z zdravljenjem rakaste bolezni. Izvajata se na enak način kot vsaka druga medicinska terapija. Prehransko intervencijo, kot osnovni ukrep preprečevanja podhranjenosti in razvoja kaheksije, je treba pričeti dovolj zgodaj, da preprečimo in/ali zmanjšamo nadaljnjo izgubo telesne celične mase. Energetske potrebe bolnikov z rakom so primerljive z energetskimi potrebami bolnikov, ki nimajo raka. Potrebe po beljakovinah so 1,2 do 2,0 g/kg telesne teže/dan. Pri bolnikih s kaheksijo lahko uporabimo modulacijo presnove z omega-3 maščobnimi kislinami