Notes on diet for cancer patients

  Cancer and its various treatments can lead to malnutrition, so adequate nutrition should be given as early as possible. To arrange the diet of cancer patients, the nutritional status should be evaluated firstly, and then the quality and quantity of nutrients, the form of diet and the way of supply should be determined according to the patient’s stage of disease and different treatment measures.  A simple way to evaluate the nutritional status of a patient is to use weight as an indicator. Generally, healthy people usually consume enough protein and calories, so their body weight can remain stable. However, cancer patients’ consumption and poor appetite due to cancer cause the need and calorie intake to be objective indicators of adequacy. Weight standard can be determined by age, gender and height. A more common and convenient method is to compare oneself before and after the disease and before and after treatment. If you lose weight, it means that you are not getting enough and you need to increase your diet.  Cancer patients consume a lot, so they need 20% more protein and calories than normal people. If malnutrition has developed, more protein can be added. The best protein intake is vegetable protein and some animal protein. In addition, attention should be paid to choosing low-fat, low-salt and vitamin- and mineral-rich foods, which are beneficial to the treatment and recovery of cancer patients.  In addition to considering the above nutritional factors, attention should also be paid to making full use of the anti-cancer factors in food when arranging the diet of cancer patients. Some foods can induce cancer while others can fight cancer. Cancer patients should avoid cancer-inducing foods and eat more cancer-fighting foods as much as possible. According to research, common anti-cancer foods include cruciferous vegetables (such as cabbage and cauliflower), radish, garlic, sour plum, soybean, beef, etc.  The diet of cancer patients should not only focus on its content, but also consider their hobbies and eating environment. Eating their favorite food can increase the secretion of gastric juice, which can promote appetite and improve the absorption and utilization of food. In addition, the eating environment can also affect the patient’s appetite, so a pleasant eating environment should be created for the patient.  The diet of cancer patients includes common rice, soft rice, semi-liquid and liquid food, which should be provided according to the patient’s specific condition and digestion and absorption ability. For example, some patients after neck surgery are prone to choking and coughing when eating, which makes them afraid to eat, so they should be given soft rice or soft and dry semi-liquid food. Patients with neck radiation therapy have less saliva, dry and painful throat, and difficulty in swallowing, so the diet should be more watery and cooler.  Common methods of supplemental nutrition in home care include oral, nasal, and fistula tube feeding. Only when the patient has no appetite or cannot eat from the mouth is nasal feeding or fistula tube feeding used.  1.Transoral diet: This is the best way of intake, and any patient who can eat by mouth should be encouraged to do so.  2.Nasal feeding: insert a rubber tube or a sorbent catheter through the nasal cavity in order to instill nutrients. The nasal feeding tube should not be inserted too much, to the lower end of the esophagus pancreatic mouth is appropriate, so as to avoid coiling the catheter in the stomach. Nasal feeding is suitable for coma, extreme anorexia and certain oral surgery patients, generally using high-calorie fluid or mixture of milk, attention should be paid to the speed of feeding, do not instill too much at a time, each time to 300 to 500 ml is appropriate, can be given 4 to 6 times a day. Food temperature should be kept at 37-38℃, too cold and too fast can easily cause reactions.  3.Tube-feeding through gastrointestinal or intestinal fistula: Through the artificial fistula of gastrointestinal tract, use rubber tube or sorbent tube to instill food, and the food can be thicker than that of tube feeder.  Due to the different treatments received by cancer patients, the diet should be appropriate according to the specific treatment method. For example, patients receiving radiotherapy and chemotherapy often have abnormal taste and anorexia, and everything they eat becomes bitter or tastes wrong. The way to deal with: eat more high-protein, high-nutrition food and fresh fruits and vegetables; add seasonings in food; do more color, flavor and shape of food to cause appetite; drink a small glass of acidic beverage before meals can play an appetizing role, give the patient an appropriate amount of zinc and vitamin B complex, can also improve the sense of taste and increase appetite.  There is another method of supplementation, namely total parenteral nutrition, also known as intravenous hyper-nutrition, which is the application of adequate calories and amino acids from intravenous input. The most common clinical indications are as follows: ① intestinal fistula; ② after extensive small bowel resection; ③ chronic long-term small bowel obstruction; ④ chemotherapy stage of cancer patients; ⑤ malnutrition and hypoproteinemia. Because of the high concentration of intravenous hypernutrition fluid, it needs to be fed via a fast-flowing vein. Generally, the subclavian vein is used because this vein is in a more fixed position. When applying intravenous hypernutrition, attention should be paid to the preparation of nutrition solution, intubation technique, and infusion speed.