5/27/2023

Nutrition in cancer
patients
Minidian Fasitasari
Department of Nutrition, Medical Faculty of UNISSULA Semarang
Academic year 2022/2023

Kemampuan akhir yang diharapkan

Setelah mengikuti kuliah selama 100 menit, mahasiswa diharapkan

mampu menganalisis Terapi Nutrisi pada Pasien Kanker secara tepat,
dengan indikator penilaian:

Ketepatan dalam menentukan defisiensi nutrisi yang terjadi

pada pasien kanker

Ketepatan dalam menentukan terapi nutrisi yang tepat bagi

pasien kanker

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Outlines

 Introduction
 Inflammation and cancer
 Cancer cachexia
 Recommendations
 Obesity and cancer

Introduction

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Annic et al. Swiss Med Wkly. 2020;150:w20204

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Global Leadership Initiative

on Malnutrition (GLIM)
criteria

Weight loss >5% within past 6

months or >10% beyond 6 months

Low BMI (Asia)

BMI <18,5 for age <70 years
BMI <20 for age >70 years

Lower intake:
<50% >1 week, or any reduction
>2 weeks

MNA

Cutsem & Arends. European Journal of Oncology Nursing (2005) 9, S51–S63

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Inflammation and cancer

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Elinav, et al. Nature Reviews: Cancer, 2013: 13, 759-771

Elinav, et al. Nature Reviews: Cancer, 2013: 13, 759-771

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Elinav, et al. Nature Reviews: Cancer, 2013: 13, 759-771

Cancer cachexia

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Definition

 a multifactorial syndrome
 characterized by ongoing loss of skeletal muscle mass (with or
without loss of fat)
 leading to progressive functional impairment,
 cannot be fully reversed by conventional nutritional support.
 involuntary weight loss of more than 5% over 6 months (or 2% when
evidence of sarcopenia is present).

Del Fabbro, 2015. ASCO educational book

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Cohen 2010. Neoplastic Disease in: Nutrition Therapy & Pathophysiology

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Ravasco. J. Clin. Med. 2019, 8, 1211

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Recommendations

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Routes for administration

• The modification of foods and fluids by fortifying
Oral nutritional food with protein, carbohydrate and/or fat plus
support (ONS) minerals and vitamins (e.g. the provision of snacks
and/or oral supplements)

Enteral tube • The provision of calories, protein, electrolytes,

feeding vitamins, minerals, trace elements, and fluids
(EN) via an intestinal route

Parenteral • The provision of calories, amino acids,

nutrition electrolytes, vitamins, minerals, trace
(PN) elements, and fluids via an intravenous route

Routes of administration in EN

http://www.baxternutritionacademy.com/ie/images/NutriAc-Mod-2.3-Fig1.jpg

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Routes of administration in PN

http://www.baxternutritionacademy.com/ie/images/NutriAc-Mod-2.3-Fig2_big.jpg

http://www.baxternutritionacademy.com/ie/images/NutriAc-Mod-2.3-Fig3_big.jpg

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Cohen 2010. Neoplastic Disease in: Nutrition Therapy & Pathophysiology

Obesity and cancer

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Zitvogel, et al. Nature Immunology, 2017: 18 (8)

Zitvogel, et al. Nature Immunology, 2017: 18 (8)

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