
DOI: 10.1055/s-0040-1718992
Intervenções nutricionais na prevenção e tratamento de pacientes oncológicos em nível ambulatorial
Nutritional Interventions in the Prevention and Treatment of Oncological Outpatients
Resumo
A desnutrição em portadores de câncer (PCs) é frequente, particularmente, em PCs de cabeça e pescoço, e do trato digestivo, dada a localização dos tumores, que podem impedir a ingestão e a absorção dos nutrientes. Dada a gravidade da desnutrição associada ao câncer, exigem-se medidas de adequação da ingestão alimentar, principalmente em relação ao consumo de energia por esses pacientes. As intervenções nutricionais (INs) devem ser iniciadas sempre que for diagnosticado risco nutricional atual ou esperado, quando os pacientes devem ser encaminhados a nutrólogos/nutricionistas especializados em PCs. As principais abordagens da IN são o aconselhamento nutricional, a prescrição de suplementos nutricionais orais, e a nutrição enteral, a serem determinados e selecionados por meio de triagem e avaliação nutricional. Diferentes diretrizes nutricionais orientam os profissionais na condução do apoio nutricional. O objetivo do presente estudo foi a realização de uma revisão narrativa da literatura referente ao papel da nutrição e os principais meios de intervenção nutricional, que contribuem para a prevenção e o tratamento de PCs em âmbito ambulatorial, por meio de pesquisa literária nos idiomas português e inglês usando recursos eletrônicos. Concluiu-se que as intervenções nutricionais são imperativas em casos de desnutrição associada ao câncer, mas que ainda são necessárias novas pesquisas para determinar o papel real dos alimentos na prevenção do câncer.
Abstract
Malnutrition in cancer patients (CPs) is frequent, particularly in cases of head and neck cancer, and cancer of the digestive tract, due the location of the tumors, which may prevent nutrient intake and absorption. Given the severity of cancer-related malnutrition, adequate food intake measures are required, especially in relation to the energy consumed by these patients. Nutritional interventions (NIs) should be initiated whenever current or expected nutritional risk is diagnosed, when patients should be referred to specialized CP nutritionists. The main approaches of the NIs are nutritional counseling, prescription of oral nutritional supplements, and enteral nutrition, to be determined and selected through nutritional screening and assessment. Different nutritional guidelines help professionals in the provision of nutritional support. The aim of the present study was to conduct a narrative literature review regarding the role of nutrition and the main means of nutritional intervention, which contribute to the prevention and treatment of cancer outpatients through a literary research in Portuguese and English using electronic resources. We concluded that nutritional interventions are imperative in cases of cancer-associated malnutrition, but further research is needed to determine the true role of food in the prevention of cancer.
Publication History
Received: 14 August 2020
Accepted: 25 August 2020
Publication Date:
08 December 2020 (online)
© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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Referências
- 1 Kimokoti RW, Millen BE. Nutrition for the Prevention of Chronic Diseases. Med Clin North Am 2016; 100 (06) 1185-1198 https://hugepdf.com/downloadFile/download-medical-clinics-of-north-america_pdf access2019oct.29 [Internet]
- 2 Arends J, Bachmann P, Baracos V. et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr 2017; 36 (01) 11-48 https://www.clinicalnutritionjournal.com/article/S0261-5614(16)30181-9/pdf access2019oct.29 [Internet]
- 3 Caccialanza R, Pedrazzoli P, Cereda E. et al. Nutritional Support in Cancer Patients: A Position Paper from the Italian Society of Medical Oncology (AIOM) and the Italian Society of Artificial Nutrition and Metabolism (SINPE). J Cancer 2016; 7 (02) 131-135 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4716844/pdf/jcav07p0131.pdf access2019oct.29 10.7150/jca.13818 [Internet]
- 4 Lee JLC, Leong LP, Lim SL. Nutrition intervention approaches to reduce malnutrition in oncology patients: a systematic review. Support Care Cancer 2016; 24 (01) 469-480 http://eprints.qut.edu.au/88929/3/88929.pdf access2019oct.29 [Internet]
- 5 Campbell TC. Cancer Prevention and Treatment by Wholistic Nutrition. J Nat Sci 2017; 3 (10) e448 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5646698/pdf/nihms906795.pdf access2019oct.29 [Internet]
- 6 Wiseman MJ. Nutrition and cancer: prevention and survival. Br J Nutr 2019; 122 (05) 481-487 https://www.cambridge.org/core/services/aop-cambridge-core/content/view/9CB9679E3837FF0A2F0CBA4E3C56B6D6/S0007114518002222a.pdf/div-class-title-nutrition-and-cancer-prevention-and-survival-div.pdf access2019oct.29 [Internet]
- 7 Torres TA. Estado nutricional e consumo alimentar de pacientes em tratamento de Câncer [monografia]. Brasília: UniCEUB, Faculdade de Ciências da Educação e Saúde, Curso de Nutrição; 2019 [acesso em: 2019 out. 29]. 30 p. Disponível em: https://repositorio.uniceub.br/jspui/bitstream/prefix/13489/1/21604887.pdf
- 8 Bindels LB, Thissen JP. Nutrition in cancer patients with cachexia: A role for the gut microbiota?. Clin. Nutr. Exp. [Internet]. 2016 [access 2019 oct. 29]; 6:74-82. Available from: https://www.sciencedirect.com/science/article/pii/S2352939315000196
- 9 Fearon K, Strasser F, Anker SD. et al. Definition and classification of cancer cachexia: an international consensus. Lancet Oncol 2011; 12 (05) 489-495 https://s3.amazonaws.com/academia.edu.documents/40380119/Definition_and_classification_of_cancer_20151125-23934-1f6k0i3.pdf?response-content-disposition=inline%3B%20filename%3DDefinition_and_classification_of_cancer.pdf&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Credential=AKIAIWOWYYGZ2Y53UL3A%2F20191116%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20191116T150436Z&X-Amz-Expires=3600&X-Amz-SignedHeaders=host&X-Amz-Signature=7624c2ecc7125ca7caa85e1b7a0b379585d1331966d5bed80f16e65c520857b0 access2019nov.03 [Internet]
- 10 da Silva HP, Zamberlan C, Birk N, Ilha S. Fatores que influenciam na alteração do estado nutricional de pacientes oncológicos. Disciplinarum Scientia [Internet]. 2018 [acesso em: 2019 out. 29]; 19(2):267-79. Disponível em:
- 11 Heber D, Li Z. Nutrition intervention in cancer. Med Clin North Am 2016; 100 (06) 1329-1340 https://hugepdf.com/downloadFile/download-medical-clinics-of-north-america_pdf access2019oct.29 [Internet]
- 12 Coa KI, Epstein JB, Ettinger D. et al. The impact of cancer treatment on the diets and food preferences of patients receiving outpatient treatment. Nutr Cancer 2015; 67 (02) 339-353 https://www.tandfonline.com/doi/pdf/10.1080/01635581.2015.990577?needAccess=true access2019oct.29 [Internet]
- 13 Thompson KL, Elliott L, Fuchs-Tarlovsky V, Levin RM, Voss AC, Piemonte T. Oncology Evidence-Based Nutrition Practice Guideline for Adults. J Acad Nutr Diet 2017; 117 (02) 297-310.e47 https://www.smeo.org.mx/descargables/Oncology-Feb-2017-c.pdf access2019oct.29 [Internet]
- 14 Santos CAD, Ribeiro AQ, Rosa CDOB. Ribeiro RDCLDepressão, déficit cognitivo e fatores associados à desnutrição em idosos com câncer. Ciênc. Saúde Colet. [Internet]. 2015 [acesso em: 2019 out. 29]; 20:751-60. Disponível em: https://www.scielosp.org/pdf/csc/2015.v20n3/751-760/pt
- 15 Buyken AE, Mela DJ, Dussort P. et al. Dietary carbohydrates: a review of international recommendations and the methods used to derive them. Eur J Clin Nutr 2018; 72 (12) 1625-1643 https://www.nature.com/articles/s41430-017-0035-4.pdf access2019oct.29 [Internet]
- 16 World Health Organization. Dietary recommendations / Nutritional requirements. WHO/FAO [Internet]. 2019 [access 2019 oct. 29]. Available from: https://www.who.int/nutrition/topics/nutrecomm/en/
- 17 Gurgel DC, Capistrano Junior VLM, Nogueira IC, Pacheco Neto P. Atividade física e câncer: intervenções nutricionais para um melhor prognóstico. Motri. [Internet]. 2018 [citado 2019 Nov 02]; 14(1):398-404. Disponível em: http://www.scielo.mec.pt/scielo.php?script=sci_arttext&pid=S1646-107×22018000100062&lng=pt